All About Buprenex

What is Buprenex?

If you have severe pain that requires an opioid drug, your doctor may prescribe Buprenex.* But before prescribing Buprenex, your they will have you try other pain relievers first. If those treatments don’t provide relief, if they cause too many side effects, or if they cause serious side effects, Buprenex may be an option for you.

Buprenex is used to relieve severe pain in adults and in some children. To learn more, see the “Is Buprenex used for pain?” section below.

* It’s possible that Buprenex may not be available in your area. To check whether it’s available, talk with your doctor or pharmacist.

Buprenex basics

Buprenex is a partial opioid agonist that contains the active ingredient buprenorphine. The drug comes as a liquid solution. You’ll receive Buprenex from your doctor in one of the following ways:

• an intravenous infusion, which is an injection into a vein over a period of time
• an injection into a muscle

Buprenex is available in a generic form. You may choose to receive the generic or brand-name version. If you’re comparing Buprenex versus buprenorphine, note that both work well and are safe to use.

Read on to learn more about Buprenex’s side effects, dosage, and more.

What are Buprenex’s side effects?

Like most drugs, Buprenex may cause mild or serious side effects. The lists below describe some of the more common side effects that Buprenex may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Buprenex. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Buprenex can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Buprenex’s prescribing information.

Mild side effects that have been reported with Buprenex use include:

• constipation*
• sedation (feeling drowsy and less alert than usual)*
• nausea
• dizziness

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects of Buprenex can occur, but they aren’t common. If you have serious side effects, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects that have been reported with Buprenex use include:

• boxed warnings*:
  • addiction and misuse
  • life threatening respiratory depression (slow, ineffective breathing)
  • neonatal opioid withdrawal syndrome (symptoms of opioid withdrawal in a newborn)
• severe hypotension (low blood pressure)
• adrenal insufficiency (low levels of certain hormones)
• severe constipation
• allergic reaction*

* For more information about these side effects, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects that Buprenex may cause.

Boxed warnings

Buprenex has boxed warnings. These are serious warnings from the Food and Drug Administration (FDA) about drug effects that may be dangerous. Boxed warnings for Buprenex include:

Addiction and misuse. Buprenex is an opioid. This means the drug can lead to opioid addiction and misuse, which can cause overdose and, in some cases, death.

Life threatening respiratory depression. Buprenex may affect your breathing. Some people have experienced serious, life threatening, and, in some cases, fatal respiratory depression (slow, ineffective breathing) while using Buprenex. These problems may occur at any time during the treatment. But your risk is highest when you first start having Buprenex treatment. Your risk is also increased if your doctor raises your dose.

Neonatal opioid withdrawal syndrome. You can use Buprenex if you’re pregnant. But long-lasting use throughout pregnancy can result in withdrawal symptoms in your newborn. Withdrawal symptoms may include a high-pitched cry, trouble gaining weight, and shaking. Neonatal opioid withdrawal syndrome can be life threatening if not treated quickly.

What might help

You’ll receive Buprenex at a hospital or clinic. Your doctor will take certain steps to help prevent the risks associated with Buprenex treatment. These steps may include:

• For addiction and misuse: Before prescribing Buprenex, your doctor will assess your risk for addiction or misuse. During your treatment, they will continue to regularly monitor you for this risk. Your doctor may stop prescribing Buprenex if you show signs of addiction or misuse.
• For life threatening respiratory depression: While you’re having Buprenex, your doctor will check your breathing on a regular basis. Your risk for respiratory depression (slow, ineffective breathing) will increase when you first start using Buprenex and if your dose increases. After your receive your first dose, your doctor will closely monitor your breathing for 24 to 72 hours.
• For neonatal opioid withdrawal syndrome: If you’re pregnant, talk with your doctor about the benefits and risks of Buprenex treatment. If you use Buprenex for an extended period during pregnancy, your newborn may need treatment for neonatal opioid withdrawal syndrome. This treatment needs to be readily available at the time of delivery. Some options may include methadone, morphine, and buprenorphine.

