Side Effects of Buprenex: What You Need to Know

If you’re receiving treatment for severe pain that requires a powerful type of pain reliever called an opioid, your doctor may suggest giving you Buprenex (buprenorphine). Understanding this drug’s possible side effects can help you and your doctor decide if Buprenex is the right treatment option for you.

Buprenex is a prescription drug that’s an effective treatment for helping relieve severe pain. It contains the active drug buprenorphine, which is an opioid. Opioids are prescribed only after you’ve tried other treatment types, and they weren’t effective at easing your pain.

Your doctor or another healthcare provider may give you Buprenex to relieve a short-term episode of severe pain. Buprenex is typically only given in hospitals or clinics.

Your doctor may give you this drug in one of two ways. It can be given as an injection into your muscle or into your vein.

For more information about Buprenex, read this in-depth article on the drug.

Like other drugs, Buprenex can cause mild or serious side effects. Keep reading to learn more.

Some people may experience mild or serious side effects during their Buprenex treatment. More common side effects that have been reported with this drug include:

• drowsiness*
• nausea
• dizziness
• vertigo (feeling off-balance or unsteady)

Of these side effects, drowsiness is the most common side effect of Buprenex. Keep reading to learn about some other potential side effects that could occur with this medication.

* To learn more about this side effect, see “Side effects explained” below.

Buprenex can cause mild side effects in some people. Examples of mild side effects that have been reported with Buprenex include:

• sweating
• headache
• pinpoint pupils (the pupils temporarily become smaller)
• confusion
• fatigue (lack of energy)
• nausea and vomiting
• dizziness
• vertigo (dizziness that makes you feel off-balance or unsteady)
• constipation*
• drowsiness*

* To learn more about this side effect, see “Side effects explained” below.

In most cases, these side effects should be short term. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist.

In some cases, Buprenex may cause mild side effects other than the ones listed above. For a complete list of side effects reported with Buprenex, see the drug’s prescribing information.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Buprenex, visit MedWatch.

Serious side effects have been reported with Buprenex. However, many of these serious side effects aren’t common.

Serious side effects that have been reported in people using Buprenex include:

• respiratory depression (weak, shallow, or slow breathing),* which can be life threatening (see “Side effects explained” below)
• addiction or misuse* (see “Buprenex and misuse” below)
• hypotension (low blood pressure)
• severe constipation†
• allergic reaction†
• adrenal gland problems, including low cortisol levels
• shock (a medical emergency in which your organs aren’t getting enough oxygen-rich blood)

If you develop serious side effects while taking Buprenex, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* Buprenex has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA).
† To learn more about this side effect, see “Side effects explained” below.

Buprenex comes with several precautions. Be sure to tell your doctor about any health conditions that you have before receiving this drug.

Boxed warnings

Buprenex has four boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

• Addiction and misuse. Taking Buprenex may raise your risk for misusing or becoming addicted to this drug. For more details, see the “Buprenex and misuse” section below.
• Risks from use with benzodiazepines or other CNS depressants. Using Buprenex with benzodiazepines or other central nervous system (CNS) depressants (substances that slow down the central nervous system) can be dangerous. For more details, see the interactions question in the “FAQs about Buprenex’s side effects” section below.
• Life threatening respiratory depression. Using Buprenex can cause respiratory depression (weak, shallow, or slow breathing). Respiratory depression from Buprenex can be fatal. For more details, see “Side effects explained” below).
• Neonatal opioid withdrawal syndrome. Buprenex is meant for short-term use. But if it’s taken long term during pregnancy, the drug may cause neonatal opioid withdrawal syndrome (symptoms of opioid withdrawal in a newborn). To learn more, see “Pregnancy and breastfeeding” below.

Other warnings

Buprenex may not be safe for you if you have certain medical conditions or other factors that affect your health. (These conditions or factors are sometimes called contraindications.) Talk with your doctor about your health history before you take Buprenex. Factors to consider include those in the list below.

Age 65 years or older or are very ill. You may have a higher risk for serious breathing problems with Buprenex if you’re age 65 years or older or are very ill. Your doctor may recommend a safer treatment option for you than Buprenex.

Severe lung, heart, liver, or kidney problems. If you have medical conditions that affect how your lung, heart, liver, or kidneys work, you may have a higher risk for serious side effects with Buprenex. If so, your doctor will choose a different treatment or monitor you more closely after giving you Buprenex.

