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Medical and Pharmacy Editor:

Brand Name: Buprenex

Generic Name: buprenorphine

Drug Class: Opioid Analgesics; Analgesics, Opioid Partial Agonist

What Is Buprenorphine and How Does It Work?

Buprenorphine is indicated for the management of pain severe enough to require an opioid analgesic and for which alternate treatments are inadequate. Buprenorphine is available under the following different brand names: Buprenex.

Limitations of Use

Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses reserve buprenorphine for use in patients for whom alternative treatment options [e.g., non-opioid analgesics or opioid combination products]:

  • Have not been tolerated, or are not expected to be tolerated
  • Have not provided adequate analgesia, or are not expected to provide adequate analgesia

Dosages of Buprenorphine:

Adult and Pediatric Dosage Forms and Strengths

Injectable solution: Schedule III (Buprenex

  • 0.3 mg/mL

Tablet, sublingual: Schedule III (generic)

  • 2 mg
  • 8 mg

Dosage Considerations – Should be Given as Follows:

Risk of opioid addiction, abuse, and misuse, which can lead to overdose and death

  • 0.25 mg orally every 12 hours initially; may increase to 1 mg/day after 3 days (up to 4 mg/day in some patients)

Moderate-to-Severe Pain

  • Adult: 0.3 mg intravenous/intramuscular (IV/IM) every 6 hours; for IV, administered slowly over 2 minutes; may be repeated once (up to 0.3 mg) if required 30-60 minutes after initial dose
  • Children under 2 years: Safety and efficacy not established
  • Children 2-12 years: 2-6 mcg/kg slow IV/IM every 4-6 hours as needed
  • Children over 12 years: As in adults
  • Geriatric: 0.15 mg IV/IM every 6 hours; for IV, administered slowly over 2 minutes

Opioid Dependence

Induction (sublingual tablet)

  • 8 mg sublingually (SL) on day 1, then 16 mg SL on day 2; continued over 3-4 days

Maintenance (buprenorphine-naloxone combination)

  • Switch to buprenorphine/naloxone combination for unsupervised maintenance
  • For dosing, see drug monograph for buprenorphine/naloxone

Children under 16 years: Not recommended

Children 16 years and older: As in adults

Dosage Modifications

  • Renal impairment: Use with caution; dosage adjustments recommended
  • Hepatic impairment
    • Mild: No dose adjustment is needed
    • Moderate: No dose adjustment is necessary, closely monitor patients for signs and symptoms of toxicity or overdose
    • Severe: Reducing the starting and titration incremental dose by half, and monitor for signs and symptoms of toxicity or overdose

Dosing Modifications

  • Renal impairment: Supplemental dose in hemodialysis not necessary

Dosing Considerations

  • For prescriber qualifications, see prescribing information
  • Also given in combination with naloxone
  • Decrease dose with hepatic or renal impairment, respiratory disease, geriatric or debilitated patients
Medically Reviewed by a Doctor on 4/14/2017

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