Constipation

Constipation is a common side effect reported by people using Buprenex. The drug reduces the movement of food and liquids through your stomach and intestines. This can affect how quickly your body digests food and how easy it is for you to pass stool.

What might help

Your doctor can tell you how to prevent and manage constipation while using Buprenex. To prevent constipation during your Buprenex treatment, your doctor may recommend:

• adding more fiber to your diet
• drinking plenty of water each day
• exercising regularly

Your doctor may also recommend taking a stimulant laxative to help manage constipation. Stimulant laxatives include senna (Ex-Lax) or bisacodyl (Dulcolax). Stimulant laxatives might be prescribed with or without a stool softener, such as docusate sodium (Colace).

You can also try using an osmotic laxative, such as polyethylene glycol (MiraLAX). This type of laxative treats constipation by drawing water into the bowels, which helps soften stool.

It’s important to note that you shouldn’t take bulk-forming laxatives (such as psyllium) during your Buprenex treatment. These laxatives can make constipation worse if you’re taking an opioid such as Buprenex.

In some cases, severe constipation may occur with Buprenex. If you experience severe constipation, call your doctor. They may prescribe a drug such as methylnaltrexone (Relistor) to treat this issue or suggest that you have medical care.

Sedation

Sedation is the most common side effect of Buprenex. It involves feeling drowsy and less alert than usual. Although people in clinical studies experienced sedation while using Buprenex, it was easy for them to wake up and become alert.

Sedation can become a problem if you combine certain drugs or substances with Buprenex. These include benzodiazepines, alcohol, or other substances affecting areas of the brain that control breathing.

What might help

If you experience sedation with Buprenex, you shouldn’t drive or operate heavy machinery until this side effect has passed and you feel alert again. If you need to take any other medication that causes sedation, talk with your doctor first. They can tell you which medications are safe to take with Buprenex.

Allergic reaction

Some people may have an allergic reaction to Buprenex. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth or redness/deepening of skin color for a brief time)
• hives (swollen, pink, and itchy bumps on your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Buprenex. But if you think you’re having a medical emergency, call 911 or your local emergency number.

How is Buprenex given?

Your doctor will decide how you’ll receive Buprenex. They’ll also explain how much you’ll receive and how often. Be sure to follow any instructions from your doctor. The information below describes how doses are given.

Receiving Buprenex

Buprenex comes as a liquid solution. Your doctor will give you Buprenex either as an intravenous (IV) infusion, which is an injection into your arm over a period of time, or as an injection into a muscle.

You’ll receive Buprenex at a hospital or clinic. Your doctor will take certain measures to make sure you receive the drug safely. You’ll receive doses of Buprenex up to 6 hours apart, as needed. If your pain is not better after 30 to 60 minutes, your doctor may give you a second dose. The frequency of your doses will depend on how well Buprenex relieves your pain. It will also depend on other factors, such as other health conditions you have and other medications you’re taking.

Children between the ages of 2 and 12 years may receive doses every 4 to 6 hours.

Dosage

Your doctor will prescribe the lowest effective dose for the shortest amount of time to manage your pain. Each person will receive a different starting dose, depending on:

• the severity of their pain
• their experience with other pain relievers
• their risk factors for addiction and misuse

Receiving Buprenex with other drugs

Your doctor may prescribe the lowest dose of Buprenex if you’re taking other medications that affect your breathing or alertness. If you have questions about using Buprenex with other drugs, talk with your doctor.

Questions about receiving Buprenex

Below are some common questions about using Buprenex.

• What if I miss a dose of Buprenex? Your doctor will give you each dose of Buprenex. If you miss an appointment, you should call their office right away to reschedule.
• Will I need to use Buprenex long term? No, you won’t use Buprenex long term. Your doctor will prescribe the lowest effective dose of Buprenex for the shortest time possible. If you need long-term pain relief, your doctor may suggest a different medication instead.
• Should I have Buprenex with food? You can have Buprenex with or without food. You’ll receive the drug through injections into a muscle or as an IV infusion. Eating won’t have an effect on how Buprenex is absorbed.
• How long does Buprenex take to work? It depends on how you receive the drug. When injected into a muscle, Buprenex may start working within 15 minutes. The effect can last for 6 hours or longer. If you’re receiving Buprenex through an IV infusion, you’ll experience faster pain relief.

