WARNING: ADDICTION, ABUSE, and MISUSE; LIFE-THREATENING RESPIRATORYDEPRESSION; ACCIDENTAL EXPOSURE; and NEONATAL OPIOID WITHDRAWAL SYNDROME
Addiction, Abuse, and Misuse
BUTRANS® exposes patients and other users
to the risks of opioid addiction, abuse, and misuse, which can lead
to overdose and death. Assess each patient’s risk prior to prescribing
BUTRANS, and monitor all patients regularly for the development of
these behaviors or conditions [see Warnings and Precautions and Overdosage].
Life-Threatening Respiratory Depression
Serious,
life-threatening, or fatal respiratory depression may occur with use
of BUTRANS. Monitor for respiratory depression, especially during
initiation of BUTRANS or following a dose increase. Misuse or abuse
of BUTRANS by chewing, swallowing, snorting or injecting buprenorphine
extracted from the transdermal system will result in the uncontrolled
delivery of buprenorphine and pose a significant risk of overdose
and death [see Warnings and Precautions ].
Accidental Exposure
Accidental exposure to
even one dose of BUTRANS, especially by children, can result in a
fatal overdose of buprenorphine [see Warnings and Precautions].
Neonatal Opioid Withdrawal Syndrome
Prolonged use of BUTRANS during pregnancy can result in neonatal
opioid withdrawal syndrome, which may be life-threatening if not recognized
and treated, and requires management according to protocols developed
by neonatology experts. If opioid use is required for a prolonged
period in a pregnant woman, advise the patient of the risk of neonatal
opioid withdrawal syndrome and ensure that appropriate treatment will
be available [see Warnings and Precautions].
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BUTRANS SUMMARY
BUTRANS is a transdermal system providing
systemic delivery of buprenorphine, a mu opioid partial agonist analgesic,
continuously for 7 days.
BUTRANS is indicated for the
management of pain severe enough to require daily, around-the-clock,
long-term opioid treatment and for which alternative treatment options
are inadequate.
Limitations of Use
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Because of the risks of addiction, abuse
and misuse with opioids, even at recommended doses, and because of
the greater risk of overdose and death with extended-release opioid
formulations, reserve BUTRANS for use in patients for whom alternative
treatment options (e.g., non-opioid analgesics or immediate-release
opioids) are ineffective, not tolerated, or would be otherwise inadequate
to provide sufficient management of pain.
-
BUTRANS is not indicated as an as-needed
(prn) analgesic
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NEWS HIGHLIGHTS
Published Studies Related to Butrans (Buprenorphine)
Neonatal outcomes and their relationship to maternal buprenorphine dose during
pregnancy. [2014] neonatal clinical outcomes... CONCLUSIONS: (1) Findings failed to support the existence of a dose-response
A randomized, double-blind evaluation of buprenorphine taper duration in primary
prescription opioid abusers. [2013] IMPORTANCE: Although abuse of prescription opioids (POs) is a significant public
health problem, few experimental studies have investigated the treatment needs of
this growing population. OBJECTIVE: To evaluate, following brief stabilization with a combination of
buprenorphine hydrochloride and naloxone hydrochloride dihydrate, the relative
efficacy of 1-, 2-, and 4-week buprenorphine tapering regimens and subsequent
naltrexone hydrochloride therapy in PO-dependent outpatients...
A randomised controlled trial of sublingual buprenorphine-naloxone film versus
tablets in the management of opioid dependence. [2013] (substance use, psychosocial function)... CONCLUSIONS: The study demonstrated dose equivalence and comparable clinical
Cocaine use reduction with buprenorphine (CURB): rationale, design, and
methodology. [2013] study... CONCLUSIONS: This research using 2 medications will demonstrate whether BUP,
Analgesia after feline ovariohysterectomy under midazolam-medetomidine-ketamine
anaesthesia with buprenorphine or butorphanol, and carprofen or meloxicam: a
prospective, randomised clinical trial. [2012] One hundred female cats undergoing routine ovariohysterectomy under
midazolam-medetomidine-ketamine anaesthesia were included in a blinded,
randomised, prospective clinical study to compare postoperative analgesia
produced by four analgesic drug combinations given preoperatively (n = 25 per
group)...
