Buprenorphine

Adult Medication

Brand Names: US

Belbuca; Buprenex; Butrans; Probuphine Implant Kit

Brand Names: Canada

Butrans

Warning

Implant:

  • Very bad problems can happen when this drug is put in or taken out. These include the implant moving, sticking out of the skin, or coming out by itself. This may cause nerve or blood vessel injury in the arm. It could be deadly if the implant or pieces of it move into the blood vessels or your lungs. Call your doctor right away if the implant sticks out of the skin or comes out by itself. Call your doctor right away if you have numbness or weakness in your arm, chest pain, or shortness of breath.
  • It is common to have itching, pain, irritation, redness, swelling, scarring, bleeding, or bruising where the implant is put in or taken out. Call the doctor if you have bleeding, or if any of these effects happen often or get worse.
  • You may only get this drug through a special program. Talk with your doctor.

All products:

  • This drug may cause very bad and sometimes deadly breathing problems. Call your doctor right away if you have slow, shallow, or trouble breathing.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • This drug has an opioid drug in it. The use of opioid drugs along with a benzodiazepine drug or other drugs that may make you drowsy or slow your actions has led to very bad side effects. Side effects that have happened include slowed or trouble breathing and deaths. Benzodiazepine drugs include drugs like alprazolam, diazepam, and lorazepam. Benzodiazepine drugs are used to treat many health problems like anxiety, trouble sleeping, or seizures. Talk with the doctor.
  • Many drugs interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs.
  • Do not take with alcohol or products that have alcohol. Unsafe and sometimes deadly effects may happen.
  • Get medical help right away if you feel very sleepy, very dizzy, or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up.
  • Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor.

All oral products, injection, and patch:

  • This drug may be habit-forming with long-term use.
  • This drug is a strong pain drug that can put you at risk for addiction, abuse, and misuse. Misuse or abuse of this drug can lead to overdose and death. Talk with your doctor.
  • You will be watched closely to make sure you do not misuse, abuse, or become addicted to this drug.
  • Do not take more than what your doctor told you to take. Taking more than you are told may raise your chance of very bad side effects.
  • The chance of very bad and sometimes deadly breathing problems may be greater when you first start this drug or anytime your dose is raised.
  • Even one dose of this drug may be deadly if it is taken by someone else or by accident, especially in children. If this drug is taken by someone else or by accident, get medical help right away.

All oral products:

  • Misuse or abuse of this drug by chewing, swallowing, injecting, or snorting it can lead to overdose and death.

Patch:

  • Misuse or abuse of this drug by placing it in the mouth or chewing, swallowing, injecting, or snorting it can lead to overdose and death.

What is this drug used for?

Implant and under the tongue (sublingual) tablet:

  • It is used to treat pain drug (opioid) addiction.

Implant:

  • This drug is only for use by people who have been taking pain drugs (opioids) and are used to their effects. Talk with the doctor.

Injection:

  • It is used to ease pain.

Cheek film and patch:

  • It is used to ease very bad pain.
  • It is only to be used when around-the-clock (continuous) care is needed for a long time. It is also only to be used when other pain drugs do not treat your pain well enough or you cannot take them.

All oral products, injection, and patch:

  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

All products:

  • If you have an allergy to buprenorphine or any other part of this drug.
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you are using another drug that has the same drug in it.

All oral products, injection, and patch:

  • If you have any of these health problems: Very bad lung problems like asthma or trouble breathing, high levels of carbon dioxide in the blood, or stomach or bowel block or narrowing.
  • If you are taking any of these drugs: Butorphanol, nalbuphine, or pentazocine.

Cheek film and patch:

  • If you or a family member have a long QT on ECG.
  • If you are taking any of these drugs: Certain drugs to treat a heartbeat that is not normal like amiodarone, disopyramide, dofetilide, procainamide, quinidine, or sotalol.
  • If you are taking any drugs that can cause a certain type of heartbeat that is not normal (prolonged QT interval). There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.

Implant:

  • If you have liver disease.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • To lower the chance of feeling dizzy or passing out, rise slowly over a few minutes when sitting or lying down. Be careful climbing stairs.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • This drug may cause withdrawal symptoms if you are dependent or addicted to narcotics. Talk with your doctor.
  • Do not take this drug with other strong pain drugs or if you are using a pain patch without talking to your doctor first.
  • If you drink grapefruit juice or eat grapefruit often, talk with your doctor.
  • Very bad and sometimes deadly liver problems have happened with this drug. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Long-term use of an opioid drug like this drug may lead to lower sex hormone levels. This may lead to signs like change in sex ability in men, no menstrual period in women, lowered interest in sex, or fertility problems. Call your doctor if you have any of these signs.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Patch:

  • Avoid use of heat sources (such as sunlamps, tanning beds, heating pads, electric blankets, heat lamps, saunas, hot tubs, heated waterbeds). Avoid long, hot baths or sunbathing. Your temperature may rise and cause too much drug to pass into your body.
  • If the sticky side of the patch touches another person’s skin, wash the area with water only, and get medical help right away.

All oral products, injection, and patch:

  • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of signs of withdrawal. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
  • If you have been taking this drug for a long time or at high doses, it may not work as well and you may need higher doses to get the same effect. This is known as tolerance. Call your doctor if this drug stops working well. Do not take more than ordered.

All products other than injection:

  • This drug is not approved for use in children. Talk with the doctor.

