Buprenorphine

Buprenorphine

Buprenorphine is a prescription opioid medication used in specific medical settings, most commonly as part of treatment for opioid use disorder (OUD). It is a partial opioid agonist, meaning it activates opioid receptors in the brain but produces a ceiling effect on some opioid effects compared with full opioid agonists.

Buprenorphine can help reduce opioid withdrawal symptoms and cravings and may be used as part of a comprehensive treatment program that includes medical monitoring and behavioral support.

It is also available in certain formulations for the management of pain. The approved uses, formulations, strengths, and prescribing requirements vary by country and product.

Product Details

How Buprenorphine Works

Buprenorphine has a high affinity for mu-opioid receptors in the central nervous system. It partially activates these receptors and can reduce opioid withdrawal symptoms and cravings.

Because it binds strongly to opioid receptors, buprenorphine can also displace other opioids from those receptors. If it is started too soon after use of a full opioid agonist, it can sometimes trigger precipitated withdrawal.

Medical Uses

Buprenorphine may be prescribed for:

• Opioid use disorder
• Reduction of opioid withdrawal symptoms
• Reduction of opioid cravings
• Maintenance treatment as part of an OUD treatment program
• Pain management with certain approved formulations

Treatment should be individualized according to the patient’s medical history, opioid exposure, clinical condition, and prescribed formulation.

Formulations

Buprenorphine is available in several formulations, depending on the intended medical use and country.

These may include:

• Sublingual tablets
• Sublingual films
• Buccal films
• Transdermal patches
• Long-acting injectable formulations
• Other specialized formulations

Not all formulations are approved for every indication.

Common Side Effects

Possible side effects may include:

• Headache
• Nausea
• Vomiting
• Constipation
• Dizziness
• Drowsiness
• Sweating
• Fatigue
• Abdominal discomfort
• Dry mouth

Side effects vary depending on the formulation, dose, duration of treatment, and individual patient factors.

Serious Safety Information

Buprenorphine can cause respiratory depression, particularly when combined with other substances that slow breathing.

Seek immediate medical attention for symptoms such as:

• Severe difficulty breathing
• Very slow or shallow breathing
• Extreme sleepiness
• Loss of consciousness
• Severe confusion
• Blue or gray lips or skin

The risk can increase when buprenorphine is combined with alcohol, benzodiazepines, other sedatives, or certain other medications.

Dependence and Withdrawal

Although buprenorphine is used to treat opioid use disorder, it is itself an opioid medication and can cause physical dependence.

Stopping regular treatment suddenly may cause withdrawal symptoms. A healthcare professional can determine whether and how treatment should be reduced or discontinued.

Drug Interactions

Buprenorphine may interact with:

• Alcohol
• Benzodiazepines
• Other opioids
• Sleep medications
• Sedating antihistamines
• Certain antidepressants
• Other central nervous system depressants
• Certain medicines that affect liver enzymes

Patients should provide their healthcare professional with a complete list of medicines, supplements, and other substances they use.

Important Precautions

Before taking buprenorphine, discuss your medical history with a healthcare professional, particularly if you have:

• Breathing problems
• Sleep apnea
• Liver disease
• Head injury or increased intracranial pressure
• A history of substance-use disorder
• Gallbladder problems
• Adrenal or thyroid problems
• Pregnancy or plans to become pregnant

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