Buprenorphine
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
NO
Pharmaceutical Class
Partial Opioid Agonist
Controlled Drug Substance
YES
Buprenorphine
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Click HereSummary
Buprenorphine is used to treat opioid dependence and moderate to severe pain, especially when other painkillers are not effective.
Buprenorphine is a partial opioid agonist. It activates opioid receptors but to a lesser extent than full opioids like morphine. This helps reduce cravings and withdrawal symptoms without causing the same level of euphoria.
For opioid dependence, the starting dose is 2-4 mg which may be increased up to 16 mg per day. For pain relief, it is used in lower doses, often in patch form 5-20 mcg per hour or injections 0.3-0.6 mg every 6-8 hours. It's available as tablets, films, injections, and patches.
Common side effects include nausea, headache, constipation, dizziness, sweating, and drowsiness. Serious risks include breathing problems, allergic reactions, liver issues, and dependence if misused.
People with severe liver disease, breathing problems or a history of opioid allergies should avoid it. It is also not recommended for those with severe head injuries or untreated mental illness. Pregnant or breastfeeding women should consult a doctor before use.
Indications and Purpose
What is Buprenorphine used for?
Buprenorphine is mainly used for opioid addiction treatment, helping people reduce dependence on stronger opioids like heroin or fentanyl. It is also used for moderate to severe pain relief, especially in cases where other painkillers are not effective. It provides long-lasting relief with fewer side effects than traditional opioids.
How does Buprenorphine work?
Buprenorphine partially activates opioid receptors, reducing pain and withdrawal symptoms while limiting euphoria. This makes it less addictive than full opioids. It has a "ceiling effect," meaning higher doses do not increase effects, lowering overdose risk.
Is Buprenorphine effective?
Yes, Buprenorphine is highly effective in treating opioid addiction and pain. It helps prevent withdrawal symptoms and cravings in opioid-dependent patients and provides long-term pain relief. It has a lower risk of overdose compared to full opioids, making it a safer alternative.
How does one know if Buprenorphine is working?
For opioid dependence, reduced cravings and withdrawal symptoms indicate effectiveness. For pain relief, a decrease in pain intensity shows it is working. If symptoms persist, your doctor may adjust the dose for better results.
Directions for Use
What is the usual dose of Buprenorphine?
For opioid dependence, the starting dose is 2–4 mg, which may be increased up to 16 mg per day based on the patient's needs. For pain relief, it is used in lower doses, often in patch form (5–20 mcg per hour) or injections (0.3–0.6 mg every 6–8 hours). A doctor should determine the exact dose.
How do I take Buprenorphine?
Buprenorphine is available as sublingual tablets or films, which must be placed under the tongue to dissolve. It is also available as a patch for long-term pain relief or an injection for hospital use. Do not chew or swallow sublingual tablets, as they will not work properly. Always follow your doctor’s instructions.
For how long do I take Buprenorphine?
The duration depends on the condition being treated. For opioid dependence, treatment can last weeks to months or longer, depending on individual progress. For pain management, it is used for as long as necessary under medical supervision. Your doctor will decide when and how to stop safely.
How long does it take for Buprenorphine to start working?
When taken sublingually, Buprenorphine starts working within 30 to 60 minutes, reaching peak effect in 1 to 4 hours. When used as a patch, it may take 12 to 24 hours to provide noticeable pain relief. Injections work within minutes and are used for immediate pain control.
How should I store Buprenorphine?
Store at room temperature (20–25°C) in a dry place, away from moisture and sunlight. Keep it out of reach of children and dispose of unused medication properly to prevent misuse.
Warnings and Precautions
Who should avoid taking Buprenorphine?
People with severe liver disease, breathing problems, or a history of opioid allergies should avoid it. It is also not recommended for those with severe head injuries or untreated mental illness. Pregnant or breastfeeding women should consult a doctor before use.
Can I take Buprenorphine with other prescription drugs?
Buprenorphine interacts with benzodiazepines (e.g., diazepam), alcohol, antidepressants, and sedatives, increasing the risk of drowsiness and breathing problems. Always check with your doctor before mixing medications.
Can I take Buprenorphine with vitamins or supplements?
Most vitamins are safe, but supplements like St. John’s Wort can affect how Buprenorphine works. Always inform your doctor about any supplements you take to avoid interactions.
Can Buprenorphine be taken safely while pregnant?
Buprenorphine can be used during pregnancy if prescribed by a doctor, as it is safer than full opioids. However, it may cause mild withdrawal symptoms in newborns. Always discuss risks with your doctor.
Can Buprenorphine be taken safely while breastfeeding?
Buprenorphine passes into breast milk in small amounts, but it is generally considered safe under medical supervision. Monitor the baby for sleepiness or feeding problems and consult your doctor if any issues arise.
Is Buprenorphine safe for the elderly?
Yes, but elderly patients may be more sensitive to its effects, especially dizziness, confusion, and breathing problems. Lower doses are usually recommended, with close monitoring.
Is it safe to exercise while taking Buprenorphine?
Light exercise is safe, but avoid heavy workouts if you feel dizzy or weak. Stay hydrated and listen to your body’s response.
Is it safe to drink alcohol while taking Buprenorphine?
No, alcohol increases the risk of breathing problems, drowsiness, and overdose. Avoid alcohol completely while using Buprenorphine.
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