Surrey Heartlands

Joint Formulary & PAD

Buprenorphine - Pain

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Status 1

Green (see narrative)
Formulations :
  • Patches
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
Restrictions / Comments :
Important
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
Documents :
 
Safety Information
Opioid Patch Safety: Counselling Checklist
Patient resource
Pain management - Prescription agreement (Patient) - May 24
Patient resource
Opioid Patch Information To Keep Patients Safe
Webpage
Brand-name Prescribing in Primary Care
 

Status 2

Blue
Formulations :
  • Sublingual tablets
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
Guidelines BNF SPC
CD
R
Restrictions / Comments :
Important
Use in patients unable to tolerate oral medications or where morphine is contra-indicated. 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

Documentation

Patient resource
Pain management - Prescription agreement (Patient) - May 24
Patient resource
Pain management - Prescription agreement (Patient) - June 2018.docx
Patient resource
Pain (Persistent) - Opioids -Patient Information - April 2018.docx
Information
Pain -Opioids - Assessment Tool- April 2018.docx

PAD Profile

ChemicalSubstance :
Buprenorphine
Indication :
Pain
Group Name :
Keywords :
opioid analgesics, analgesia, opioids,
Brand Names Include :
Temgesic, Tephine, Natzon, Prefibin, Subutex, Bunov, Bupramyl, Butec, BuTrans, Panitaz, Rebrikel, Reletrans, Sevodyne
Important Information :
Latest Additions Date From :
Latest Additions Date To :
Guidelines :
Pain
Supporting Documents :
8
Traffic Light Entries :
2

Other Indications

Below are listed other indications that Buprenorphine is used to treat.

  • No records returned.

Other Drugs

Below are listed other drugs that are used to treat Pain .

Committee Recommendations (2)

06 Jun 18 - Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

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.

07 Mar 18 - Surrey Medicines Commissioners Group

 

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.