Buprenorphine

Key facts

• The most common side effects of buprenorphine are constipation, feeling sick and sleepy.
• It is possible to become addicted to buprenorphine, but your doctor will explain how to reduce the risks.
• Your treatment plan may include details of how and when to stop taking buprenorphine.
• It’s best not to drink alcohol when you first start taking (or using) buprenorphine. You’re more likely to get side effects such as feeling sleepy or drowsy.
• Tell a doctor or nurse about your buprenorphine patch if you’re having any treatment or tests. Also, remind your pharmacist about your patch when you collect prescriptions or buy other medicines.

Who can and cannot have buprenorphine

Buprenorphine can be used by most adults and sometimes children if a specialist doctor recommends it.
Buprenorphine patches are usually only recommended if you’ve been taking other strong opioid painkillers.
Your doctor will work out how much buprenorphine to give you, depending on what dose of other opioids you have had.
Buprenorphine is not suitable for some people. Tell your doctor before starting it if you:

• have ever had an allergic reaction to buprenorphine or any other medicines
• have breathing difficulties such as asthma or a lung condition
• are a heavy drinker, or addicted to alcohol or other drugs
• have a head injury or condition that causes fits or seizures
• have irregular heartbeats (arrhythmia)
• have kidney or liver problems
• have low blood pressure
• have myasthenia gravis (a condition where muscles become weak)
• are trying to get pregnant, are pregnant or breastfeeding

How and when to use it

Follow your doctor’s instructions about how to use this medicine. This is particularly important because buprenorphine can be addictive.
For end of life care, your doctor will monitor how well buprenorphine is working to control your pain. Speak to them if you’re worried about addiction.
Doses vary from person to person. Your dose will depend on:

• how bad your pain is
• how you’ve responded to other painkillers
• if you get any side effects from buprenorphine

Buprenorphine tablets and injections are fast-acting. They’re used for pain that is expected to last for a short time.
Buprenorphine patches are slow-release. This means buprenorphine is gradually released through the skin into your body.

Strength of buprenorphine

Buprenorphine comes in different strengths, depending on the type:

• patches – these release 5 micrograms, 10 micrograms, 15 micrograms or 20 micrograms every hour for 7 days, or 35 micrograms, 52.5 micrograms or 70 micrograms every hour for 3 or 4 days
• tablets – 200 micrograms or 400 micrograms

How often to take or use buprenorphine

How often you take or use buprenorphine depends on the type that you’ve been prescribed:

• patches – apply a new patch every 3, 4 or 7 days, depending on the strength and the brand you’ve been prescribed
• tablets – taken when you need them for pain relief – each dose will usually last 6 to 8 hours. Talk to your doctor if this is not controlling your pain

Some patches keep working after they have been removed, as they “store” buprenorphine under the skin. Buprenorphine patches take longer to start working, but last longer. They’re used when pain lasts for a long time.
Sometimes your doctor may prescribe a buprenorphine patch, with another fast-acting painkiller. This is to manage sudden flare-ups of pain that “break through” the relief the patches give.

Overdose warning

Do not apply more than 1 patch at a time, unless your doctor tells you to.
Using more patches than recommended could lead to a fatal overdose.