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  • buprenorphine (transdermal)
 

buprenorphine (transdermal)

Pronunciation: BUE pre NOR feen

Brand: Butrans

What is the most important information I should know about this drug?

Multum donot

You should not use buprenorphine if you are allergic to it, or if you have a severe breathing disorder such as asthma, or a bowel obstruction called paralytic ileus.

Never wear more than 1 buprenorphine skin patch at a time unless your doctor has told you to.

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Do not expose the skin patch to heat while you are wearing it. Heat can increase the amount of drug you absorb through your skin and may cause harmful effects.

Call your doctor at once if you have weak or shallow breathing, snoring that is new or unusual, slow heart rate, confusion, severe dizziness, seizure, or feeling like you might pass out.

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Avoid letting another person handle your buprenorphine skin patches. Keep both used and unused patches out of the reach of children or pets. The amount of buprenorphine in a used skin patch could be fatal to a child or pet who accidentally sucks or chews on it. Seek emergency medical attention if this happens.

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Do not stop using buprenorphine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using buprenorphine.

What is this drug?

Buprenorphine is an opioid pain medication. An opioid is sometimes called a narcotic.

Buprenorphine transdermal (skin patch) is used to treat moderate to severe chronic pain when treatment is needed around the clock.

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Buprenorphine is not for treating pain just after surgery, or for treating occasional short-term pain.

Buprenorphine transdermal may also be used for purposes not listed in this medication guide.

What should I discuss with my health care provider before using this drug?

Multum donot

You should not use buprenorphine if you are allergic to it, or if you have:

  • asthma or severe breathing disorder; or
  • a bowel obstruction called paralytic ileus.
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Do not use buprenorphine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use buprenorphine before the MAO inhibitor has cleared from your body.

To make sure you can safely use buprenorphine, tell your doctor if you have any of these other conditions:

  • COPD (chronic obstructive pulmonary disease), sleep apnea, or other breathing disorders;
  • a personal or family history of Long QT syndrome:
  • hepatitis B or C;
  • liver or kidney disease;
  • a thyroid disorder;
  • gallbladder disease;
  • curvature of the spine;
  • a history of head injury or brain tumor;
  • epilepsy or other seizure disorder;
  • Addison's disease or other adrenal gland disorders;
  • enlarged prostate, urination problems;
  • depression or other mental illness; or
  • a history of drug or alcohol addiction.
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Buprenorphine may be habit-forming and should be used only by the person it was prescribed for. Never share buprenorphine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

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FDA pregnancy category C. It is not known whether buprenorphine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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Buprenorphine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using buprenorphine.

Your dose needs may be different if you have recently used an opioid pain medicine and your body is tolerant to it. Opioids include Tylenol #3, Lortab, Vicodin, Exalgo, OxyContin, Percocet, Actiq, Duragesic, Methadose, Dolophine, Kadian, MS Contin, Oramorph, Opana, and many others. Talk with your doctor if you are not sure you are opioid-tolerant.

How should I use this drug?

Use exactly as prescribed. Never use buprenorphine in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

If you are switching to buprenorphine transdermal from another narcotic pain medicine, you may need to slowly stop using the other medicine. Follow your doctor's instructions.

Apply the skin patch only to clean, dry skin. Use only clear water to wash the skin before you apply a skin patch. Soaps or other chemicals could increase the amount of buprenorphine your skin absorbs.

Apply the patch to a flat and hairless area of the chest, back, side, or outer side of your upper arm. Wear the patch around the clock for 7 days. Never wear more than 1 buprenorphine skin patch at a time unless your doctor has told you to.

Do not use a buprenorphine transdermal skin patch if it has been cut or damaged.

After removing a skin patch fold it in half, sticky side in, and flush the patch down the toilet or use the Patch-Disposal Unit provided with this medication. Apply a new patch to a different skin area on the chest, back, side, or upper arm. Do not use the same skin area twice in a row.

Multum donot

Never share this medication with another person, even if they have the same symptoms you have.

Multum donot

Ask your doctor how to avoid withdrawal symptoms when you stop using buprenorphine.

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Keep both used and unused buprenorphine skin patches out of the reach of children or pets. The amount of buprenorphine in a used skin patch could be fatal to a child or pet who accidentally sucks or chews on the patch. Seek emergency medical attention if this happens.

Keep track of how many skin patches have been used from each new package of this medication. Buprenorphine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

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Store at room temperature. Keep each patch in its foil pouch until you are ready to use it.

What happens if I miss a dose?

If you forget to change a patch on your scheduled day, remove the patch and apply a new one as soon as you remember. Do not wear extra patches to make up a missed dose.

What happens if I overdose?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. The amount of buprenorphine in a used or unused skin patch can be fatal to a child who accidentally sucks or chews on the patch.

Overdose symptoms may include extreme drowsiness, weak or limp feeling, weak pulse, cold and clammy skin, fainting, shallow breathing, snoring, or breathing that stops.

What should I avoid while using this drug?

Multum noalcohol

Do not drink alcohol or you may have serious, life-threatening side effects.

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This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how buprenorphine will affect you.

Multum nosun

Do not expose the skin patch to heat while you are wearing it. This includes a hot tub, heating pad, electric blanket, sauna, heated water bed, or a hot bath. Avoid exposure to sunlight or tanning beds. Heat can increase the amount of drug you absorb through your skin and may cause harmful effects.

Multum emt

Avoid letting another person handle your buprenorphine skin patches. If the sticky side of a skin patch comes into contact with another person, wash the skin with clear water and seek medical care at once.

What are the possible side effects of this drug?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

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Stop using buprenorphine and call your doctor at once if you have a serious side effect such as:

  • slow heart rate, weak or shallow breathing, deep sighs, snoring that is new or unusual;
  • confusion, severe dizziness, feeling like you might pass out;
  • blisters, swelling, or severe irritation where the patch was worn;
  • seizure (convulsions); or
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • headache;
  • vomiting, dry mouth, upset stomach, constipation;
  • mild dizziness or drowsiness; or
  • redness, itching, or mild skin rash where the patch was worn.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect this drug?

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Tell your doctor if you regularly use other medicines that can make you sleepy or slow your breathing (such as cold or allergy medicine, sedatives, anti-nausea medicine, other narcotic pain medicines, sleeping pills, muscle relaxers, heart rhythm medications, and medicine for seizures, depression, or anxiety). They can add to the side effects of buprenorphine and dangerous side effects may result.

  • dexamethasone (Decadron, Hexadrol);
  • St. John's wort;
  • rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), or rifapentine (Priftin);
  • phenobarbital (Solfoton) or other barbiturates;
  • diazepam (Valium) or similar medicines such as alprazolam (Xanax), lorazepam (Ativan), clorazepate (Tranxene), and others;
  • a heart rhythm medication such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), flecaininde (Tambocor), procainamide (Pronestyl), propafenone, (Rythmol), quinidine (Quin-G), sotalol (Betapace), and others;
  • HIV medication such as efavirenz (Sustiva), etravirine (Intelence), nevirapine (Viramune), or ritonavir (Kaletra, Norvir); or
  • seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline).

This list is not complete and other drugs may interact with buprenorphine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about buprenorphine.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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