Buprenorphine Patch | Side Effects, Dosage, Uses & More
Advertisement

Generic Name:

buprenorphine, Transdermal patch

All Brands

  • Butrans
SECTION 1 of 5

Highlights for buprenorphine

Transdermal patch
1

Buprenorphine transdermal patch is used to treat severe pain that requires constant opioid treatment.

2

This drug comes in the form of a patch you apply to your skin. This drug is also available as a sublingual tablet (a tablet that dissolves under your tongue) and a buccal film (a film you apply on the inside of your cheek). It also comes as an injection, which is only given by a healthcare provider.

3

The transdermal patch is only available as the brand-name drug Butrans. It isn’t available as a generic drug.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Addiction, abuse, and misuse warning. This drug can be addictive. It can increase your risk of addiction and drug abuse. This can lead to overuse and may be fatal (cause death).

Breathing problem warning. This drug may cause trouble breathing. This is most likely to happen when you first start taking it, during dosage increases, or if you take more of this drug than prescribed. Your doctor may monitor you closely when increasing your dosage of this medication. Make sure that you use this drug exactly as prescribed by your doctor.

Accidental exposure warning. If your child accidentally takes this medication, call 9-1-1 right away. Children have died from accidentally taking this drug. Store this drug out of the reach of children.

Withdrawal in newborns warning. Taking this medication during pregnancy may cause withdrawal symptoms in the newborn. To prevent this from happening, your doctor may decrease your dosage or stop your treatment with this drug before you deliver your baby. If you’re taking this drug during pregnancy, your doctor will monitor you closely.

Physical dependence

This drug can cause physical dependence. This is different from drug addiction. You shouldn’t stop taking this drug suddenly. Doing so can cause withdrawal symptoms. If you need to stop taking this medication, your doctor will reduce your dosage slowly.

Controlled substance

This drug is a controlled substance because it can be abused. Keep this medication in a secure place. Don’t share or sell this drug It can harm others.

Heart problems

This medication may cause a heart rhythm problem called QT prolongation. Your risk may be higher if you have a history of long QT syndrome or if you take medication for irregular heart rate or rhythm. Tell your doctor before taking this medication if you have heart disease or low potassium levels. Also tell your doctor if you have an irregular heart rhythm, a slow heart rate, heart failure, or have had a recent heart attack.

What is buprenorphine?

Buprenorphine is a prescription drug. It’s available as a transdermal patch you apply to your skin. This drug is also available as a sublingual tablet (a tablet that dissolves under your tongue) and a buccal film (a film you apply on the inside of your cheek). It also comes as an injection, which is only given by a healthcare provider.

The buprenorphine transdermal patch is only available as the brand-name drug Butrans. It isn’t available as a generic drug.

Buprenorphine may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Buprenorphine is used to treat severe pain that requires constant opioid treatment.

How it works

Buprenorphine belongs to a class of drugs called opioids. A class of drugs is a group of medications that work in a similar way.

See Details

How it works

Buprenorphine belongs to a class of drugs called opioids. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Buprenorphine works by blocking certain opioid receptors in your body. It blocks the kappa-opioid receptor. This action helps decrease the amount of pain you feel. It also binds to the mu-opioid receptor. This action decreases how much pain you feel and helps prevent or treat physical dependence.

Advertisement
SECTION 2 of 5

buprenorphine Side Effects

Transdermal patch

More common side effects

The more common side effects of buprenorphine transdermal patch can include:

  • headache

  • nausea

  • vomiting

  • constipation

  • sleep problems

  • dizziness

  • reactions at the application site, including warmth, itching, rash, or redness

  • dry mouth

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Trouble breathing or slow breathing

  • Sleepiness

  • Dizziness

  • Trouble with coordination

  • Liver problems. Symptoms can include:

    • yellowing of your skin or the whites of your eyes
    • dark urine
    • pale stools
    • loss of appetite
    • stomach pain
    • nausea
  • Allergic reactions. Symptoms can include:

    • rash
    • hives
    • swelling of your face
    • wheezing
    • decrease in blood pressure
    • loss of consciousness
  • Physical dependence. If you become physically dependent on this drug, you may have withdrawal symptoms when you stop using it. Symptoms can include:

    • shaking
    • increased sweating
    • feeling hot or cold
    • runny nose
    • watery eyes
    • goose bumps
    • diarrhea
    • vomiting
    • muscle pain
  • Low blood pressure. Symptoms can include:

    • dizziness, especially when you stand up from a sitting or lying position
  • Heart problems. Symptoms can include:

    • dizziness
    • fainting
    • abnormal heart rhythm
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Buprenorphine may cause drowsiness and slow your reaction time. Drowsiness is most common during the first weeks of treatment and during dosage increases. However, it can also happen if you take this medication with alcohol or other drugs that cause drowsiness. You shouldn’t drive, use machinery, or do other activities that require alertness until you know you can function normally.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

buprenorphine May Interact with Other Medications

Transdermal patch

Buprenorphine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Food interactions

You shouldn’t eat grapefruit, grapefruit juice, or Seville oranges while you’re taking this drug. These foods can increase the amount of buprhenorphine in your body. This raises your risk of side effects.

Alcohol interaction

Drinking alcohol with buprenorphine can cause death or loss of consciousness. Do not drink alcohol while taking this drug.

Medications that might interact with this drug

Interactions that increase your risk of side effects
  • Increased side effects from buprenorphine: Taking buprenorphine with certain medications raises your risk of side effects from buprenorphine. This is because the amount of buprenorphine in your body may be increased. Examples of these drugs include:
    • Antifungal drugs, such as ketoconazole
      • Taking these drugs together may cause dizziness, nausea, trouble breathing, and other side effects. Your doctor may decrease the dosage of your antifungal drug or buprenorphine if you have to take them together.
    • Antibiotics, such as erythromycin
      • Taking these drugs together may cause dizziness, nausea, trouble breathing, and other side effects. Your doctor may decrease the dosage of your antibiotic or buprenorphine if you have to take them together.
    • HIV drugs, such as ritonavir and atazanavir
      • Taking any of these drugs with buprenorphine may cause dizziness, nausea, trouble breathing, and other side effects. Your doctor may decrease the dosage of your HIV drug or buprenorphine if you have to take them together.
  • Increased side effects from both drugs: Taking buprenorphine with certain medications raises your risk of side effects. This is because buprenorphine and these other medications can cause the same side effects. As a result, these side effects can be increased. Examples of these drugs include:
    • Benzodiazepines and sedating medications, such as alprazolam or lorazepam
      • Taking these medications with buprenorphine may cause breathing problems, coma, and death. You should only take benzodiazepines with buprenorphine if your doctor gives them to you together.

Interactions that can make your drugs less effective
  • When buprenorphine is less effective: When buprenorphine is used with certain drugs, it may not work as well to treat your condition. This is because the amount of buprenorphine in your body may be decreased. Examples of these drugs include:
    • Seizure drugs, such as phenobarbital, carbamazepine, and phenytoin
      • You may have withdrawal symptoms if you take any of these drugs with buprenorphine.
    • Rifampin
      • You may have withdrawal symptoms if you take any of these drugs with buprenorphine.
    • Efavirenz, nevirapine, and etravirine
      • Your doctor may monitor your dosage of these drugs if you take any of them with buprenorphine.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
liver problem warning
People with liver problems

If you have liver problems or a history of liver disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects. If you have severe liver problems, your doctor may switch you to a different pain medication.

lung or breathing problems
People with trouble breathing or other lung problems

This drug can make it harder to breathe. If you have a lung problem, you may already have trouble breathing. Ask your doctor if this drug is safe for you to take.

bowel problem warning
People with bowel blockage

If you have a bowel blockage or narrowing of your stomach or intestines, you shouldn’t use this drug. It may make your condition worse.

heart problem warning
People with heart problems

If you have the heart rhythm problem called QT prolongation, ask your doctor if this drug is safe for you. This medication may cause QT prolongation. Your risk may be higher if you have a history of long QT syndrome or if you take medication for irregular heart rate or rhythm.

head injury warning
People with a history of head injury

If you have a history of a head injury or increased pressure in your skull, this drug may increase the pressure in your skull more. Ask your doctor whether this medication is safe for you.

low body weight warning
People with a low body weight

You may be more sensitive to the effects of this drug. These can include trouble breathing, which can be life-threatening.

pregnancy warning
Pregnant women

Buprenorphine is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or plan to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

beast feeding warning
Women who are breast-feeding

Buprenorphine may pass into breast milk and cause side effects in a child who is breastfed. These side effects can include drowsiness and trouble breathing.

