Introduction
Buprenorphine is an opioid drug, having a combination of agonist and antagonist properties.
Buprenorphine is known to produce the action of natural endorphins by stimulating the opioid receptors in the brain and spinal cord. These block the transmission of pain signals sent by the nerves to the brain. Hence, even if the cause of the pain still exists, less pain is actually felt.
Buprenorphine patches
Buprenorphine patches or transdermal buprenorphine is considered in chronic severe pain when lower doses of strong opioids are indicated.
The buprenorphine patches contain a reservoir of buprenorphine that passes slowly from the patch through the skin and into the bloodstream. The blood level of the medicine rises slowly in the first 24 hours after the first patch is put on.
Hence, the initial effect of the patch is not rapid. Nevertheless, after this stage, the blood level of the medicine remains steady. The patch is changed every 96 hours (4 days), thus providing constant relief.
Transtec patches contain the active ingredient buprenorphine, which is a medicine in the class of opioid analgesics (painkillers). Meanwhile, the BuTrans patches are a lower dose buprenorphine formulation, which release 5mcg/hour, 10mcg/hour and 20 mcg/hour for 7 days.
Research indicates that the 7-day patch has shown effective results in treating chronic osteoarthritic pain, low back pain and non-malignant pain.
Dosage issues
Buprenorphine patches are available in three strengths, which include 5 micrograms (mcg) per hour, 10 mcg per hour and 20 micrograms per hour.
Patients new to the usage of opioids should ideally start at the lowest strength. Supplemental analgesics should also be continued as needed for some time as the buprenorphine concentrations rise slowly.
To increase the dose, remove the current patch and apply a higher-strength patch or a combination of two patches. More than 20-micrograms per/hour patches should not be used.
Directions for use
Health care providers and pharmacists lay down the following specific conditions for the proper use of buprenorphine patches, including Trasntec and BuTrans:
i) The patch should be applied to non-irritated, intact skin of the upper outer arm, upper chest, upper back or the side of the chest, leaving out any area that has large scars.
ii) Only use clean water to clean the site of application.
iii) The patch should be applied immediately upon removal from the sealed sachet.
iv) The patch should be worn continuously for 7 days.
v) While wearing the patch, patients are advised to stay away from external heat sources such as heating pads, electric blankets, heat lamps etc.
vi) After removal of a patch, a new patch should not be applied to the same site for at least 3-4 weeks.
Side Effects
The common side effects experienced with the use of buprenorphine patches include:
· Vomiting
· Nausea
· Headache
· Dizziness
· Somnolence
· Constipation
Conclusion
The Buprenorphine patches are considered an effective second line alternative for patients with severe chronic pain who develop intolerance towards large, oral and regular doses of weak opioids or combination analgesics.