Implant and under the tongue (sublingual) tablet:

  • Follow up with the doctor as you have been told.

Implant:

  • If the implant comes out by itself, keep it away from children. Accidental exposure may cause death. If someone else, especially a child, is exposed to the implant by accident, get medical help right away.
  • Do not try to take this drug out by yourself. This could lead to infection and withdrawal. Talk with your doctor.
  • Try not to touch the implant area very often after it is put in. Touching it often may raise the chance of infection.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Trouble breathing, slow breathing, or shallow breathing.
  • Very bad dizziness or passing out.
  • Too much sweat.
  • Fast or slow heartbeat.
  • A heartbeat that does not feel normal.
  • Feeling confused.
  • Very hard stools (constipation).
  • Feeling very tired or weak.
  • Feeling nervous and excitable.
  • Fever or chills.
  • Sore throat.
  • Change in balance.
  • Mood changes.
  • Very bad belly pain.
  • Extra muscle action or slow movement.
  • Slurred speech.
  • Swelling in the arms or legs.
  • Change in eyesight.
  • A burning, numbness, or tingling feeling that is not normal.
  • Trouble speaking.
  • Chest pain or pressure.
  • Trouble passing urine.
  • Hallucinations (seeing or hearing things that are not there).
  • Muscle or joint pain.
  • Memory problems or loss.
  • Seizures.
  • Very bad headache.
  • Shakiness.
  • Feeling very sleepy.
  • A very bad and sometimes deadly health problem called serotonin syndrome may happen if you take this drug with drugs for depression, migraines, or certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; very bad diarrhea, upset stomach, or throwing up; or very bad headache.
  • Taking an opioid drug like this drug may lead to a rare but very bad adrenal gland problem. Call your doctor right away if you have very bad dizziness or passing out, very bad upset stomach or throwing up, or if you feel less hungry, very tired, or very weak.

Injection:

  • Irritation where the shot is given.

Patch:

  • Very bad skin irritation.

Implant:

  • Low mood (depression).
  • Swelling, warmth, or redness at the implant site.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

  • Hard stools (constipation).
  • Dizziness.
  • Feeling sleepy.
  • Upset stomach or throwing up.
  • Belly pain.
  • Feeling tired or weak.
  • Headache.

Patch:

  • Skin irritation.

Implant:

  • Tooth pain.
  • Back pain.
  • Mouth pain.
  • Throat pain.
  • Not able to sleep.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

Under the tongue (sublingual) tablet:

  • Place tablet under the tongue and let melt.
  • Do not chew or swallow whole.
  • Do not eat, drink, smoke, or talk while this drug is melting.

Cheek film and patch:

  • Do not use if the pouch that holds this drug is torn, open, or not sealed all the way.
  • Do not use for fast pain relief or on an as needed basis.
  • Do not use for pain relief after surgery if you have not been taking drugs like this drug.

Cheek film:

  • Do not use this drug if it is cut, damaged, or changed in any way.
  • Do not put this drug on any areas with sores.
  • Use right after opening.
  • Wash your hands before use.
  • Be sure your hands are dry before you touch this drug.
  • Wet the inside of your cheek with your tongue or water.
  • Place the film inside the mouth on a wet cheek. Place the yellow side of the film against the inside of the cheek. Hold for 5 seconds so it sticks to the cheek. Let it melt.
  • Do not touch or move this drug with your tongue or finger after it has been placed.
  • Do not eat or drink until this drug has melted all the way.

Patch:

  • Do not use patches that are cut or do not look right.
  • Wash your hands before and after use.
  • Take off old patch first.
  • Put patch on clean, dry, healthy skin on the upper arm, upper back, upper chest, or side of the chest.
  • Clip hair at site before putting patch on. Do not shave.
  • Put the patch in a new area each time you change the patch.
  • Do not put a new patch on the same skin area as an old patch for at least 21 days.
  • If the patch falls off, put a new one on.
  • If the patch loosens, put tape ONLY on the edges of the patch to hold it in place.
  • If there are problems with the patch not sticking, cover the patch with dressings as you have been told.
  • Do not put on more than 1 patch at the same time unless your doctor tells you to.

All oral products and skin patch:

  • To gain the most benefit, do not miss doses.
  • Take this drug at the same time of day.

Injection:

  • It is given as a shot into a muscle or vein.

Implant:

  • It is put in as an implant under the skin.
  • If the implant is sticking out of the skin or comes out by itself, call your doctor right away. Follow what your doctor has told you to do.

What do I do if I miss a dose?

All oral products:

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

Patch:

  • Put on a missed patch as soon as you think about it after taking off the old one.
  • Do not apply double dose or extra doses.

Implant and injection:

  • Call your doctor to find out what to do.

How do I store and/or throw out this drug?

All oral products and skin patch:

  • Store at room temperature.
  • Store in a dry place. Do not store in a bathroom.

Cheek film:

  • Store in foil pouch until ready for use.

Patch:

  • Store patches in pouch until ready for use.
  • After you take off a skin patch, be sure to fold the sticky sides of the patch to each other.
  • Follow the info that comes with this drug for throwing out patches that are used or not needed. Check with your pharmacist if you have questions about how to throw out this drug.

Implant and injection:

  • If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.

All products:

  • Check with your pharmacist about how to throw out unused drugs.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Last Reviewed Date

2016-09-02

Copyright

© 2016 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rights reserved.