Questions for your doctor

You may have questions about Buprenex and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

• Before your appointment, write down questions like:
  • How will Buprenex affect my body, mood, or lifestyle?
• Bring someone with you to your appointment if doing so will help you feel more comfortable.
• If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare providers are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

What does Buprenex cost?

Costs of prescription drugs can vary, depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices of Buprenex in your area, visit WellRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit MedicineAssistanceTool.org to see if they offer cost-assistance options for this drug.

What are some frequently asked questions about Buprenex?

Find answers to some commonly asked questions about Buprenex.

How long does Buprenex last in your system?

If you receive Buprenex by injection into a muscle, the drug’s effect lasts for at least 6 hours. If you receive an intravenous infusion (an injection into a vein over a period of time), the drug’s effect will last for a shorter time. The drug will also be removed from your system faster. However, it will start to work faster. On average, Buprenex is eliminated from your system in 8 to 10 hours.

Will Buprenex make me feel ‘high’?

Yes, it’s possible to feel high during or after Buprenex treatment. Buprenex contains an active ingredient called buprenorphine, which is an opioid. Opioids have a warning for addiction and misuse. Your doctor will prescribe the lowest possible dosage. But addiction and misuse can occur even at recommended dosages.

If you’ve experienced addiction or misuse of opioids or other substances, talk with your doctor before using Buprenex. Your doctor may still prescribe it, but they may recommend frequent counseling and close monitoring during your treatment.

Do I have to store Buprenex at home?

No, you will not keep Buprenex in your home. You’ll receive it at a hospital or clinic.

Is Buprenex used for pain?

Buprenex is used to treat severe pain in adults and in children ages 2 to 12 years who have previously tried other pain relievers. Buprenex can be used if past treatments didn’t provide enough relief or if they caused too many side effects or any serious side effects.

Buprenex is a partial opioid agonist, which is a type of drug that helps relieve pain. It works by targeting pain receptors (a type of protein) in the brain and provides pain relief.

When you’ve been injured, your body uses these pain receptors to send a signal to your brain that you’re hurt. Then your brain allows you to start feeling the pain. When Buprenex targets the pain receptors, it changes the message that your brain receives and the way your body feels the pain. This allows you to not feel the pain as strongly as you would have.

If you have questions about how Buprenex is used to treat pain, talk with your doctor or pharmacist.

What should be considered before using Buprenex?

Some important things to discuss with your doctor when considering treatment with Buprenex include your overall health and any medical conditions you have.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before using Buprenex, be sure to tell your doctor about all medications you take ( including prescription and over-the-counter types). Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Buprenex..

Interactions with drugs or supplements

Buprenex can interact with several types of drugs. These include:

• benzodiazepines, such as lorazepam (Ativan) and oxazepam (Serax)*
• antidepressants, such as citalopram (Celexa), venlafaxine (Effexor), amitriptyline (Elavil), and phenelzine (Nardil)
• antibiotics, such as erythromycin (Erythrocin) and rifampin (Rifadin)
• HIV drugs, such as efavirenz (Sustiva) and ritonavir (Norvir)

This list does not contain all types of drugs that may interact with Buprenex. Your doctor or pharmacist can tell you more about these interactions and any others that may occur.

Boxed warnings

Buprenex has four boxed warnings. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

Boxed warnings for Buprenex include:

• Addiction and misuse.*
• Life threatening respiratory depression (slow, ineffective breathing).*
• Neonatal opioid withdrawal syndrome (symptoms of opioid withdrawal in a newborn).*
• Risks of use with benzodiazepines or other central nervous system (CNS) depressants. Using CNS depressants (including alcohol and certain prescription drugs) with Buprenex may slow down your CNS to a dangerous degree. This can lead to extreme sleepiness, severe breathing problems, coma, and in some cases, death. Before receiving Buprenex, tell your doctor if you’re using a benzodiazepine or another CNS depressant. They’ll monitor you more closely during your Buprenex treatment.

