Generic Name: buprenorphine (injection) (byoo pre NOR feen)Brand Names: Buprenex
Buprenorphine is an opioid (narcotic) medication that is similar to morphine, codeine, and heroin..
Buprenorphine injection is used to treat moderate to severe pain.
Buprenorphine injection may also be used for purposes other than those listed in this medication guide.What is the most important information I should know about buprenorphine injection?
Like other narcotic medicines, buprenorphine injection can slow your breathing, even after the pain-relieving effects wear off. Death may occur if breathing becomes too weak.
Using buprenorphine injection together with other drugs that cause drowsiness can slow the functions of your breathing and central nervous system to dangerous levels. These effects could result in a fatal overdose.Avoid drinking alcohol, which can increase some of the side effects of buprenorphine injection. Using too much of this medicine in addition to drinking alcohol can cause death. You may have withdrawal symptoms when you stop receiving buprenorphine after using it over a long period of time. Do not stop using this medication suddenly unless your doctor instructs you to. You may need to use less and less before you stop the medication completely. Buprenorphine injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.What should I discuss with my healthcare provider before receiving buprenorphine injection?Buprenorphine injection can cause withdrawal effects in a person who is addicted to narcotics. Before receiving buprenorphine injection, tell your doctor if you have a history of drug abuse or addiction. Do not use this medication if you are allergic to buprenorphine or naloxone (Narcan), or if you have used another narcotic drug within the past 4 hours.
Before using buprenorphine, tell your doctor if you are allergic to any drugs, or if you have:
asthma, COPD, sleep apnea, or other breathing disorders;
mental illness or a history of suicide attempt;
a history of alcoholism or IV drug use; or
a history of seizures, head injury, or brain tumor.
If you have any of these conditions, you may not be able to receive buprenorphine injection, or you may need a dosage adjustment or special tests during treatment.FDA pregnancy category C. This medication may be harmful to an unborn baby. It could also cause addiction or withdrawal symptoms in a newborn if the mother receives buprenorphine injection during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Buprenorphine passes into breast milk and may be harmful to a nursing baby. It may also decrease breast milk production. Do not receive buprenorphine injection if you are breast-feeding a baby.
Buprenorphine injection is given through a needle placed into a muscle. You will most likely receive this injection in a clinic or hospital setting. The medicine must be given slowly and can take up to 2 minutes to inject.
To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.You may have withdrawal symptoms when you stop receiving buprenorphine after using it over a long period of time. Do not stop using this medication suddenly unless your doctor instructs you to. You may need to use less and less before you stop the medication completely.
Since buprenorphine injection is usually given by a healthcare provider, it is unlikely that you will miss a dose.
Symptoms of a buprenorphine overdose may include slowed breathing, extreme weakness, cold or clammy skin, small pupils, fainting, and coma.
Using buprenorphine injection together with other drugs that cause drowsiness can slow the functions of your breathing and central nervous system to dangerous levels. These effects could result in a fatal overdose.Avoid drinking alcohol, which can increase some of the side effects of buprenorphine injection. Using too much of this medicine in addition to drinking alcohol can cause death. Buprenorphine injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Like other narcotic medicines, buprenorphine injection can slow your breathing. Death may occur if breathing becomes too weak.Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
slow or shallow breathing;
feeling light-headed, fainting;
confusion, unusual thoughts or behavior; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may be more likely to occur, such as:
stomach pain, nausea, vomiting, constipation;
warmth or tingly feeling;
sleep problems (insomnia); or
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Opiate Dependence:
Initial dose: 8 mg sublingually on day 1.Maintenance dose: Rapidly titrate to the recommended target dose of 16 mg/day. In clinical trials, patients received 8 mg on day 1 and 16 mg on day 2 and thereafter. Further dose adjustments may be made in 2 mg to 4 mg increments up to a level that suppresses opioid withdrawal symptoms and holds the patient in treatment. The usual daily range is 4 mg to 24 mg sublingually.The tablets should be placed under the tongue at the same time and allowed to dissolve. If patients are taking more than 2 tablets per dose and cannot hold more than 2 under the tongue comfortably, they should use 2 tablets at a time, allowing them to dissolve completely before taking more tablets.For patients taking heroin or short-acting opioids, the first dose should be administered at least 4 hours after the patient last used opioids or preferably when early withdrawal symptoms appear. Withdrawal symptoms may occur during buprenorphine induction treatment of patients taking methadone or long-acting opioids, especially high opioid doses or when buprenorphine is administered shortly after the last opioid dose. The optimal time for the first dose has not been reported.The optimal method of tapering to discontinuation has not been reported.
Usual Adult Dose for Pain:
0.3 mg slow IM or IV every 6 hours as needed. May repeat once 30-60 minutes after the initial dose. Maximum single dose: 0.6 mg (IM only).
Usual Pediatric Dose for Pain:
<2 years: Safety and effectiveness have not been established.2-12 years: 2-6 mcg/kg IM or slow IV every 4-6 hours.13-18 years: 0.3 mg IM or slow IV every 6 hours; may repeat dose in 30-60 minutes.
Before receiving buprenorphine injection, tell your doctor if you use any of the following drugs:
an antifungal antibiotic such as fluconazole (Diflucan), ketoconazole (Nizoral), itraconazole (Sporanox), or voriconazole (Vfend);
an antibacterial antibiotic such as azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Ery-Tab, Erythrocin), or telithromycin (Ketek);
HIV medication such as nevirapine (Viramune), delavirdine (Rescriptor), efavirenz (Sustiva), indinavir (Crixivan), ritonavir (Norvir), saquinavir (Invirase), or nelfinavir (Viracept);
rifampin (Rifadin, Rifater, Rifamate, Rimactane);
a sedative such as diazepam (Valium), midazolam (Versed), alprazolam (Xanax) lorazepam (Ativan), clorazepate (Tranxene), triazolam (Halcion), flurazepam (Dalmane), or temazepam (Restoril); or
seizure medication such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), phenobarbital (Luminal, Solfoton), and others.
If you are using any of these drugs, you may not be able to receive buprenorphine injection, or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect buprenorphine injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.