Buprenorphine at a glance
Medicine class
Strong opioid; partial agonist at mu-opioid receptors.
Licensed roles represented here
Severe or cancer-related pain not responding to non-opioid analgesics; specialist treatment of opioid dependence.
What is Buprenorphine used for?
These products have different UK licences and are not interchangeable.
Relevtec and Bupeaze patches: moderate to severe cancer pain and severe pain that does not respond to non-opioid analgesics. They are not licensed for acute pain.
Buvidal prolonged-release injection: opioid-dependence treatment within combined medical, social and psychological care for adults and adolescents aged 16 years or over.
How does Buprenorphine work?
Buprenorphine binds strongly to opioid receptors. Partial activation of mu receptors reduces pain signalling and can suppress opioid craving and withdrawal while blocking some effects of other opioids. It is an antagonist at kappa receptors.
Buprenorphine preparations and strengths
Injection
Route: Parenteral
Strengths: 8 mg, 16 mg, 24 mg, 32 mg, 64 mg, 96 mg, 128 mg, 160 mg
How to take Buprenorphine
Follow the instructions for the exact product supplied because patches and prolonged-release injections are used differently.
Apply a patch to clean, completely dry, non-irritated, relatively hairless, flat skin. Trim hair rather than shaving; avoid soaps, creams and lotions at the site.
Remove the previous patch first, rotate sites, press the new patch firmly into place and wash your hands afterwards.
Do not cut patches or expose them to direct heat. Check that the patch remains attached after bathing or swimming.
Fold used patches sticky sides together, keep them away from children and return them to a pharmacy for safe disposal.
Buvidal must be injected under the skin by a healthcare professional. It must not be self-administered, taken home, or injected into a vein or muscle.
Buprenorphine side effects
Common or expected effects
- Constipation
- Nausea or vomiting
- Sleepiness, tiredness or dizziness
- Headache
- Itching, redness or rash; patches may cause application-site reactions
- Sweating or insomnia; Buvidal may cause injection-site pain, itching, redness, swelling or a lump
Get urgent medical advice
- Slow, shallow or difficult breathing
- Profound sleepiness, collapse or inability to wake
- Seizure
- Severe allergic reaction with facial or throat swelling or breathing difficulty
- Possible serotonin syndrome, including agitation or confusion with sweating, fever, diarrhoea, muscle stiffness or twitching
- Severe or worsening injection-site inflammation, abscess, ulceration or tissue damage
Buprenorphine in pregnancy
Advice is formulation-specific. Relevtec and Bupeaze patches are contraindicated during pregnancy. Buvidal may be used only when expected benefit outweighs fetal risk. Exposure near delivery may cause newborn breathing problems or withdrawal. Discuss pregnancy promptly with the specialist or prescriber rather than stopping treatment without advice.
Buprenorphine while breastfeeding
Advice differs by product. The selected pain-patch product information advises against breastfeeding, while Buvidal should be used cautiously. UK specialist advice considers buprenorphine for opioid dependence compatible with breastfeeding after individual assessment, with monitoring of the infant for unusual sleepiness, poor feeding or weight gain, breathing problems, constipation or pallor.
Buprenorphine interactions
Tell the prescriber and pharmacist about all prescribed, non-prescribed and recreational substances. Several combinations increase sedation, breathing problems or withdrawal risk.
Alcohol
Can substantially increase sleepiness, impaired judgement and respiratory depression.
Benzodiazepines and other sedatives
Can cause profound sedation, coma or fatal respiratory depression.
Common questions about Buprenorphine
Answers are fully visible for fast scanning and source review.
Is buprenorphine an opioid?
Yes. It is a strong opioid with partial activity at mu-opioid receptors.
Can a buprenorphine patch treat sudden pain?
The selected Relevtec and Bupeaze patches are not licensed for acute pain because absorption through the skin is gradual.
More questions about Buprenorphine
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.