* For more information about this boxed warning, see the “What are Buprenex’s side effects?” section above.

Other warnings

Buprenex may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you use Buprenex. Factors to consider include:

• Significant breathing problems. Buprenex can affect your breathing. If you already have a condition that affects your breathing, such as chronic obstructive pulmonary disease or asthma, using Buprenex may make these conditions worse.
• Allergic reaction. If you’ve had an allergic reaction to Buprenex or any of its ingredients, you shouldn’t use Buprenex. Ask your doctor what other medications are better options for you.
• Diseases in your digestive system. If you have a blockage in your digestive system, using Buprenex may worsen your condition. For example, Buprenex can cause spasms in your sphincter of Oddi (a muscle that releases digestive proteins from your pancreas into your small intestine). This can lead to pancreatitis (inflammation in your pancreas).

Use with alcohol

Alcohol affects certain functions of your brain. This means it can be dangerous to drink alcohol while receiving Buprenex treatment. Doing so could cause serious side effects. These include deep sedation (a state of decreased consciousness when you’re not easily awakened), serious breathing problems, coma, and in some cases, death.

If you have questions about the risks of drinking alcohol while receiving Buprenex, talk with your doctor.

Pregnancy and breastfeeding

If you’re pregnant, long-term use of Buprenex may cause neonatal opioid withdrawal syndrome. With this condition, newborns experience symptoms of opioid withdrawal. Neonatal opioid withdrawal syndrome can be life threatening if doctors don’t treat it quickly.

If you’re taking Buprenex for a long period of time during pregnancy, it’s important to be aware of the risks to the fetus. Your doctor should be prepared to provide treatment for neonatal opioid withdrawal syndrome at delivery, if needed.

You should not breastfeed your child during Buprenex treatment. Studies show that buprenorphine (the active ingredient in Buprenex) can pass into breast milk when the drug is in sublingual tablet form. (A sublingual medication is one that dissolves under your tongue.)

Although Buprenex doesn’t come as a sublingual tablet, there may also be a risk of its active ingredient passing into breastmilk.

If you are breastfeeding your child, talk with your doctor. They can suggest a different medication to treat your pain.

Can Buprenex be misused?

Buprenex can be misused because it’s an opioid. And using opioids can make you more likely than others to experience addiction and misuse. Buprenex is a controlled substance, so even at recommended doses, there’s still a risk of addiction and misuse. Before your doctor prescribes it, they’ll review your health history and assess your risk. They’ll also monitor you closely while you’re receiving the drug.

What should be done in case of overdose?

Having too much Buprenex can cause very serious side effects. For this reason, your doctor will carefully determine your Buprenex dosage. This is especially important when switching from another opioid, which can be fatal if the first Buprenex dose is too high.

Symptoms of overdose

Symptoms of overdose can include:

• severe breathing problems
• drowsiness leading to coma
• muscle weakness
• snoring
• cold and clammy skin
• small pupils
• fluid buildup in the lungs
• slow heartbeat
• low blood pressure
• blocked airway
• death

What to do in case you receive too much Buprenex

If you’re given too much Buprenex, your doctor will carefully monitor your breathing. If you’re having breathing problems, your doctor might give you medication or other treatments. Keep in mind that these problems are rare, and your doctor is trained to give you the appropriate amount of a drug.

What to ask your doctor

If you have questions about using Buprenex, talk with your doctor or pharmacist. Your doctor can tell you about other treatment options for your condition. Below are some articles you might find helpful.

• Pain Relief Basics
• 5 Surprising Natural Painkillers

Some questions to ask your doctor about Buprenex may include:

• Can I use natural painkillers with Buprenex?
• Can I use buprenorphine patches instead of receiving the drug as an injection or infusion?
• Which alternative pain relievers can I use instead of Buprenex if I’m pregnant?
• If I don’t experience pain relief with Buprenex, what are my other treatment options?