By using a fentanyl or buprenorphine patch, which mini- mizes or eliminates withdrawal. How long do patients have to be in treatment before they are considered. Past Findings and More Evidence Against,” Addiction. Butrans is a trade name for the buprenorphine transdermal system. A buprenorphine transdermal system is a prescription skin patch that includes time-release.
Generic Name: Buprenorphine Transdermal Patch (byoo pre NOR feen)
Brand Name: Butrans
Brand Name: Butrans
Medically reviewed by Drugs.com. Last updated on Aug 23, 2019.
Warning
- This medicine 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 medicine has an opioid drug in it. Severe side effects have happened when opioid drugs were used with benzodiazepines or other drugs that may make you drowsy or slow your actions. This includes slow or troubled breathing and death. Benzodiazepines include drugs like alprazolam, diazepam, and lorazepam. Benzodiazepines may be used to treat many health problems like anxiety, trouble sleeping, or seizures. If you have questions, talk with your doctor.
- Many drugs interact with buprenorphine transdermal patch 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 buprenorphine transdermal patch 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 buprenorphine transdermal patch for a long time during pregnancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor.
- This medicine is a strong pain drug that can put you at risk for addiction, abuse, and misuse. Misuse or abuse of buprenorphine transdermal patch 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 buprenorphine transdermal patch.
- 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 buprenorphine transdermal patch or anytime your dose is raised.
- Even one dose of buprenorphine transdermal patch may be deadly if it is taken by someone else or by accident, especially in children. If buprenorphine transdermal patch is taken by someone else or by accident, get medical help right away.
- Misuse or abuse of buprenorphine transdermal patch by placing it in the mouth or chewing, swallowing, injecting, or snorting it can lead to overdose and death.
Uses of Buprenorphine Transdermal 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.
- It may be given to you for other reasons. Talk with the doctor.
What do I need to tell my doctor BEFORE I take Buprenorphine Transdermal Patch?
- If you have an allergy to buprenorphine or any other part of buprenorphine transdermal patch.
- 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 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 or a family member have a long QT on ECG.
- 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 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.
- 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 breast-feeding. Do not breast-feed while you take buprenorphine transdermal patch.
This is not a list of all drugs or health problems that interact with buprenorphine transdermal patch.
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 buprenorphine transdermal patch 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 Buprenorphine Transdermal Patch?
- Tell all of your health care providers that you take buprenorphine transdermal patch. 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 buprenorphine transdermal patch 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.
- Very bad and sometimes deadly liver problems have happened with buprenorphine transdermal patch. 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 may lead to lower sex hormone levels. Call your doctor if you have a lowered interest in sex, fertility problems, no menstrual period (women), or change in sex ability (men).
- This medicine 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 buprenorphine transdermal patch.
- Taking an opioid drug like buprenorphine transdermal patch 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.
- If you are 65 or older, use buprenorphine transdermal patch with care. You could have more side effects.
- This medicine 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 buprenorphine transdermal patch, call your doctor right away.
- 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.
- Long-term or regular use of opioid drugs like buprenorphine transdermal patch may lead to dependence. Lowering the dose or stopping buprenorphine transdermal patch 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 buprenorphine transdermal patch. 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 buprenorphine transdermal patch 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 buprenorphine transdermal patch stops working well. Do not take more than ordered.
- This medicine is not approved for use in children. Talk with the doctor.
How is this medicine (Buprenorphine Transdermal Patch) best taken?
Use buprenorphine transdermal patch as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- Do not take buprenorphine transdermal patch 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 blood work checked as you have been told by the doctor. Talk with the doctor.
- This medicine may cause withdrawal symptoms if you are dependent or addicted to narcotics. Talk with your doctor.
- Use buprenorphine transdermal patch at the same time of day.
- Do not use if the pouch that holds buprenorphine transdermal patch 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 buprenorphine transdermal 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.
What do I do if I miss a dose?
- 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.
See also:
Buprenorphine dosage information (in more detail)
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:
- 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.
- 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 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 buprenorphine transdermal patch 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.
What are some other side effects of Buprenorphine Transdermal Patch?
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:
- Constipation.
- Upset stomach or throwing up.
- Stomach pain or diarrhea.
- Feeling dizzy, sleepy, tired, or weak.
- Headache.
- Trouble sleeping.
- Back pain.
- Dry mouth.
- Signs of a common cold.
- Skin irritation.
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 the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
See also:
Buprenorphine side effects (in more detail)
If OVERDOSE is suspected:
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.
How do I store and/or throw out Buprenorphine Transdermal Patch?
- Store at room temperature in a dry place. Do not store in a bathroom.
- 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 buprenorphine transdermal patch for throwing out patches that are used or not needed. Check with your pharmacist if you have questions about how to throw out buprenorphine transdermal patch.
