Drug ID: 2d00000068
Drug Name: Buprenorphine
Generic Names: Tidigesic (0.2 mg) | Addnok | Buprigesic (0.3 mg) | Pentorel (2 ml) | Tidigesic (1 ml) | Buprinor | Morgesic | Talgesic | Tidigesic (2 ml) | Norphin | Morgesic (2 ml) | Buprine | Pentorel | Bunogesic (2ml) | Buprigesic (2 ml) | Buprene | Bunogesic | Subutex
Category: Opioid Dependance Agents
Legal Status: Opioid Prescription only drug
Indication for Mother: Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Recommended Dose: Adult- IM/SC/IV- The recommended dose is 0.3 to 0.6mg.
Sublingual- The recommended dose is 0.2 to 0.4mg, tree or four times per day.
Recommended In: This medication is a narcotic analgesic, prescribed for moderate to severe pain.
Directions For Use: It comes as a solution for injection to be administered by a healthcare provider into the large muscle or into the vein.
It also comes as a tablet to be placed under the tongue.
Storage: Store it at room temperature (25°C) and away from excess heat and moisture.
Dosage Forms: Intramuscular Injection | Intravenous Injection | Subcutaneous Injection | Sub-lingual tablets
Side Effects: Most Common - Nausea, vomiting, dizziness, increased sweating, headache, low blood pressure and shortness of breath.
Central Nervous System - Confusion, blurred vision, emotion, weakness/fatigue, dry mouth, nervousness, depression, slurred speech and tingling.
Heart - High blood pressure and fast or slow heart rate.
Gastrointestinal - Constipation.
Respiratory - Difficulty in breathing and bluish.
Skin - Itching.
Eye and ENT - Double vision and visual abnormalities.
Miscellaneous - Injection site reaction, urinary retention, dreaming, flushing/warmth, and chills/cold, ringing in the ear, eye inflammation and mental illness.
In Case of Overdose: The manifestations of acute overdose include pinpoint pupils, sedation, hypotension, respiratory depression, and death.
In the event of overdose, the respiratory and cardiac status of the patient should be monitored carefully. When respiratory or cardiac functions are depressed, primary attention should be given to the re-establishment of adequate respiratory exchange through provision of a patent airway and institution of assisted or controlled ventilation. Oxygen, IV fluids, vasopressors, and other supportive measures should be employed as indicated.
In the case of overdose, the primary management should be the re-establishment of adequate ventilation with mechanical assistance of respiration, if required. Naloxone may be of value for the management of buprenorphine overdose. Higher than normal doses and repeated administration may be necessary. The long duration of action of Buprenorphine should be taken into consideration when determining the length of treatment and medical surveillance needed to reverse the effects of an overdose. Insufficient duration of monitoring may put patients at risk.
Avoid If: Contraindicated during labor, and in people with known hypersensitivity.
Caution should be exercised in patients with history of slow breathing, drowsiness, stomach problems, diarrhea, head injury, stroke, mental illness, suicidal thoughts, lung or other breathing problem (chronic obstructive pulmonary disease [COPD]), underactive thyroid, changes in blood electrolytes level, enlarged prostate, urinary obstruction, seizures, liver or kidney disease, any allergy, who are taking other medications, elderly, children especially less than 2 years old, during pregnancy and breastfeeding.
It may cause drowsiness or dizziness, do not drive a car or operate machinery and get up slowly from bed while taking this medication.
Avoid alcohol consumption.
Drug Interaction: Some products that may interact with this drug include: narcotic antagonists (such as naltrexone), certain narcotic pain medications (mixed narcotic agonist-antagonists such as butorphanol, nalbuphine, pentazocine).
Many drugs besides buprenorphine may affect the heart rhythm (QT prolongation), including amiodarone, bretylium, disopyramide, dofetilide, ibutilide, procainamide, quinidine, sotalol, among others.
Other medications can affect the removal of buprenorphine from your body, which may affect how buprenorphine works. Examples include azole antifungals (such as ketoconazole), HIV medications (such as ritonavir, saquinavir), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), St. John's wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others.
The risk of serious side effects (such as slow/shallow breathing, severe drowsiness, dizziness) may be increased if this medication is taken with other products that may also affect breathing or cause drowsiness. Therefore, tell your doctor or pharmacist if you are taking other products such as alcohol, allergy or cough-and-cold products, anti-seizure drugs (such as phenobarbital), medicine for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, other narcotics (such as hydrocodone, oxycodone), and psychiatric medicines (such as risperidone, amitriptyline, trazodone). Your medications or doses of your medications may need to be changed.
Deaths have occurred when buprenorphine has been misused by injecting it ("shooting up"), especially when used in combination with benzodiazepines (such as diazepam) or other depressants such as alcohol or additional narcotics.