Clinical Trials Related to Butrans (Buprenorphine)
Butrans for Treatment of Restless Legs Syndrome [Withdrawn]
The primary objective of the study is to determine whether Butrans Transdermal System (BTDS)
reduces RLS symptom severity in patients with moderate to severe idiopathic RLS who are
naïve to opiate treatment.
The secondary objective of the study is to investigate the effects of BTDS on mood, sleep,
and quality of life.
The study will consist of nine visits. Depending on the need for medication titration, there
may also be two scheduled telephone contacts.
Visit 1: This is a screening visit to determine study eligibility. Eligible subjects who
choose to participate must undergo medication washout as described in the detailed protocol
between visits 1 and 2.
Treatment period #1 (Visits 2 - 5; day 0 - 28): Baseline measures will be recorded and
subjects randomized to treatment order at visit 2 (day 0). Study medication as well as
rescue medication (l-dopa, a non-blinded active treatment to be used within a limited dose
range as described in the detailed protocol) will be dispensed. Subjects will begin
treatment period #1 immediately after this. The study medication will be titrated within
the allowed range according to subject's reported symptoms during visit 3 (day 7), visit 4
(day 14), telephone contact (day 21). Visit 5 will occur on day 28 and will include
assessment of outcome measures for the first treatment period. Visit 5 will also mark the
beginning of the second treatment period.
Treatment period #2 (Visits 6 - 8; day 28 - 56): Procedures will be similar to those
described above during treatment period #1. Visit 8 will mark the end of the second
treatment period during which outcome measures will be ascertained.
Follow up visit (Visit 9; day 70): This will be a safety follow-up visit approximately two
weeks after visit 8 for review of adverse events.
Buprenorphine for the Treatment of Neonatal Abstinence Syndrome [Completed]
Neonatal abstinence syndrome is a disease that affects children who were exposed to opioid
drugs prior to birth. Commonly used treatments at present include morphine or tincture of
opium. Buprenorphine is a drug used in adults to treat narcotic dependence, but has not
been used for Neonatal Abstinence Syndrome. This trial is designed to see if the use of
sublingual (under the tongue) buprenorphine is able to be used safely and easily in newborns
with the neonatal abstinence syndrome. Secondary goals will be to see if treatment with
buprenorphine is associated shorter stays in the hospital and fewer days of treatment than
the use of standard therapy. Another secondary goal will be to understand buprenorphine
concentration in the blood of babies treated with the drug (this is called
"pharmacokinetics").
Preference for Subutex� (Buprenorphine) Versus Suboxone� (Buprenorphine/Naloxone) in Opioid Dependent Patients on Subutex� (Study P05094)(COMPLETED) [Completed]
This study is designed to determine if opioid dependent subjects who are already receiving
Subutex® prefer the Suboxone® tablet over the Subutex® tablet after switching from Subutex®
to Suboxone®. Subjects who are selected to participate in this study will continue their
prescribed dose of Subutex® (buprenorphine 2 to 16 mg daily) for the first two days of the
study (Day 1 and Day 2) then switch to and receive an equivalent dose of Suboxone®
(buprenorphine 2 to 16 mg daily) for the last 3 days of the study (Day 3, Day 4 and Day 5).
The Day 5 Visit will be the subject's last study visit. Upon completing the study, subjects
will continue their pre-study prescribed dosage of Subutex®.
A Six-Month Randomized Controlled Trial (RCT) of Probuphine Safety and Efficacy in Opioid Addiction [Completed]
Probuphine (buprenorphine implant) is an implant placed just below the skin containing
buprenorphine (BPN). BPN is an approved treatment for opioid dependence. This study will
confirm the efficacy of Probuphine vs. placebo and compare Probuphine treatment verses
treatment with sublingual buprenorphine in the treatment of patients with opioid dependence.
Disposition Effects of Cyclosporin on Buprenorphine [Recruiting]
The purpose of this study is to see how healthy volunteers bodies handle buprenorphine.
Reports of Suspected Butrans (Buprenorphine) Side Effects
Death (27),
Vomiting (22),
Nausea (22),
Pain (21),
Dyspnoea (20),
Headache (19),
Inadequate Analgesia (18),
Dizziness (16),
Drug Ineffective (14),
Somnolence (14), more >>
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Page last updated: 2014-11-30
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