Buprenorphine

Adult Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Belbuca; Brixadi; Brixadi (Weekly); Buprenex [DSC]; Butrans; Probuphine Implant Kit [DSC]; Sublocade

Brand Names: Canada

BuTrans 10; BuTrans 15; BuTrans 20; BuTrans 5; Probuphine [DSC]; Sublocade; Subutex

Warning

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.
  • Severe side effects have happened when opioid drugs were used with benzodiazepines, alcohol, marijuana, other forms of cannabis, or street drugs. This includes severe drowsiness, breathing problems, and death. Benzodiazepines include drugs like alprazolam, diazepam, and lorazepam. If you have questions, 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.
  • 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.
  • If you are pregnant or plan to get pregnant, talk with your doctor right away. Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. Withdrawal in the newborn can be life-threatening if not treated.

All oral products, short-acting injection, and patch:

  • This is an opioid drug. Opioid drugs can put you at risk for addiction, abuse, and misuse. These can lead to overdose and death. You will be watched closely while taking 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.

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.

Long-acting injection:

  • This drug is given into the fatty part of the skin only. If given other ways (into a vein or muscle), this can be deadly. If you have questions, talk with the doctor.
  • Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. Withdrawal can be life-threatening if not treated.

What is this drug used for?

Implant, long-acting injection, and under the tongue (sublingual) tablet:

  • It is used to treat opioid addiction. Opioid drugs include heroin and prescription pain drugs like oxycodone and morphine.

Implant and long-acting injection:

  • 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.

Cheek film, patch, and short-acting injection:

  • It is used to manage pain.

Cheek film and patch:

  • 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, short-acting 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?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have a latex allergy, talk with your doctor. Some products have latex.
  • If you have any of these health problems: Lung or breathing problems like asthma, trouble breathing, or sleep apnea; high levels of carbon dioxide in the blood; or stomach or bowel block or narrowing.
  • If you have liver disease.
  • If you are taking any of these drugs: Butorphanol, nalbuphine, or pentazocine.
  • If you are using another drug that has the same drug in it.
  • If you have taken certain drugs for depression or Parkinson’s disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
  • If you are taking any of these drugs: Linezolid or methylene blue.
  • If you are pregnant or may be pregnant. This drug may cause harm to an unborn baby. You will need to talk with your doctor about if this drug is right for you.
  • If you are breast-feeding. Do not breast-feed while you take this drug.

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 if you have been sitting or lying down. Be careful going up and down stairs.
  • 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.
  • Have your blood work and other lab tests checked as you have been told by your doctor.
  • Do not take with alcohol or products that have alcohol. Unsafe and sometimes deadly effects may happen.
  • This drug may cause withdrawal symptoms if you are dependent or addicted to narcotics. Talk with your doctor.
  • Severe 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, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Long-term use of an opioid drug may lead to lower sex hormone levels. Call your doctor if you have a lowered interest in sex, fertility problems, no menstrual period, or ejaculation problems.
  • This drug may raise the chance of seizures in some people, including people who have had seizures in the past. Talk to your doctor to see if you have a greater chance of seizures while taking this drug.
  • Taking an opioid drug like this drug may lead to a rare but severe adrenal gland problem. Call your doctor right away if you feel very tired or weak, you pass out, or you have severe dizziness, very upset stomach, throwing up, or decreased appetite.
  • If you are 65 or older, use this drug with care. You could have more side effects.

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, short-acting injection, and patch:

  • Long-term or regular use of opioid drugs like this drug may lead to dependence. Lowering the dose or stopping this drug all of a sudden may cause a greater risk of withdrawal or other severe problems. Talk to your doctor before you lower the dose or stop this drug. You will need to follow your doctor’s instructions. Tell your doctor if you have more pain, mood changes, thoughts of suicide, or any other bad effects.
  • 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.

Cheek film, patch, and short-acting injection:

  • If your pain gets worse, if you feel more sensitive to pain, or if you have new pain after you take this drug, call your doctor right away. Do not take more than ordered.

Implant, long-acting injection, and under the tongue (sublingual) tablet:

  • Follow up with the doctor as you have been told.
  • Be sure you know how to treat pain while you take this drug. Do not take opioid pain drugs unless your doctor tells you to. Pain drugs may not work as well while you take this drug. Do not take more pain drugs to try to get them to work. If you have an emergency, tell your health care provider that you take this drug. If you have questions, talk with your doctor.

