
Buprenorphine - Pain
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Status 1
- Patches
Prescribe by brand. Care: available as 3-day, 4-day and 7-day patches. Refer to Trust / Primary Care Pharmacy advice for locally preferred brands
BuTec is the locally preferred brand for 7-day patches.
Status 2
- Sublingual tablets
Documentation
PAD Profile
Other Indications
Below are listed other indications that Buprenorphine is used to treat.
Other Drugs
Below are listed other drugs that are used to treat Pain .
- Alfentanil hydrochloride
- Aspirin
- Cannabis (medicinal)
- Co-codamol
- Co-dydramol 10/500
- Co-dydramol 20/500
- Co-dydramol 30/500
- Co-proxamol (Dextropropoxyphene hydrochloride/para
- Codeine phosphate
- Diamorphine hydrochloride
- Dihydrocodeine tartrate
- Fentanyl
- Gabapentin
- Ibuprofen
- Ketamine
- Meptazinol hydrochloride
- Methoxyflurane
- Morphine sulfate
- Nefopam hydrochloride
- Oxycodone
- Oxycodone with naloxone
- Paracetamol
- Pethidine hydrochloride
- Pregabalin
- Sufentanil
- Tramadol hydrochloride
- Tramadol with Dexketoprofen
- Tramadol with paracetamol
- Ziconotide acetate
Committee Recommendations (2)
A stepped approach to pain management is recommended. Paracetamol is considered a 1st line option for the treatment of pain.
Sub-lingual / buccal - consider for use patients who are unable to tolerate standard codeine/ dihydrocodeine tablets or capsules or if morphine is contra-indicated. Note added Jnauary 2025 - If this formulation is indicated, prescribing may be initiated and stabilised by a specialist service but has the potential to transfer to primary care WITHOUT a formal shared care agreement. In some circumstances a specialist may recommend that prescribing can be started in primary care.
Patches - (low dose) for use in the limited number of patients who are unable to tolerate oral medications or if morphine is contra-indicated. Higher dose buprenorphine patches are not included in the pathway within this guideline and have a limited place in therapy for persistent non-malignant pain.
Please refer to the guidelines.
Consider a patient agreement is completed by the patient (see below) prior to a trial of Buprenorphine.
It is recommended that buprenorphine patches are prescribed by BRAND - see UKMI Branded Prescribing Recommendations document. The locally preferred brand for buprenorphine 7-day patches is Butec® Butec® is available across all of the dose ranges, already represents the most commonly prescribed brand nationally (>50%), and is considerably less costly than the originator brand BuTrans. Patients currently receiving generically written prescriptions should be reviewed with a view to change the prescribing to a cost-effective brand.