- 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.
Consumer information use
- 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.
- This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time buprenorphine transdermal patch is refilled. If you have any questions about buprenorphine transdermal patch, please talk with the doctor, 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.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Related questions
More about buprenorphine
- During Pregnancy or Breastfeeding
Consumer resources
Other brands:Subutex, Belbuca, Butrans, Sublocade, ... +2 more
Professional resources
Related treatment guides
- Reference Number: HEY-943/2019
- Departments: Pain Medicine
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Introduction
You have been given this leaflet because you have been prescribed Buprenorphine patches. This leaflet has been produced to give you general information about your treatment. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.
What is Burpenorphine and what is it used for?
Buprenorphine patches are used to treat some types of chronic pain. Buprenorphine patches contain the active ingredient buprenorphine which belongs to a group of medicines called strong analgesics or ‘painkillers’. They have been prescribed for you by your doctor to relieve moderate, chronic pain that requires the use of a strong painkiller. This may reduce the level of your pain and allow you to increase your activity.
How do I apply the Burpenorphine patch?
Before applying the Buprenorphine patch
Choose an area of non-irritated, intact skin on your upper arm, outer arm, upper chest, upper back or side of the chest. Ask for assistance if you cannot apply the patch yourself.
The Buprenorphine patch should be applied to a relatively hairless or nearly hairless skin site. If no suitable hair free sites are available the hairs should be cut with a pair of scissors. Do not shave them off.
Avoid applying the patch to skin which is red, irritated or has any other blemishes, for instance large scars. The area of skin you choose must be dry and clean. If necessary, wash it with cold or lukewarm water. Do not use soap, alcohol, oil, lotions or other detergents as this might prevent your patch from sticking properly. After a hot bath or shower, wait until your skin is completely dry and cool.
Applying the patch
- Step 1: Each patch is sealed in a pouch. Just before use, open the pouch by tearing where indicated and take out the patch; do not use the patch if the seal is broken.
- Step 2: The sticky side of the patch is covered with a silver, protective foil. Carefully peel off half of the foil, trying not to touch the sticky side of the patch.
- Step 3: Place the patch on to the area of skin you have chosen and remove the remaining foil.
- Step 4: Press the patch against your skin with the palm of your hand and count slowly to 30. Make sure that the whole patch is in contact with your skin, especially at the edges.
Wearing the patch
Butrans patches should be worn for 7 days and Transtec patches should be worn for 4 days. Provided that you have applied the patch correctly, there is little risk of it coming off. If the edges of the patch begin to peel off, they may be taped down with a suitable skin tape. You may shower, bathe or swim whilst wearing it.
Take special care
Do not expose the patch to extreme heat (e.g. heating pads, electric blanket, heat lamps, sauna, hot tubs, heated water beds, hot water bottle etc) as this may lead to larger quantities of the active ingredient being absorbed into the blood than normal. External heat may also prevent the patch from sticking properly. If you have a high temperature this may alter the effects of Buprenorphine patches as described above.
In the unlikely event that your patch falls off before it needs changing, do not use the same patch again. Stick a new one on straight away (see ‘Changing the patch’ below).
Changing the patch
- Take the old patch off.
- Fold it in half with the sticky side inwards.
- Open and take out a new patch, using the empty pouch to dispose of the old patch. Now discard the pouch safely
- Even used patches contain some active ingredient that may be harmful to children or animals, so make sure your used patches are always kept out of sight and reach.
- Find an alternative site to stick your next patch, you should not apply a new patch to the same site for 3-4 weeks.
- Remember to change your patch at the same time of day, to help you remember this make a note of the date and time that you change the patch.
Do not suddenly stop taking your medicine. The dose should be lowered gradually. Call your doctor or nurse for advice. Remember to ask for a repeat prescription before your patches are finished to ensure that you do not run out of patches.
How long will I need to take Buprenorphine?
This will depend on why you are using this and how your pain responds to treatment. You can continue to take buprenorphine for as long as it helps your pain if you are not having any side effects. It may be necessary for your doctor to change the dose during your treatment.
Can I drink alcohol?
The combination of buprenorphine and alcohol can cause significant drowsiness. We would advise you to avoid alcohol when using a buprenorphine patch.
Can I take other medicines together with Buprenorphine?
Buprenorphine patches must not be used together with a type of medicine known as a monoamine oxidase inhibitor antidepressants (examples include tranylcypromide, phenelzine, isocarboxazid, moclobamide and linezolid) or if you have taken this type of medicine in the last two weeks.