Allergic reaction. If you’ve had an allergic reaction to Buprenex or any of its ingredients, you shouldn’t take Buprenex. Ask your doctor what other medications are better options for you.

Severe low blood pressure. In rare cases, Buprenex may cause a drop in blood pressure. This can sometimes lead to fainting. If you’re experiencing hypotension (low blood pressure) or shock (which can cause low blood pressure), your doctor may not give you Buprenex. If they do, they’ll carefully monitor your blood pressure after you receive your dose. If they don’t, they’ll recommend another treatment that may be a safer choice for you.

Increased pressure inside your skull. In rare cases, Buprenex may cause increased intracranial pressure (raised pressure in your skull). If you already have increased intracranial pressure, your doctor may choose a different treatment option for you. Or they’ll monitor your intracranial pressure after your Buprenex treatment.

Conditions that affect your digestive tract. If you have certain problems with your digestive system, using Buprenex may worsen your condition. These may include a blockage in your intestines or problems with your bile duct. Talk with your doctor if you have a history of these conditions. They can recommend the safest treatment option for you.

Seizures. If you have a seizure disorder, Buprenex may raise your risk for seizures. If you’re currently being treated for a seizure disorder, or have in the past, tell your doctor. They can determine whether Buprenex is right for you.

Alcohol use and Buprenex

It’s not safe to receive Buprenex treatment if you’ve been drinking alcohol.* If you receive Buprenex with alcohol in your system, this can cause dangerous side effects. These include excessive drowsiness and respiratory depression (weak, shallow, or slow breathing). These side effects may lead to loss of consciousness (not being able to respond to sound or touch) or even death.

Alcohol is a central nervous system (CNS) depressant (a substance that slows down the CNS). The CNS controls vital body functions, such as breathing. When the CNS is slowed down too much, your breathing may become too slow and lead to the dangerous side effects mentioned above.

If you drink alcohol, let your doctor know when your last drink was before they give you Buprenex. They may test your blood for the presence of alcohol before giving Buprenex. Or they may prescribe a different treatment option for you.

* Buprenex has a boxed warning for use with CNS depressants, including alcohol. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Pregnancy and breastfeeding while taking Buprenex

Buprenex is meant for short-term use. But if it’s taken long term during pregnancy, the drug may cause neonatal opioid withdrawal syndrome (symptoms of opioid withdrawal in a newborn). Without treatment, this condition could be life threatening to a newborn.

Buprenex has a boxed warning for neonatal opioid withdrawal syndrome. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning helps to alert doctors and patients about drug effects that may be dangerous.

If you’re pregnant, tell your doctor before they give you Buprenex. They’ll discuss the risks with you, or they may recommend a different treatment to ease your pain.

It’s recommended that you avoid breastfeeding while using Buprenex. Buprenorphine (the active drug in Buprenex) passes into breast milk, and it’s not known how this may affect a breastfed child.

If you’re currently breastfeeding, talk with your doctor before receiving Buprenex.

Here are some frequently asked questions and answers about Buprenex’s side effects.

Is Buprenex safe for use in humans?

Yes, Buprenex is safe for use in humans. It’s approved by the Food and Drug Administration (FDA). Buprenex is considered to be a safe and effective treatment for relieving severe pain in certain situations.

Buprenex is a prescription medication that contains the active drug buprenorphine. Buprenorphine is also approved for use in animals when given by veterinarians.

Buprenorphine is the active drug in Simbadol, a brand-name pet medication. It’s typically used in cats to relieve pain after surgery. Veterinarians may also give this drug to dogs or other animals to ease pain after surgery.

Some drugs, such as buprenorphine, come in both human and pet medications. However, there are often major differences in human and pet dosages of the same drug.

To avoid potentially dangerous effects, such as life threatening respiratory depression, pet owners should not take their pets’ medications. And you shouldn’t give human medications to pets, unless specifically prescribed for your pet by a veterinarian.

Could I have any long-term side effects from Buprenex?

Buprenex isn’t meant to be a long-term treatment, so this drug isn’t known to cause long-term side effects. Buprenex is given by your doctor to treat a short-term episode of severe pain. It’s only given while you’re in a hospital or clinic, where you’ll be monitored for side effects that may occur.

If you have questions about possible side effects, talk with your doctor.

