buprenorphine hydrochloride

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buprenorphine hydrochloride

Buprenex, Burinex (UK), Subutex, Temgesic (UK), Transtec (UK)

Pharmacologic class: Opioid agonist-antagonist

Therapeutic class: Opioid analgesic

Controlled substance schedule III

Pregnancy risk category C


Unclear. May bind to opiate receptors in CNS, altering perception of and response to painful stimuli while causing generalized CNS depression. Also has partial antagonist properties, which may lead to opioid withdrawal effects in patients with physical drug dependence.


Injection: 300 mcg (0.3 mg)/ml

Tablets (sublingual): 2 mg, 8 mg

Indications and dosages

Moderate to severe pain

Adults: 0.3 mg I.M. or slow I.V. q 6 hours as needed. Repeat initial dose after 30 to 60 minutes.

Children ages 2 to 12: 2 to 6 mcg (0.002 to 0.006 mg)/kg I.M. or slow I.V. q 4 to 6 hours

Opioid dependence

Adults: 12 to 16 mg/day S.L.

Dosage adjustment

• Elderly patients


• Hypersensitivity to drug

• Elderly patients

• MAO inhibitor use within 14 days


Use cautiously in:

• increased intracranial pressure (ICP); respiratory impairment; severe renal, hepatic, or pulmonary disease; hypothyroidism; adrenal insufficiency; undiagnosed abdominal pain; prostatic hypertrophy; systemic lupus erythematosus; gout; kyphoscoliosis; diabetes mellitus; alcoholism

• elderly patients

• pregnant or breastfeeding patients

• children younger than age 13.


• Mix with lactated Ringer's injection, dextrose 5% in water, or normal saline solution.

Give I.V. dose slowly over no less than 2 minutes. Drug may cause respiratory depression (especially initial dose).

• When giving I.M., rotate injection sites to prevent induration and abscess.

• If patient is immobilized, reposition him frequently and keep head of bed elevated.

Adverse reactions

CNS: confusion, malaise, hallucinations, dizziness, euphoria, headache, unusual dreams, psychosis, slurred speech, paresthesia, depression, tremor, agitation, seizures, coma, increased ICP

CV: hypertension, hypotension, palpitations, tachycardia, Wenckebach (Mobitz Type 1) block, bradycardia

EENT: blurred vision, diplopia, amblyopia, miosis, conjunctivitis, tinnitus

GI: nausea, vomiting, constipation, flatulence, ileus, dry mouth

GU: urinary retention

Respiratory: hypoventilation, dyspnea, cyanosis, apnea, respiratory depression

Skin: diaphoresis, pruritus

Other: physical or psychological drug dependence, drug tolerance


Drug-drug. Antidepressants, antihistamines, sedative-hypnotics: additive CNS depression

MAO inhibitors: increased CNS and respiratory depression, increased hypotension

Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• Check hepatic function before and during therapy.

• Monitor respiratory status throughout therapy. Respiratory rate of 12 breaths/minute or less may warrant withholding dose or decreasing dosage.

Patient teaching

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure drop.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Advise patient to increase daily fluid intake to help prevent constipation.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved
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Procedures: Buprenorphine hydrochloride (0.3 mg/mL) at each of 3 doses (0.6, 1.2, and 1.8 mg/kg) and saline (0.9% NaCl) solution (control treatment) were administered intramuscularly to birds in a randomized within-subject complete crossover study.
Source: Methadone hydrochloride (22); buprenorphine extended-release (23); buprenorphine and naloxone (24); buprenorphine (25); buprenorphine hydrochloride (26); naltrexone hydrochloride (27); buprenorphine and naloxone (28); naltrexone extended-release (29); US Food and Drug Administration.
These results are consistent with a previous study evaluating buprenorphine hydrochloride in American kestrels; however, the small number of males (n = 4) in both studies prevent the authors from drawing a final conclusion concerning a potential difference attributable to sex.
The same findings were reported in the similar study evaluating the standard buprenorphine hydrochloride formulation, (13) and thus baseline thermal threshold should be considered a fixed variable in future studies with similar analgesic models.
The companies added Buprenorphine Hydrochloride Sublingual Tablets is the generic version of Reckitt Benckiser's Subutex Sublingual Tablets.
In addition, the company has received the final approval from the US Food and Drug Administration (FDA) for the Abbreviated New Drug Application (ANDA) of Buprenorphine Hydrochloride Sublingual Tablets for the treatment of opioid dependence.
Pharmacokinetics of buprenorphine hydrochloride following intramuscular and intravenous administration to American kestrels (Falco sparverius).
Objective--To evaluate the thermal antinociceptive effects and duration of action of buprenorphine hydrochloride after IM administration to American kestrels (Falco sparverius).
Conclusion and Clinical Relevance--At the doses tested, buprenorphine hydrochloride resulted in thermal antinociception in American kestrels for at least 6 hours, which suggested that buprenorphine has analgesic effects in this species.