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Buprenorphine (Absorbed through the skin)

Buprenorphine (bue-pre-NOR-feen)

Treats moderate to severe chronic pain. This medicine is a narcotic analgesic.

Brand Name(s):

Butrans

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to buprenorphine or to adhesives. You should not use this medicine if you have severe breathing or lung problems (such as severe asthma) or if you have paralytic ileus.

How to Use This Medicine:

Patch

  • Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to.
  • Wash your hands with soap and water before and after applying a patch.
  • Buprenorphine skin patches come in sealed pouches. Do not use this medicine if the pouch seal is broken or if the patch is cut, damaged, or changed in any way.
  • Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.
  • The patient instructions will show the body areas where you can wear the patch. When putting on each new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before applying a new one.After you apply the patch, push down on it with the palm of your hand for 15 seconds to make sure it sticks to your skin.
  • Do not put the patch over burns, cuts, or irritated skin.
  • Do not use soap, lotion, alcohol, or oil on your skin before you apply the patch. Wash the skin only with clear water. Let your skin dry completely. Do not shave the skin where you will apply the patch. If you must get rid of some hair, cut the hair with a pair of scissors.
  • Put on a new patch if the old one has fallen off and cannot be reapplied.If a patch is loose, tape it to your skin with first aid tape.
  • Never put the patch in your mouth.
  • For gel patches: If any of the gel comes out of the patch and gets directly on your skin, wash it off right away with clear water. The gel is only supposed to go through the patch and onto your skin.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

If a dose is missed:

  • If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Store the patches at room temperature in the original package, away from heat, moisture, and direct light.
  • This medicine can cause serious side effects if used by adults or children who are not used to strong narcotic pain medicines. Make sure you store the medicine in a safe and secure place to prevent others from getting it. Keep the medicine away from pets.
  • Throw any used patch away so that children or pets cannot get to it. There is still enough medicine in a used patch to make a child or pet very sick. When you throw away a used patch, fold it in half with the sticky sides together and flush it down the toilet, and then wash your hands thoroughly with soap and water. You may also place the used patch in the patch disposal unit to be thrown in a trash can. When you stop treatment, take all of the leftover patches out of the packages and throw them away.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you also use carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), rifampin (Rifadin®, Rimactane®), medicines to treat heart rhythm problems (such as amiodarone, disopyramide, dofetilide, procainamide, quinidine, sotalol, Cordarone®, Norpace®, Tikosyn®), or medicines to treat HIV/AIDS (such as atazanavir, Kaletra®, Reyataz®). Tell your doctor if you also use medicine for nerves or sleeping (such as alprazolam, clonazepam, diazepam, lorazepam, Xanax®), a phenothiazine medicine (such as promethazine, Phenergan®, Thorazine®), or muscle relaxants (such as carisoprodol, tubocurarine, Soma®). Tell your doctor if you use atropine, dicyclomine (Bentyl®), or glycopyrrolate (Robinul®).
  • Tell your doctor if you drink alcohol or if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding or if you have kidney disease, liver disease, heart disease, heart rhythm problems, lung disease or breathing problems (such as chronic obstructive pulmonary disease [COPD], cor pulmonale, hypercapnia), low blood pressure, thyroid problems, Addison disease, pancreas problems, prostate problems, gallbladder problems, low potassium in the blood, or stomach or bowel problems. Tell your doctor if you have a history of head injury, brain tumor, seizures, depression, or mental illness. Tell your doctor if you have a history of alcohol or drug abuse.
  • Do not use more of this medicine or take it more often than your doctor tells you to. This can be life-threatening. Symptoms of an overdose include extreme dizziness or weakness, shortness of breath, slow heartbeat, seizures, and cold, clammy skin. Call your doctor right away if you notice these symptoms.
  • Stop using this medicine and tell your doctor right away if you develop swelling, burns, or blisters at the application site.
  • Do not let the patch get too hot. It may release too much medicine too quickly. Avoid direct sunlight, and do not use a heating pad, electric blanket, heated waterbed, sauna, sun lamp, or hot tub. Call your doctor if you have a fever higher than 102 degrees.
  • Be careful about letting other people come in contact with your patch. The patch could stick to someone else, such as when you hug them or if someone helps you put the patch on. If any medicine gets on another person, wash it off right away with clear water.
  • This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
  • This medicine may make you lightheaded, dizzy, or drowsy. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded or dizzy.
  • This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
  • Call your doctor if your symptoms do not improve or if they get worse.It may take a day or longer for the medicine to reach its full effect.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blue lips, fingernails, or skin
  • Change in how much or how often you urinate, difficult or painful urination
  • Confusion, trouble breathing, slow or shallow breathing, weakness, sweating, cold or clammy skin
  • Fast, slow, or uneven heartbeat
  • Fever, chills, cough, sore throat, and body aches
  • Lightheadedness, dizziness, fainting
  • Seizures
  • Swelling, burns, or blisters where the patch is stuck to your skin
  • Yellow skin or eyes

If you notice these less serious side effects, talk with your doctor:

  • Constipation, nausea, vomiting, dry mouth, stomach pain
  • Headache
  • Redness, itching, or mild skin rash where the patch is placed on your skin
  • Sleepiness or unusual drowsiness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 4/4/2014
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