Before taking buprenorphine

Before taking buprenorphine make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have liver, kidney or prostate problems.
• If you have breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD).
• If you have low blood pressure.
• If you have thyroid problems.
• If you suffer from convulsions.
• If you have a problem in your bile duct.
• If you have been constipated for more than a week, or have an inflammatory bowel problem.
• If you have ever had a problem with a drug addiction.
• If you have an adrenal gland problem.
• If you have myasthenia gravis (a muscle weakening disorder).
• If you have recently suffered a serious head injury.
• If you have ever had an allergic reaction to this or to any other medicine.
• If you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines. It is important that you let your doctor know if you are taking any other strong painkillers.

How to take buprenorphine tablets and use buprenorphine patches

• Before starting this treatment, read the manufacturer's printed information leaflet.
• Follow the directions your doctor has given you carefully.
• If you have been given sublingual tablets: put the tablet under your tongue and allow it to dissolve completely. Avoid swallowing until after the tablet is fully dissolved. You will have been told to take a dose every 6 to 8 hours depending on how severe your pain is. It is not important whether you take buprenorphine before or after food.
• If you have been given patches: apply the patch to a dry, non-irritated, non-hairy area of skin on your upper body. Remove and replace the patch after 96 hours if you have been given Transtec® patches, and after 7 days if you have been given BuTrans® patches. Apply the replacement patch to a different area of skin.
• Do not exceed the dose you have been prescribed. Signs of overdose can include pinpoint pupils, difficulty breathing and extreme drowsiness or unconsciousness. If you suspect that you or someone else has had an overdose of buprenorphine, contact your doctor or go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

Getting the most from your treatment

• Keep your regular appointment with your doctor so your progress can be monitored.
• Do not drink alcohol with buprenorphine as this will increase the side-effects of dizziness and drowsiness.
• Stopping treatment suddenly can cause problems if you have been taking buprenorphine regularly. Your doctor will probably want you to reduce your dose gradually if this is necessary.
• Taking buprenorphine regularly for a long time can lead to your body becoming dependent on it, which might cause you to feel restless and irritable if you stop it. If you are concerned about this, discuss the problem with your doctor or pharmacist.
• This medicine may cause a positive reaction to 'anti-doping' tests used in sport.
• If you are planning a trip abroad you are advised to carry a letter with you from your doctor because buprenorphine is a controlled drug. If you plan to travel for more than 3 months, you must check with the Home Office before you travel as you will need to apply in writing for a licence to take buprenorphine with you.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are taking buprenorphine.
• If you buy any medicines, check with a pharmacist that they are safe to take with buprenorphine.

• The amount of buprenorphine which passes through your skin into your body may increase if you have a fever or if the patch is close to a heat source such as an electric blanket or hot water bottle.
• If a rash develops where you have used a patch, avoid this area for as long as possible and speak with your doctor if it is severe.
• You may shower, bathe or swim while you are wearing the patches. If a patch comes off before you are due to change it, do not replace it but use a new patch instead.
• When you remove a patch, fold it in half with the sticky side inside, and then throw it away carefully.

Can buprenorphine cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

How to store buprenorphine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Temgesic® 200 microgram Sublingual tablets, Schering-Plough Ltd, electronic Medicines Compendium. Dated June 2009, accessed September 2010.
• Manufacturer's PIL, BuTrans® 5, 10 and 20 ug/h Transdermal Patch, Napp Pharmaceuticals Limited, electronic Medicines Compendium. Dated January 2009, accessed September 2010.
• Manufacturer's PIL, Transtec® transdermal patch, Napp Pharmaceuticals Limited, electronic Medicines Compendium. Dated May 2005, accessed September 2010.
• British National Formulary; 59th Edition (March 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.