Buprenorphine

Transdermal: Patient w/ known or suspected paralytic ileus, substantial resp depression or severe bronchial asthma. Management of acute, intermittent, mild, or short-term (including post-op) pain. Concomitant admin of IV buprenorphine and oral diazepam. Concurrent use or w/in 14 days of discontinuation of MAOIs.

Patient w/ pulmonary impairment or compromised resp function (e.g. COPD, cor pulmonale, decreased resp reserve [e.g. asthma, severe obesity, sleep apnoea], hypoxia, hypercapnia, pre-existing resp depression). Patient w/ hypothyroidism, myxedema, adrenocortical insufficiency (e.g. Addison's disease), dysfunction of biliary tract including acute pancreatitis, acute alcoholism, delirium tremens, toxic psychoses, kyphoscoliosis, prostatic hypertrophy or urethral stricture; comatose patients. Patient w/ CNS depression, history of seizure disorders, head injury, intracranial lesions or conditions in which intracranial pressure may be increased. Patient w/ personal or family history of QT interval prolongation, hypokalaemia or unstable cardiac disease (e.g. AF, CHF, myocardial ischaemia), particularly in transdermal admin. Hepatic or renal impairment. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Avoid exposing the patch to external heat. Monitoring Parameters Establish baseline liver function levels prior to therapy and periodically monitor liver function throughout therapy in patients treated for opioid dependence.

CNS depression, including somnolence, dizziness, alterations in judgment and levels of consciousness, including coma; sedation, dizziness, sweating, vertigo, headache; nausea, vomiting, dry mouth, constipation, dyspepsia, abdominal cramps, flatulence, diaphoresis; rash, urticaria, pruritus; miosis, blurred vision, hallucinations and other psychotomimetic effects; hypotension leading to syncope, HTN, tachycardia, bradycardia, ECG abnormalities.
Potentially Fatal: Resp depression (transdermal).

Plasma-buprenorphine concentrations may be affected when co-administered w/ drugs that induce or inhibit CYP3A4 isoenzyme. Enhanced depressant effects of other CNS depressants, other opiate agonists, anaesth, antihistamines, muscle relaxants, tranquilisers (e.g. phenothiazines), sedatives and hypnotics (e.g. benzodiazepines). Increased and/or prolonged activity w/ drugs that may reduce hepatic blood flow (e.g. halothane). Receiving class IA (e.g. quinidine, procainamide) or class III (e.g. sotalol, amiodarone) antiarrhythmic agents w/ transdermal buprenorphine may increase the risk of QT interval prolongation.

Analgesics (Opioid) / Antidotes, Detoxifying Agents & Drugs Used in Substance Dependence

N02AE01 - buprenorphine ; Belongs to the class of oripavine derivative opioids. Used to relieve pain.
N07BC01 - buprenorphine ; Belongs to the class of drugs used in the management of opioid dependence.