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Buprenorphine

Last updated on 02/07/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions  |   Tips  |   Where To Buy  

GENERIC NAME: Buprenorphine

CHINESE NAME: 丁丙諾啡

BRAND NAME(S) IN HONG KONG: Temgesic, Norspan

DRUG CLASS: Analgesics, Drugs in substance dependence

SUB CLASS: Opioid Analgesics

USED FOR: Moderate to severe pain, opioid dependence

AVAILABLE DOSAGE FORMS:
– 5 mcg/hr, 10 mcg/hr, 20 mcg/hr (transdermal patches)
– 0.2 mg (sublingual tablets)
– 0.3 mg/ml (injections)

What is Buprenorphine for?

Buprenorphine belongs to a class of medications called opioid analgesics. It works by inhibiting nerve signal transmission of pain in the brain and nervous system. It is a powerful analgesic and is used for severe pain management, for example in chronic pain management for cancer patients. Buprenorphine is also used to treat people with opioid addiction by producing similar effects and preventing withdrawal symptoms in people who stopped using opioid drugs.

How to use it?

Buprenorphine is available as transdermal patches and sublingual tablets. Your doctor will regularly check to see if the dosage should be adjusted based on your level of pain.

For transdermal patches, apply to the skin as directed by your doctor. Select a dry, non-hairy area on a flat part of the body, such as the chest, sides, back or upper arms. Change the patch every 72 hours and apply to a different area each time to avoid irritation. Avoid applying the medication on open wounds. Avoid exposing the application site to heat as it affects drug absorption. Fold the patch in half and discard properly.

For sublingual tablets, place a tablet under your tongue and let it dissolve. Do not crush, chew or swallow the tablet.

Moderate to severe pain
Adult
Sublingual: 200-400 mcg every 6-8 hours.
Child
Sublingual:
16-25 kg: 100 mcg every 6-8 hours.
25-37.5 kg: 100-200 mcg every 6-8 hours.
37.5-50 kg: 200-300 mcg every 6-8 hours.
50 kg and above: 200-400 mcg every 6-8 hours.

For opioid dependence
Adult
Sublingual: Initially 0.8-4 mg for 1 dose on the first day, and increase the dose daily to the usual dose of 12-24 mg daily if required. Maximum dose is 32 mg per day.

What are the side effects of Buprenorphine?

Common side effects of Buprenorphine include constipation, dizziness and drowsiness, dry mouth, euphoric mood, flushing, hallucinations, nausea and vomiting (more common on initiation), respiration depression (with high dose). Mild irritation, itching or redness may occur at the application site. Like all opioid medications, people can become tolerant or addicted to Buprenorphine, which can result in withdrawal symptoms when you try to stop the medicine.

Who should not take Buprenorphine?

– People allergic to Buprenorphine or any component of the formulation.
– Patients with respiratory depression, serious bronchial asthma or gastrointestinal obstruction.

Pharmacist Tips:

– Note that opioids have the potential to be addictive and you can become tolerant over time.
– Tell your doctor if you experience severe side effects, such as difficulty breathing.
– Do not stop the medication abruptly if you have used Buprenorphine over long periods of time.
– Eat more high-fibre foods, drink more water and do more exercise to reduce the side effects of constipation.
– It is best to avoid alcohol while taking Buprenorphine.

Common dosing schedule:
Buprenorphine sublingual tablets may be used every 6-8 hours or as required.
Fentanyl transdermal patches should be changed every 72 hours.

This schedule is for reference only, adjustments may be made according to individual needs.

Some common medications Buprenorphine may interact with:
– Antidepressants, e.g. Amitriptyline, Doxepin
– Benzodiazepines, e.g. Lorazepam, Midazolam
– Medicines for lowering blood pressure, e.g. Atenolol, Verapamil
– Monoamine oxidase inhibitors, e.g. Isocarboxazid, Selegiline

Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Buprenorphine in Hong Kong?

In Hong Kong, Buprenorphine is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk

Need more information?

For detailed information about the use of Buprenorphine in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.