Buprenorphine is a partial opioid agonist.
The lowest dose formulation (Butrans 5mcg/hr) is equivalent to 12mg oral morphine/24 hours.
Side effects: As per all opioids, including nausea and constipation.
Transdermal preparations release buprenorphine in micrograms per hour, over several days (the exact time frame depends on the preparation).
Butrans® patches release between 5 and 20 micrograms of buprenorphine per hour (equivalent to 12-48 mg of morphine per 24 hours) over 7 days. These patches are of particular utility in patients who have low analgesic requirements.
Transtec® patches are changed twice weekly (every 3-4 days).
It can take 2-3 days to reach peak plasma concentrations of buprenorphine therefore allow 3 days before assessing effect.
After removal, plasma concentrations of buprenorphine will be halved after 30 hours.
Transdermal opioid preparations must be prescribed by brand name.
Transdermal buprenorphine patch preparations:
Caution when prescribing and counselling patients and ensure you have the correct frequency of change for the brand/patch strength you have selected.
7 day patches: BuTrans, BuTec, Bunov, Bupramyl, Panitaz, Rebrikel, Reletrans, Sevodyne 5 micrograms/hour, 10 micrograms/hour,
15 micrograms/hour, 20 micrograms/hours
4 day patches: Bupeaze, Carlosafine, Relevtec, Transtec 35micrograms/hour, 52.5micrograms/hour, 70 micrograms/hour
3 days patches: Hapoctasin 35 micrograms/hour, 52.5micrograms/hour
70 micrograms/hour
Use the links below for further information about Transdermal Opioids:
Disclaimer
This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.
Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.
While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.