Does Buprenex interact with any other drugs?

Yes, Buprenex can interact with other drugs. One of the most serious drug interactions with Buprenex involves central nervous system (CNS) depressants. CNS depressants include alcohol as well as certain classes of prescription drugs. (A drug class is a group of medications that work in a similar way.)

Your CNS includes your brain and spinal cord, which control all of your vital body functions by sending messages to your body. CNS depressants are substances that slow down your CNS.

Using Buprenex with CNS depressants can slow down your CNS to a dangerous degree. This can lead to serious side effects such as severe drowsiness, respiratory depression (weak, shallow, or slow breathing), coma, or even death.

Benzodiazepines are CNS depressants. They’re a class of drugs often prescribed to treat anxiety or seizures. Examples of commonly prescribed benzodiazepines include:

• Xanax (alprazolam)
• Klonopin (clonazepam)
• Valium (diazepam)
• Ativan (lorazepam)

Before receiving Buprenex, tell your doctor if you’re taking a benzodiazepine or other CNS depressant. They’ll monitor you more closely during your Buprenex treatment.

For other possible interactions that could happen with this drug, see this in-depth article.

Learn more about some of the side effects Buprenex may cause.

Life threatening respiratory depression

Respiratory depression is a rare but serious side effect of Buprenex. With respiratory depression, your breathing becomes weak, shallow, or slow. This can lead to loss of consciousness (not being able to respond to sound or touch), coma, and even death.

Early symptoms of respiratory depression to watch for include drowsiness, trouble breathing, headache, and confusion.

What might help

Respiratory depression is a life threatening medical emergency that requires immediate medical care.

To lower your risk for respiratory depression, it’s important to tell your doctor if you have certain factors before they give you Buprenex. These may include whether you’ve used any central nervous system (CNS) depressants (substances that slow down your CNS), and if so, when you took them and how much.

Examples of CNS depressants include:

• alcohol
• barbiturates, such as butalbital (an active drug in Fioricet)
• benzodiazepines, such as Xanax (alprazolam) or Valium (diazepam)
• muscle relaxers, such as Soma (carisoprodol)
• sedatives (sleep medications), such as Ambien (zolpidem)
• other opioids, such as oxycodone (an active drug in Percocet) or morphine

Your doctor will use this information to help determine if Buprenex is right for your treatment. If they do prescribe Buprenex, your doctor will monitor you for possible side effects, including respiratory depression.

After your Buprenex treatment, ask your doctor how long to wait before drinking alcohol or continuing to use any prescribed CNS depressants. If you have questions about your risk for respiratory depression, talk with your doctor.

Drowsiness

Buprenex can cause drowsiness in some people. In fact, this is the most commonly reported side effect of the drug. With drowsiness, you may feel less alert or abnormally tired.

Because of the risk for drowsiness, it’s important not to drive or operate heavy machinery after receiving Buprenex.

What might help

Drowsiness from Buprenex is usually temporary. It should improve on its own once the drug wears off. It usually takes Buprenex an average of about 12 hours after your dose to get out of your system.

After receiving Buprenex, you shouldn’t drive or engage in other activities that could be dangerous if you’re not fully alert. This is true even if you don’t feel very drowsy.

If you have questions about when it’s safe for you to resume your normal activities after receiving Buprenex, talk with your doctor.

If a friend or family member who received Buprenex seems very drowsy, is having trouble breathing, or you can’t wake them, call 911. They may be experiencing respiratory depression (weak, shallow, or slow breathing). This condition requires emergency medical care.

Severe constipation

As with all opioids, severe constipation can be a serious side effect of Buprenex. However, this is not a common side effect of the drug.

Opioids, including Buprenex, can affect the way your digestive tract works. This can lead to symptoms of constipation which may include:

• dry, hard bowel movements
• having trouble passing stools
• having fewer than three bowel movements per week
• feeling of an incomplete bowel movement
• abdominal (belly) pain

If untreated, severe constipation can lead to many other problems, such as nausea, rectal pain or bleeding, or a blockage.

What might help

Unlike some of the other side effects from Buprenex, severe constipation doesn’t usually go away on its own.

There are many over-the-counter (OTC) laxative options that can treat severe constipation. Some come in forms that you take by mouth, and others are used in your rectum.

