Buprenorphine is a synthetic opioid agonist-antagonist derived from thebaine, used in the form of the hydrochloride (HCl) salt as an analgesic for moderate to severe pain and as an anesthesia adjunct. It is administered sublingually or by intramuscular or IV injection including the skin patch.

Known as a narcotic, buprenorphine is a Schedule V controlled substance. The Butrans patch is used for the relief of moderate to severe pain like chronic back pain and osteoarthritis. It is also used in tablet form to treat opiate dependence. Butrans work on neurotransmitters (endorphins) in the brain to reduce pain.

Common Brand Name: Butrans

Generic Name: buprenorphine transdermal (skin patch)

Before Starting Butrans

Inform your healthcare provider of any history you have:

• Thyroid, kidney, urinating problems, or liver troubles
• Seizures or any head injuries
• Gallbladder or pancreas issues
• Problems with your heart rhythm such as Long QT syndrome that is QuickTime QT Interval (the measure between Q wave and T wave in the heart's electrical cycle), heart disease, low potassium levels, or a family history of heart problems
• Mental health problems, abuse of prescription or street drugs, or alcohol dependency
• Pregnant, breast feeding, taking vitamins, herbs, have a fever, or medicines over-the-counter

If you have an allergy to buprenorphine, do not take it, or if you have:

• Problems with breathing, for instance asthma
• Paralytic ileus, an obstruction of the intestine
• Alcohol addiction where using Butrans skin patches will have serious side effects and can cause death

How to Use Butrans Patches

Butrans patches store buprenorphine that is absorbed through the skin into the blood. During the first three days, the medication gradually increases after putting on the first patch. After this time, the buprenorphine maintains a constant level in the blood. Every seven days for uninterrupted relief of pain, a new patch should be put on.

Instructions for Using

It is critically important that you follow your healthcare provider’s directions for understanding and attaching the Butrans patches.

• Use the patches intact—do not cut, tear or damage the product by any means.
• Apply the patch to your skin that is not broken, not irritated, not hairy, or unclean.
• Use only water—do not use soap or other skin cleaning products to clean your skin.
• The patch is best applied to the upper chest, upper back, side of the chest, or on the upper outside arm.
• Do not apply the patch to a large scar area.
• Do not apply to shaved off hair, that will remove the very top of your skin, cut hair with scissors only.
• Do not put the patch on immediately after a hot shower or bath, let the skin cool down naturally.
• Moisturizers, creams, perfume, and talcum powder should not be used, it could prevent the patch from sticking to your skin.
• Remove patch from its covering and put straight on top of your skin using your palm to rub it securely in place for 30 seconds.
• You can shower, bathe, and swim with the patch on.
• Avoid excessive heat for example, electric blankets, heat lamps, tanning beds, saunas, and hot water bottles. You can absorb more of the patch’s active ingredients with heat increasing your risk for side effects.
• Be sure to consult with your doctor if you get a fever because this has the potential for higher absorption of the ingredients
• Change your patch at the same time of the day after worn and removed after seven days.
• Apply new patches to a different area of your skin, avoiding the same area for three to four weeks.
• Use skin tape if your patch peels off at the edges; if it totally falls off, apply a new one right away remembering that the replacement needs to be changed after seven days.
• Used patches need to be stuck together, folded in half with the sticky side inside, wrapped in its original packet, or disposed safely with other methods as the active ingredient residue can be harmful to pets, children, and others. Do not flush it down the toilet, it impacts sewage treatment plants.
• Do not use more than two patches at any time without discussing first with your doctor.

Possible Side Effects of Butrans Patch

Among the adverse effects are respiratory, depression, nausea, sedation, vertigo, dizziness, vomiting, headache, miosis (eye pupil contraction), diaphoresis (perspiring), and low blood pressure (hypotension).

Other side effects:

• ŸItching at the patch site and other areas
• ŸDry mouth
• ŸConstipation
• ŸHot flushes
• ŸTired or weak
• ŸConfusion
• ŸNervousness/jittery
• ŸShortness of breath
• ŸInsomnia
• ŸSwelling in ankles (fluid retention)
• ŸChest pain
• ŸDiarrhea (loose or liquid stool)
• ŸRash
• ŸSensation of pins and needles

Whether Butrans harms an unborn baby is not known. Since Butrans is an opiate, it could cause addiction and withdrawal in a newborn that can cause death. Breast milk will deliver buprenorphine and can injure a baby. If you use Butrans patches, do not breast feed your baby.

The possible side effects of medications can have different effects on individuals and not in the same way. Some of the side effects are shown here but that does not mean everyone will have a side effect or experience any problem with Butrans patches.

Warnings

• ŸIf you are drowsy or experiencing other side effects, do not drive or operate any machinery.
• ŸConsuming alcohol while wearing the patch can increase the side effects of feeling dizzy or drowsy.
• ŸYou can become addicted to buprenorphine causing a butran patch high.

Mind Interactions

As a final thought, be sure to tell your doctor if you are taking any medicines having the same active ingredient, buprenorphine, to prevent any danger or harm to you. These would be some of the medications:

• ŸTranstec patches
• ŸTemgesic injections or sublingual (under the tongue) tablets
• ŸHapoctasin patches
• ŸTephine sublingual tablets

Some medications can decrease your blood level for buprenorphine making it not as effective when taking these drugs:

• ŸPhenobarbital
• ŸRifampicin
• ŸCarbamazepine
• ŸPhenytoin
• ŸSt John's wort (Hypericum perforatum) herbal supplement

People taking MAOIs (monoamine oxidase inhibitors) should not take buprenorphine. Some of the MAOIs are the antidepressants isocarboxacid, moclobemide, tranylcypromine and phenelzine. If you have taken one or more of these within 14 days of your patch, be sure to let your doctor know.

By the same token, consult with your doctor or pharmacist before taking any new medicines while using the Butrans patch, to make sure they are safe for you to take together.

When Not to Use Butrans

Never use Butrans if you have:

• Breathing problems such as lung conditions, or severe asthma; check with your doctor if you have COPD (chronic obstructive pulmonary disease)
• Stomach or intestine narrowing including blockage of the bowel
• Breathing problems, seriously ill, malnourished, and other compromised problems