WARNING

Butrans is a prescription medication containing the active ingredient buprenorphine, which is an opioid used to manage moderate to severe chronic pain. Like all opioids, Butrans carries certain risks, including:

• Addiction: There is a risk of developing physical and psychological dependence on Butrans, especially with long-term use or misuse.
• Respiratory depression: Butrans can cause slowed or shallow breathing, particularly in high doses or when combined with other central nervous system depressants like alcohol or benzodiazepines. This effect can be life-threatening.
• Sedation and drowsiness: Butrans can cause drowsiness, dizziness, and impair cognitive and motor functions, affecting the ability to drive or operate machinery safely.
• Withdrawal symptoms: Abruptly stopping Butrans after long-term use can lead to withdrawal symptoms such as nausea, vomiting, diarrhea, sweating, anxiety, and insomnia.
• Overdose: Taking too much Butrans can lead to overdose, which can be fatal. Symptoms of overdose include extreme drowsiness, slowed or stopped breathing, unconsciousness, and coma.
• Misuse and abuse: Butrans is sometimes misused or abused by individuals seeking its euphoric effects. This can increase the risk of overdose, addiction, and other adverse effects.
• Hypersensitivity reactions: Some individuals may experience allergic reactions to Butrans, which can manifest as skin rash, itching, swelling, or difficulty breathing.

It’s important to use Butrans exactly as prescribed by a healthcare provider and to be aware of these risks. Patients should discuss any concerns or side effects with their healthcare provider promptly.

Why is this medication prescribed?

Butrans is prescribed to manage moderate to severe chronic pain in patients who require continuous, around-the-clock opioid treatment for an extended period and cannot be managed adequately with other pain medications. It contains buprenorphine, which is a partial opioid agonist-antagonist. This means it binds to opioid receptors in the brain, producing pain relief and, to some extent, reducing the euphoric effects and potential for misuse compared to full opioid agonists like morphine or oxycodone.

How should this medicine be used?

Butrans should be used exactly as prescribed by a healthcare provider. Here are some general guidelines for its use:

• Dosage: The dosage of Butrans is individualized based on factors such as the severity of pain, previous opioid use, and the patient’s response to treatment. It is typically started at a low dose and adjusted gradually to achieve adequate pain control with minimal side effects.
• Application: Butrans is a transdermal patch that is applied to clean, dry, hairless skin on the upper outer arm, upper chest, upper back, or the side of the chest. The site of application should be rotated with each new patch to minimize skin irritation.
• Frequency: The patch is usually applied once every 7 days (every week). It is important to change the patch at the same time each week to maintain a consistent level of medication in the body.
• Avoidance of heat: Patients should avoid exposing the Butrans patch to direct heat sources such as heating pads, hot tubs, saunas, or prolonged sunlight, as this can increase the absorption of the medication and may lead to overdose.
• Disposal: Used patches should be folded so that the adhesive side sticks to itself and then flushed down the toilet immediately to prevent accidental exposure or ingestion by children or pets.
• Monitoring: Patients using Butrans should be closely monitored for signs of effectiveness, side effects, and potential misuse or abuse. Dosage adjustments may be necessary based on individual response and tolerance.
• Discontinuation: Butrans should not be stopped abruptly, as this can lead to withdrawal symptoms. When discontinuing treatment, the dose should be tapered gradually under the guidance of a healthcare provider.

It’s crucial for patients to follow their healthcare provider’s instructions carefully and to report any concerns or adverse effects promptly.

Other uses for this medicine

As for other uses of Butrans, it’s primarily indicated for managing chronic pain. Off-label uses may exist, but using Butrans for purposes other than what it’s prescribed for should only be done under the guidance of a healthcare professional.

What special precautions should I follow?

Special precautions should be observed when using Butrans to ensure safe and effective treatment. Here are some key considerations:

• Medical history review: Before starting Butrans, healthcare providers should conduct a thorough review of the patient’s medical history, including any previous opioid use, substance abuse history, respiratory conditions, mental health disorders, and concurrent medications.
• Risk assessment: Patients should be assessed for their risk of opioid misuse, abuse, addiction, and respiratory depression. Butrans may not be suitable for individuals with a history of substance abuse, respiratory insufficiency, or certain mental health conditions.
• Dosage adjustment: Patients with hepatic impairment or renal impairment may require dosage adjustments when using Butrans. Additionally, elderly patients or those with compromised respiratory function may be more sensitive to the respiratory depressant effects of opioids and may require lower initial doses.
• Concomitant medications: Healthcare providers should evaluate potential drug interactions between Butrans and other medications the patient is taking, particularly central nervous system depressants such as benzodiazepines, sedatives, hypnotics, or alcohol, as these can potentiate the respiratory depressant effects of Butrans.
• Pregnancy and breastfeeding: Butrans should be used with caution in pregnant or breastfeeding women, as opioids can cross the placenta and transfer into breast milk, potentially causing respiratory depression or withdrawal symptoms in newborns.
• Monitoring: Patients using Butrans should be closely monitored for signs of effectiveness, side effects, and misuse. Regular follow-up appointments with healthcare providers are important to assess the need for dose adjustments and to address any concerns or adverse effects promptly.
• Storage and disposal: Butrans patches should be stored securely out of reach of children and pets, as accidental exposure or ingestion can be fatal. Used patches should be disposed of properly by folding them so that the adhesive side sticks to itself and then flushing them down the toilet immediately.