Rectal laxatives tend to work more quickly (some within minutes), which may be best if you have severe constipation. Examples of fast-acting OTC laxatives include:

• Dulcolax (bisacodyl) suppository
• Fleet Glycerin (glycerin) suppository
• Fleet Mineral Oil Enema (mineral oil)
• Fleet Saline Enema (sodium phosphate)

It’s important to note that some of the laxatives listed above aren’t meant for long-term use. Using these too much can cause harmful effects. And if you’re not sure which option to choose, talk with your pharmacist or doctor.

After your constipation is relieved, you should take certain steps to prevent constipation from coming back. These include drinking lots of water, eating fiber-packed foods such as raw vegetables, and getting regular physical activity.

If you still have symptoms of constipation, or if any of your symptoms become severe, call your doctor. They can suggest next steps for you.

Nausea

Nausea is a more commonly reported side effect of Buprenex. In most cases, nausea is mild and doesn’t usually lead to vomiting.

What might help

Nausea from Buprenex is usually temporary and goes away on its own. But if you’re looking for ways to help relieve this side effect, here are a few tips to reduce nausea

• Eat only small amounts of only bland foods, such as the BRAT diet (bananas, rice, applesauce, toast).
• Increase the airflow around you by opening a window or turning on a fan.
• If your nausea comes in waves, try taking some deep, slow breaths until it passes.
• Try natural remedies, such as ginger, which may help ease feelings of nausea.
• Take an over-the-counter nausea medication. Some examples are Nauzene (sodium citrate dihydrate) or Pepto-Bismol (bismuth subsalicylate). If you’re not sure which option is best for you, ask your pharmacist for help.

If your nausea doesn’t go away or leads to severe vomiting, talk with your doctor. They may suggest other treatments or emergency medical care if you’re at risk for dehydration.

Vertigo

Vertigo is a more commonly reported side effect of Buprenex. Vertigo is dizziness that causes you to feel off-balance. With this side effect, you may feel unsteady or that your surroundings are moving or spinning (when they’re actually not).

What might help

Because Buprenex is a short-term treatment for severe pain, most of its side effects are temporary. This includes vertigo. If you have vertigo after receiving Buprenex, it’ll likely go away on its own in about 12 hours.

But if you’re looking for ways to ease this side effect until Buprenex wears off, here are a few tips:

• Certain exercises or body positions may help to relieve vertigo.
• Take deep, slow breaths to try to stay calm and relaxed. Feeling anxious or stressed about the vertigo may worsen your symptoms.
• Studies have shown that gingko biloba may be an effective natural remedy for vertigo.

If your vertigo doesn’t go away or becomes severe, talk with your doctor. They may suggest other treatments or ways to reduce this side effect.

Allergic reaction

Like most drugs, Buprenex can cause an allergic reaction in some people. However, it isn’t known how often allergic reactions occurred in studies of the drug.

Symptoms can be mild or serious and can include:

• skin rash
• hives (itchy, raised welts on your skin)
• itchiness
• flushing (warmth or redness/deepening of skin color for a brief time)
• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as diphenhydramine (Benadryl), or topical product, like hydrocortisone cream, to manage your symptoms.

If your doctor confirms you had a mild allergic reaction to Buprenex, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Buprenex, they may have you switch to a different treatment.

Buprenex is a controlled substance. This is a type of drug that has risks for physical dependence (your body needs the drug to feel normal). When your body becomes physically dependent on a drug, your risks for misusing the drug are higher.

Buprenex is a short-term treatment given by your doctor, so its potential risk for misuse is low. But if it’s used improperly, physical dependence can lead to misuse.

Buprenex has a boxed warning for addiction and misuse. This is the most serious warning from the Food and Drug Administration (FDA).

If you have a history of drug addiction or misuse, or if you’re being treated for opioid use disorder, talk with your doctor before using Buprenex. They may suggest other treatments to relieve your pain.

Buprenex is an opioid used to treat severe pain that requires an opioid. After receiving Buprenex, some people may develop mild or serious side effects. For most people, the side effects of Buprenex are usually mild and temporary.

If you have questions about the side effects of Buprenex, talk with your doctor or pharmacist. Here are a few suggestions for questions you may want to ask:

• Am I at a higher risk for side effects from Buprenex than other people?
• Do my other medications raise my risk for side effects with Buprenex?
• With my health conditions, am I at higher risk for serious side effects from this drug?

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.