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Buprenorphine is indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. Buprenorphine is available under the following different brand names:

Suboxone. Buprenorphine, sold under the brand name Suboxone, among others, is an opioid used to treat opioid addiction, acute pain, and chronic pain. It can be used under the tongue, by injection, as a skin patch, or as an implant. For opioid addiction, it is typically only started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a health care provider.

For the longer-term treatment of addiction, a combination formulation of buprenorphine/naloxone (Suboxone) is recommended to discourage misuse by injection. Maximum pain relief is generally within an hour with effects up to 24 hours.

Uses

Buprenorphine is used to treat dependence/addiction to opioids (narcotics). Buprenorphine belongs to a class of drugs called mixed opioid agonist-antagonists. It helps prevent withdrawal symptoms caused by stopping other opioids. It is used as part of a complete treatment program for drug abuse (such as compliance monitoring, counseling, behavioral contract, lifestyle changes).

Limitations of Use

Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses reserve buprenorphine for use in patients for whom alternative treatment options [e.g., non-opioid analgesics or opioid combination products]:

• Have not been tolerated, or are not expected to be tolerated
• Have not provided adequate analgesia, or are not expected to provide adequate analgesia

Side Effects

Side effects may include respiratory depression (decreased breathing), sleepiness, adrenal insufficiency, QT prolongation, low blood pressure, allergic reactions, and opioid addiction. Among those with a history of seizures, there is a risk of further seizures.

Opioid withdrawal following stopping buprenorphine is generally less severe than with other opioids. It is unclear if use during pregnancy is safe and use while breastfeeding is not recommended. Buprenorphine affects different types of opioid receptors in different ways. Depending on the type of receptor it may be an agonist, partial agonist, or antagonist.

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