By following these precautions and guidelines, healthcare providers can help ensure the safe and appropriate use of Butrans for patients with chronic pain or other medical conditions.

What special dietary instructions should I follow?

Regarding dietary instructions, there are no specific dietary restrictions associated with Butrans use. However, it’s essential to maintain a balanced diet and stay hydrated while using any medication, including Butrans.

What should I do if I forget a dose?

If a dose of Butrans is missed, it should be applied as soon as remembered, unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling up on doses to make up for a missed dose is not recommended, as it can increase the risk of overdose and other adverse effects. If unsure about what to do, it’s best to consult with a healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Butrans, like other opioid medications, can cause various side effects, ranging from mild to severe. Common side effects of Butrans may include:

• Nausea and vomiting: Gastrointestinal disturbances such as nausea and vomiting are common side effects of Butrans treatment, particularly when starting or adjusting the dosage.
• Constipation: Opioids like Butrans can slow down bowel movements, leading to constipation. It’s important for patients to maintain adequate hydration, dietary fiber intake, and physical activity to help prevent or alleviate constipation.
• Drowsiness and dizziness: Butrans can cause drowsiness, dizziness, and sedation, affecting cognitive and motor functions. Patients should avoid activities that require mental alertness, such as driving or operating machinery, until they know how Butrans affects them.
• Headache: Headaches are a common side effect reported by some individuals using Butrans. These headaches may vary in intensity and duration.
• Skin reactions: Some patients may experience skin reactions at the site of the Butrans patch application, such as redness, itching, rash, or irritation. Rotating the patch placement with each application may help minimize skin reactions.
• Insomnia: Difficulty sleeping or insomnia may occur in some individuals using Butrans, particularly during the initial stages of treatment or with dose adjustments.
• Sweating: Excessive sweating or diaphoresis is a common side effect of opioids like Butrans, especially at higher doses or in warmer environments.
• Respiratory depression: Although less common, Butrans can cause respiratory depression, particularly in high doses or when combined with other central nervous system depressants like alcohol or benzodiazepines. Respiratory depression can be life-threatening and requires immediate medical attention.
• Hypotension: Butrans may cause low blood pressure or hypotension, leading to symptoms such as dizziness, lightheadedness, or fainting.
• Hypersensitivity reactions: In rare cases, Butrans may cause allergic reactions or hypersensitivity reactions, which can manifest as skin rash, itching, swelling, or difficulty breathing. Immediate medical attention is necessary if any signs of a hypersensitivity reaction occur.

It’s essential for patients to be aware of these potential side effects and to report any persistent or bothersome symptoms to their healthcare provider. In some cases, dosage adjustments or alternative treatments may be necessary to manage side effects effectively.

What should I know about storage and disposal of this medication?

When it comes to storage and disposal of butrans patches, here’s what you should know:

• Storage: Butrans patches should be stored at room temperature away from moisture, heat, and light. Keep them in their original packaging and out of reach of children and pets.
• Disposal: After removing a used Butrans patch, fold it so that the adhesive side sticks to itself, and then flush it down the toilet immediately. This helps prevent accidental exposure or ingestion by children or pets. Do not dispose of Butrans patches in household trash where they could be accessed by others.

In case of emergency/overdose

If you suspect an overdose or encounter signs of Butrans overdose, such as extreme drowsiness, slowed or shallow breathing, unconsciousness, or coma, seek immediate medical attention by calling emergency services (such as 911 in the United States) or going to the nearest emergency room. Be prepared to provide information about the amount of Butrans used and any other substances taken.

What other information should I know?

• Inform healthcare providers about all medications, supplements, or herbal products you are taking, as Butrans can interact with certain medications, including other opioids, benzodiazepines, and central nervous system depressants.
• Avoid abruptly stopping Butrans without consulting your healthcare provider, as this can lead to withdrawal symptoms.
• Do not apply more than one Butrans patch at a time, and do not cut or alter the patches in any way, as this can lead to overdose or other adverse effects.
• Butrans may impair your ability to drive or operate machinery. Avoid such activities until you know how Butrans affects you.
• Do not drink alcohol while using Butrans, as it can increase the risk of respiratory depression and other side effects.
• Keep all appointments with your healthcare provider for monitoring and dose adjustments as needed.
• Store Butrans patches securely to prevent unauthorized use or accidental exposure.

Following these guidelines can help ensure safe and effective use of Butrans for managing chronic pain while minimizing the risk of adverse effects and accidental exposure. If you have any questions or concerns about Butrans, consult your healthcare provider or pharmacist for further guidance.