If you take some medicines such as phenobarbital or phenytoin (medicines commonly used to treat seizures, fits or convulsions), carbamazepine (a medicine to treat seizures, fits or convulsions and certain pain conditions), or rifampicin (a medicine to treat tuberculosis) the effects of Buprenorphine patches may be reduced.
Buprenorphine patches may increase any side effects experienced when taking other medicines that produce the same effects These include certain medicines to treat pain, depression, anxiety, psychiatric or mental disorders, medicines to help you sleep, medicines to treat high blood pressure such as clonidine, other opioids (which may be found in painkillers or certain cough mixtures e.g. morphine, dextropropoxyphene, codeine, dextromethorphan, noscapine), antihistamines which make you drowsy, or anesthetics such as halothane.
Buprenorphine patches must be used with caution if you are also taking benzodiazepines (medicines used to treat anxiety or to help you sleep). This combination may cause serious breathing problems.
Please read the information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this examination.
Pregnancy and Buprenorphine
You should not use Buprenorphine patches if you are pregnant or are breast-feeding, think you may be pregnant or are planning to have a baby. Ask your doctor or pharmacist for advice before taking this medicine.
Are there side effects from using Buprenorphine patches
Some individuals using this medication can experience the following side effects;
- Constipation – Your GP can prescribe a laxative to overcome this problem.
- Nausea or vomiting – This should wear off after a few days, your GP can prescribe an anti-sickness medicine if required.
- Poor concentration or feeling faint – This should also wear off after a few days.
- Buprenorphine patches may make some people unusually drowsy and breathe more slowly or weakly than expected. If you or anyone else notices that this is happening, take the patch off immediately. Call a doctor straight away. While waiting for the doctor, keep moving and talking as much as possible.
- Dry mouth, sweating, dizziness, head ache, mood changes, irregular heartbeat, confusion, facial flushing, hallucinations, bronchospasm (wheezy) and colic.
- On rare occasions there have been reports of patients having a lower blood pressure and a slower heartbeat. Some patients may suffer from an allergic reaction such as rash or itching.
- A rash, redness or slight itching of the skin caused by the patch. This is usually mild and disappears after you have removed the patch. If it does not, or if the patch irritates your skin, tell your doctor.
- If you have a fever you may experience increased side effects.
If you have any other problems, please seek advice from your GP. Side effects usually improve with time. If you are concerned about any of these side effects or if you have any other problems you should discuss this with your GP. If you apply too many patches or someone else accidentally applies your patch, contact your GP or attend the emergency department.
Can I drive while wearing a Buprenorphine patch?
If you are drowsy do not drive or operate machinery there is a new Drug driving law which came into force March 2015. This drug driving law affects buprenorphine patches. The new law states it is an offence to drive if you have over the specified limits of certain drugs in your body whether your driving is impaired or not. You could be committing an offence driving with buprenorphine in your system unless you are taking the medication in accordance with provided information or advice, given by the prescriber AND your driving is NOT impaired by your medication. The law will then provide you with a “medical defence” and you will not be breaking the law. Further information on Drug driving can be found at https://www.gov.uk/drug-driving-law If you are taking a prescribed medication and it impairs your driving, you are not fit to drive and will be breaking the law if you do so.
What do I do if I forget to change my patch?
Change your patch as soon as you remember. Also make a note of the date and time as your usual day of changing may now be different. If you are very late changing your patch, your pain may return. In this case, please contact your doctor. Do not apply additional patches; it is important to ensure that only the prescribed amount is worn at any time.
What do I do if I use more patches than I should?
As soon as you discover that you have used more patches than you should, remove all patches and call your doctor or hospital straight away. People who have taken an overdose may feel very sleepy and sick. They may also have breathing difficulties or lose consciousness and may need emergency treatment in hospital. When seeking medical attention make sure that you take this leaflet and any remaining patches with you to show to the doctor.
Where should I keep my patches?
Keep this medicine out of the sight and reach of children. Do not use Buprenorphine patches after the expiry date which is stated on the carton and on the pouch. The expiry date refers to the last day of that month. After the expiry date, take any unused patches to a pharmacy. Do not store Buprenorphine patches above 25°C. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of any medicines you no longer use.
Who should I phone if I need advice urgently about my Buprenorphine patches?
If you have any queries, do not hesitate to contact the pain clinic Monday to Friday 9am till 4pm.
Pain clinic: Hull University Teaching Hospitals NHS Trust, Pain Service, Out patient Department, East Riding Community Hospital, Beverley Telephone: (01482) 478868/336440
Outside the normal pain clinic hours (Monday to Friday 9am till 4pm) you can contact your own GP within their working hours. Out of these hours if you have any queries, contact NHS111 and inform them that you are using a taking Buprenorphine patch. They will then be able to contact the appropriate medicine consultant on duty for advice.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and well-being and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.