Implant and long-acting injection:

  • If you need to stop treatment with this drug, you will need to watch for signs of withdrawal. Tell your doctor if you have any bad effects. If you have questions, talk with your doctor.
  • If this drug comes out by itself, keep it away from children. Accidental exposure may cause death. If someone else, especially a child, is exposed to this drug 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.
  • Do not rub or massage the area where this drug is put in. Try not to touch the area very often. Touching it often may raise the chance of infection.

Long-acting injection:

  • Very bad skin problems have happened where the shot was given. Sometimes surgery was needed for these skin problems. Talk with the doctor.

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, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
  • Sweating a lot.
  • Fast, slow, or abnormal heartbeat.
  • Feeling nervous and excitable.
  • Fever, chills, or sore throat.
  • Change in balance.
  • Mood changes.
  • Severe constipation or stomach pain. These may be signs of a severe bowel problem.
  • Extra muscle action or slow movement.
  • 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 or passing out.
  • Trouble breathing, slow breathing, or shallow breathing.
  • Noisy breathing.
  • Breathing problems during sleep (sleep apnea).
  • Trouble passing urine.
  • Hallucinations (seeing or hearing things that are not there).
  • Muscle or joint pain.
  • Memory problems or loss.
  • Seizures.
  • Shakiness.
  • Slurred speech, stumbling, or feeling confused, very sleepy or dizzy, or drunk.
  • Not able to focus.
  • A severe and sometimes deadly problem called serotonin syndrome may happen if you take this drug with 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; severe diarrhea, upset stomach, or throwing up; or severe headache.

All oral products:

  • Dental problems like cavities, infections, and loss of teeth have happened with buprenorphine products that are dissolved in the mouth. This has even happened in people who did not already have dental problems. Call your doctor and your dentist right away if you have any problems with your teeth or gums.

Short-acting injection:

  • Irritation where the shot is given.

Implant:

  • Depression.
  • Pain, redness, swelling, or other reaction where the injection was given.

Long-acting injection:

  • Area that feels hard, blisters, dark scab, lumps, open wound, pain, swelling, or other very bad skin irritation where the shot was given.

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:

  • Constipation, diarrhea, stomach pain, upset stomach, or throwing up.
  • Feeling dizzy, sleepy, tired, or weak.
  • Headache.
  • Trouble sleeping.
  • Back pain.
  • Dry mouth.
  • Signs of a common cold.

Under the tongue (sublingual) tablet:

  • Numbness or tingling in the mouth.

Patch:

  • Skin irritation.

Implant:

  • Tooth pain.
  • Mouth pain.
  • Throat pain.

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.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

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 under tongue and let dissolve all the way. Do not chew, suck or swallow tablet.
  • Do not split or break tablet.
  • Do not eat, drink, smoke, or talk while this drug is dissolving.
  • Take this drug at the same time of day.
  • After this drug has dissolved, take a large sip of water, swish it around in your mouth, and swallow. Wait at least 1 hour before brushing your teeth.
  • Take good care of your teeth. See a dentist often.

Cheek film and patch:

  • Use this drug at the same time of day.
  • 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 dissolve.
  • 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 dissolved all the way.
  • After this drug has dissolved, take a large sip of water, swish it around in your mouth, and swallow. Wait at least 1 hour before brushing your teeth.
  • Take good care of your teeth. See a dentist often.

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.
  • If there is hair where you are putting the patch, clip the hair as close to the skin as you can. Do not shave the hair.
  • 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.

Short-acting injection:

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

Long-acting injection:

  • It is given as a shot into the fatty part of the skin.
  • Do not use pressure (waist band or belt) on the part where the shot is given.

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 all injection products:

  • 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 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. Throw away used patches where children and pets cannot get to them.
  • 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 all injection products:

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

All products:

  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
  • Store this drug in a safe place where children cannot see or reach it, and where other people cannot get to it. A locked box or area may help keep this drug safe. Keep all drugs away from pets.

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.
  • 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.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • A drug called naloxone can be used to help treat an overdose of this drug. Your doctor may order naloxone for you to keep with you while you take this drug. If you have questions about how to get or use naloxone, talk with your doctor or pharmacist. If you think there has been an overdose, get medical care right away even if naloxone has been used.
  • 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 generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-01-16

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Last Updated

Monday, December 12, 2022