Acron

Indications

Buprenorphine is a strong pain reliever from the opioid group. As an injection it is used to relieve moderate to severe pain, for example after surgery, after injury, in heart attack or in cancer pain. In some countries, special tablets or films placed under the tongue are also used in supervised treatment programmes for opioid dependence.

How It Works

Buprenorphine attaches to opioid receptors in the brain and spinal cord, the same places that natural pain-control chemicals act on. It only partly switches these receptors on (a "partial agonist"), so it relieves pain well but has a ceiling on some effects such as slowed breathing. It also blocks other opioids from acting fully.

Dosage and Administration

The injection is given into a muscle or slowly into a vein by a doctor or nurse, at a dose and interval set by the doctor according to the type of pain and the patient's condition. Under-the-tongue products for dependence treatment are used only as prescribed within a supervised programme. Never change the dose or stop suddenly on your own.

Interactions

• Alcohol, sleeping medicines such as Diazepam and other sedatives can cause dangerous drowsiness and slowed breathing.
• Other opioids such as Morphine or Tramadol: effects may be reduced or withdrawal may be triggered.
• Medicines that change liver enzymes, such as Ketoconazole, Ritonavir, Rifampicin or Carbamazepine, can raise or lower buprenorphine levels.
• Some antidepressants and MAO inhibitors may increase side effects.

Tell your doctor about every medicine and supplement you take.

Contraindications

• Allergy to buprenorphine.
• Severe breathing problems or acute severe asthma.
• Severe liver disease.
• Acute alcohol poisoning or delirium tremens.

Side Effects

Common effects include drowsiness, dizziness, nausea, vomiting, sweating, headache, constipation and low blood pressure. Some people feel confused or light-headed. Long-term use can lead to dependence, and stopping suddenly may cause withdrawal symptoms.

Get urgent medical help if breathing becomes slow or shallow, the person is very hard to wake, lips turn blue, or there are signs of a severe allergic reaction such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

Use in pregnancy only if the doctor decides the benefit is greater than the risk. Use near delivery can cause breathing problems or withdrawal in the newborn. Small amounts pass into breast milk; the doctor will advise whether breastfeeding is suitable and the baby should be watched for drowsiness.

Precautions and Warnings

• Can cause drowsiness: do not drive or operate machinery until you know how it affects you.
• Avoid alcohol completely.
• Use with care in liver disease, lung disease, head injury, low thyroid function, enlarged prostate and in elderly people.
• Risk of misuse and dependence: keep it secure and never share it.

Overdose

Overdose can cause severe sleepiness, pinpoint pupils, very slow breathing and coma. This is an emergency: call for medical help at once. Treatment is given in hospital and may include breathing support and Naloxone.

Therapeutic Class

Opioid analgesic (partial opioid agonist).

Storage

Store below 30°C, away from light and out of the reach of children. Injections are kept and used as directed on the pack.