Talk to your doctor about breastfeeding your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

senior warning
For seniors

The kidneys, liver, and heart of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

If you’re older than 65 years, you may be more sensitive to side effects, such as trouble breathing. This can be fatal (cause death).

childrens warning
For children

This drug hasn’t been studied in children. It shouldn’t be used in people younger than 18 years of age.

call the doctor
Contact with drug

If other people touch the sticky side of the patch, they may absorb some of the drug. This can cause side effects, especially in children. When you’re done wearing a patch, fold the sticky sides together before throwing it away.

allergy warning
Allergies

Buprenorphine can cause a severe allergic reaction. Symptoms can include:

  • rash
  • hives
  • swelling of your face
  • wheezing
  • extremely low blood pressure
  • loss of consciousness

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death.

SECTION 4 of 5

How to Take buprenorphine (Dosage)

Transdermal patch

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Severe pain

Brand: Butrans

Form: transdermal patch
Strengths: 5 mcg/hr, 7.5 mcg/hr, 10 mcg/hr, 15 mcg/hr, 20 mcg/hr
Adult dosage (ages 18–64 years)
  • Your doctor will decide your dosage of buprenorphine based on your history of pain medication use.
  • If this is your first opioid drug, your doctor will likely start you on the 5 mcg/hr patch.
  • If this is not your first opioid drug, your doctor may start you on a higher dosage.
  • You’ll apply a new patch once every 7 days and keep it on for 7 days.
Child dosage (ages 0–17 years)

This drug hasn’t been studied in children. It shouldn’t be used in people younger than 18 years of age.

Senior dosage (ages 65 years and older)

Your doctor may start you on a reduced dosage or a different treatment schedule.

Warnings

Exposure to heat: You shouldn’t expose the patch and the surrounding skin to heat sources. Sources can include heating pads, electric blankets, heat lamps, and hot tubs. Heat can increase how much of the drug you absorb. Absorbing more of the drug can increase your risk of side effects.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Buprenorphine comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

If you stop taking this drug suddenly, you can develop symptoms of withdrawal due to physical dependence. Symptoms of withdrawal can include irritability, tremors, restlessness, seizures, muscle pain, tiredness, and chills. If you need to stop taking this drug, your doctor will decrease your dosage slowly.

If you don’t take this drug at all, your severe pain won’t improve.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • very small pupils
  • drowsiness
  • low blood pressure
  • low breathing rate

Taking too much of this drug may be fatal (cause death).

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away. You doctor might need to give you a drug called naloxone to reverse the effects of buprenorphine.

What to do if you miss a dose

Take your dose as soon as you remember. If you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your pain should improve.

Buprenorphine patch is used for long-term treatment.

Important considerations for taking this drug

Store this drug carefully

  • Store buprenorphine at room temperature, Keep it between 59°F and 86°F (15°C and 30°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor, nurse, or pharmacist will show you how to apply the patch.

You can apply the patch to your upper chest, upper back, the side of your chest, or the outside of your upper arm. Apply the sticky part of the patch to your skin. Press the patch firmly for about 15 seconds. Be careful not to rub the patch.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Respiratory rate, heart rate, and blood pressure. Your doctor will monitor these levels regularly. This can help your doctor check for side effects of the drug.
  • Liver function. Your doctor will do tests to check your liver function before and during your treatment with this drug. If your liver isn’t working well, your doctor may reduce your dosage or stop your treatment with this drug.

Sun sensitivity

Don’t expose the patch to direct sunlight when you’re wearing it. Doing so may increase how much of the drug your body absorbs. This can increase your risk of side effects.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does buprenorphine Cost?

Transdermal patch

We've partnered with GoodRx so you can compare prices, find discounts and save up to 80% on your next prescription. Check out the low coupon prices below — no insurance required.

Compare prices and save up to 80% on your next refill!

Lowest price for buprenorphine

Kroger Pharmacy $106.85
Membership warehouse $130.71
Safeway $130.71
These prices represent the lowest priced national pharmacies for buprenorphine on GoodRx. They may be lower than your insurance.

Enter your zip code to find the best deal near you.

These prices represent the lowest priced national pharmacies for buprenorphine on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on March 14, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Advertisement
Advertisement
Advertisement