|Buprenorphine parenteral (Buprenex) || ||300 mcg intravenously slowly once, may be repeated after 30–60 minutes once; or 600 mcg intramuscularly once || ||300 mcg intravenously slowly once, may be repeated after 30–60 minutes once; or 600 mcg intramuscularly once $18.20/300 mcg || || || || |
|Buprenorphine transdermal (BuTrans®) ||Not available ||Not available || |
Not available orally.
Transdermal doses available: 5, 10, and 20 mcg/h. Initiate 5 mcg/h patch for opioid-naïve patients (may currently be using nonopioid analgesics); $120.80/10 mcg/h
|Not available ||Not available ||Not available || |
analgesia; may be initiated in opioid-naïve patients with 5 mcg/h.
Can titrate up dose by 5 mcg/h after 72 hours, to a maximum dose of 20 mcg/h.
Concomitant use of other opioids for acute pain could be difficult due to strong receptor binding of buprenorphine, although this is often not found in clinical practice.
|Buprenorphine sublingual (Belbuca®) ||Sublingual strip approved for pain || || |
In opioid-naive or opioid-intolerant patients, individualize dose every 12 h. Start: 75 mcg buccally every 12–24 h for at least 4 days, then increase to 150 mcg buccally every 12 h, then may increase by no more than 150 mcg buccally every 12 h no more frequently than every 4 days.
Maximum: 900 mcg/12 h;
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Used by pain management specialists.
Do no cut, chew, swallow strip. Taper slowly to discontinue.
Use lowest effective dose, shortest effective treatment duration. Titrate slowly ...