Buprenorphine

Buprenorphine is a medication primarily used in the treatment of opioid addiction and for managing moderate to severe pain. It belongs to the class of drugs known as opioid partial agonists, which means it activates opioid receptors in the brain but to a lesser extent than full opioid agonists like morphine or heroin. This characteristic makes buprenorphine effective in reducing opioid cravings and withdrawal symptoms without producing the same level of euphoria or respiratory depression. It is a synthetic thebaine congener, highly lipid soluble and 25 times more potent than morphine. It has a slower onset and longer duration of action.

Indications

Moderate to severe pain, cancer pain, pre-medication, postoperative pain & myocardial infarction.

Dosage

-Dosage varies depending on the indication and individual patient factors. For opioid addiction treatment, initial doses typically range from 2-4 mg sublingually, with adjustments made based on response and tolerance. In pain management, doses may be higher and administered via different routes, such as sublingual, transdermal, or intravenous, under the guidance of a healthcare professional. -200-400 mcg sublingually 6-8 hrly or as required. 0.3-0.6 mg I.M or slow I.V. injection every 6-8 hrs Max. : 1.8 mg.

Contra-Indications

Buprenorphine is contraindicated in individuals with a known hypersensitivity to the medication, as well as in patients with severe respiratory insufficiency, acute respiratory depression, and certain cases of severe liver impairment.

Special Precautions

Hepatic dysfunction, narcotic addicts. Labour, Impaired respiratory functions. Avoid driving or operating machinery. Paediatrics: Not recommended. Pregnancy: Contraindicated. Lactation: Use if clearly indicated. Elderly:Adverse effects may increase, use with caution.

Side Effects

Sedation, vomiting, miosis, subjective and cardiovascular effects. Postural hypotension, respiratory depression, dizziness, sweating

Drug Interactions

-Buprenorphine may interact with other medications that affect the central nervous system, including benzodiazepines, alcohol, sedatives, and certain antidepressants. Combining these drugs can potentiate respiratory depression and increase the risk of overdose. Patients should inform their healthcare providers about all medications they are taking before starting buprenorphine therapy. -Potentiation with alcohol, other CNS depressants and MAOIs. Diazepam may produce respiratory and cardiac collapse. May precipitate withdrawal in narcotic addicts.