Buprenorphine for pain relief

About buprenorphine

What is buprenorphine used for?

Buprenorphine is a strong opioid painkiller that is used to treat severe pain. It works on your nervous system and brain to reduce the amount of pain you feel.

It is also used in the treatment of some drug addictions. When it is used for this purpose, different brands of buprenorphine tablets are used.

What is buprenorphine available as?

Buprenorphine is available as:

• Injection.

• Tablets.

• Skin patches.

Tablet and injection forms of buprenorphine are used to ease short-term (acute) pain, such as the type of pain you get after an operation.

Skin patches are used for long-term (chronic) pain. The patches release buprenorphine slowly and evenly over several days.

Side effects of buprenorphine

Common side effects of buprenorphine include:

• Feeling dizzy.

• Feeling sleepy or drowsy.

• Blurred vision.

• Feeling sick.

• Being sick (vomiting).

• Headache.

• Constipation.

• Itchy rash where the patch has been.

You will find a full list in the manufacturer's information leaflet supplied with your medicine.

The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any side effects continue or become troublesome.

How to manage buprenorphine side effects

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

Who should not take buprenorphine?

Some medicines are not suitable for people with certain conditions. Before taking buprenorphine it is important that your doctor knows:

• If you are pregnant, trying for a baby, or breastfeeding.

• If you have liver or kidney problems.

• If you have prostate problems or any difficulties passing urine.

• If you have any breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD).

• If you have been told you have low blood pressure (hypotension).

• If you have any problems with your thyroid or adrenal glands.

• If you have epilepsy.

• If you have a problem with your bile duct.

• If you have been constipated for more than a week or have an inflammatory bowel problem.

• If you have a condition causing muscle weakness, called myasthenia gravis.

• If you have recently had a severe head injury.

• If you have ever been dependent on drugs or alcohol.

• If you have ever had an allergic reaction to a medicine.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

  • It is particularly important that you let your doctor know if you are taking any other strong painkillers or over-the-counter painkillers containing codeine (for example, co-codamol).

How to take buprenorphine tablets

• Read the patient information leaflet that comes with your medicine. It explains how the tablets work and lists possible side effects.

• Take buprenorphine exactly as prescribed. Your doctor or pharmacist will tell you how many tablets to take and when. The dose will also be shown on the label.

  • Most people are prescribed 200-400 micrograms every 6-8 hours, depending on pain.

• Place the tablet under your tongue and let it dissolve fully. This may take a few minutes. Do not chew it or swallow it whole.

• You can take buprenorphine with or without food.

• If you forget a dose, take it as soon as you remember, then continue as normal. Do not take two doses at the same time.

How to use buprenorphine patches

• Read the patient information leaflet in the pack. It explains how to use your patch and lists possible side effects.

• Check how often to change your patch. Different brands are changed at different times. Follow the instructions on the label or leaflet, or ask a pharmacist if you’re unsure.

• Apply the patch to clean, dry, non-hairy skin on your upper body, such as your chest, upper back, or outer arm. Avoid irritated skin.

• Change patches as directed:

  • Seven-day patches (for example, BuTrans®): change once a week on the same day. Use a different area of skin each time and avoid reusing the same spot for 3 weeks.

  • Twice-weekly patches (for example, Transtec®): change every 3–4 days on the same days each week. Avoid using the same area for at least 6 days.

  • Three-day patches (for example, Hapoctasin®): change every 3 days and rotate skin sites, avoiding the same area for at least 6 days.

• Heat can increase the dose absorbed. Fever, electric blankets, hot water bottles, or very hot baths or showers can cause more medicine to enter your body. Tell your doctor if you develop a fever or feel unusually sleepy or dizzy.

• Do not use more patches than prescribed. Always remove the old patch before applying a new one. Signs of overdose include very small pupils, slow or difficult breathing, and extreme drowsiness. Get urgent medical help if this happens.

• Skin irritation: If a rash develops, do not use that area again until it has healed. Speak to your doctor if the rash is severe.

• Bathing and swimming are allowed, but avoid overheating. If a patch falls off, do not re-attach it — apply a new one instead.

• Dispose of used patches safely. Fold the patch in half with the sticky sides together and throw it away as instructed to prevent accidental contact.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

• Ask your doctor about alcohol. You may be advised not to drink alcohol, as it can increase side effects such as dizziness and drowsiness.

• Check your prescription each time. Buprenorphine comes in different brands and strengths. Make sure you receive the one you expect. Ask a pharmacist if you’re unsure.

• Driving may be affected. Buprenorphine can slow your reactions. It is illegal to drive if you are impaired. If you do drive, carry proof that the medicine has been prescribed for you.

• If you are travelling abroad take a letter from your doctor explaining your prescription. Buprenorphine is a controlled drug and subject to legal restrictions in some countries.

• Tell healthcare professionals you are taking buprenorphine before any surgery or dental treatment.

• Check other medicines first. Some medicines can increase side effects when taken with buprenorphine. Ask a pharmacist before taking anything new.

• Use for the shortest time needed. Long-term use can lead to dependence and withdrawal symptoms when stopped. Speak to your doctor or pharmacist if you are concerned.

How to store buprenorphine

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Frequently asked questions

How long does it take for buprenorphine to work?

Buprenorphine usually starts to work within 30 to 60 minutes. Sublingual tablets work as they dissolve under the tongue, while patches release the medicine slowly over several hours to days.

Is buprenorphine addictive?

Yes, buprenorphine can be addictive, but it has a lower risk than many other opioids. It can cause physical dependence with long-term use, although it is designed to be safer and less likely to cause misuse when taken as prescribed.

What are the withdrawal symptoms from buprenorphine?

Stopping buprenorphine suddenly can cause withdrawal symptoms such as anxiety, restlessness, sweating, muscle aches, nausea, diarrhoea, and sleep problems.

How long does buprenorphine stay in your system?

Buprenorphine can stay in your system for up to 7-10 days. It can be detected in your pee (urine) for up to a week, though this can vary depending on dose, length of use, and individual metabolism.

Is it safe to take buprenorphine during pregnancy?

Buprenorphine may be occasionally used during pregnancy. However, long-term use can cause the baby to develop dependence and experience withdrawal symptoms after birth.

Always let your doctor or midwife know if you are pregnant or planning a pregnancy before taking buprenorphine.