The Medical Letter on Drugs and Therapeutics
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1362
Transdermal Buprenorphine (Butrans) for Chronic Pain
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The FDA has approved the partial opioid agonist buprenorphine in a transdermal formulation (Butrans – Purdue) for treatment of moderate to severe chronic pain. Buprenorphine has been available in the US for years in parenteral formulations for pain and in sublingual tablets for opioid dependence.1 Transdermal buprenorphine has been available in Europe for several years.2

MECHANISM OF ACTION — Buprenorphine binds with high affinity to, and slowly dissociates from, the mu opioid receptor. It produces typical opioid agonist effects, but in high doses it can act as an antagonist. Used alone, it may be less likely than full opioid agonists such as fentanyl (Duragesic, and others) to cause dependence or respiratory depression, but if respiratory depression does occur, it may not be effectively reversed by naloxone (Narcan, ... more      

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Title: Transdermal Buprenorphine (Butrans) for Chronic Pain
Article code: 1362d
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