Buprenorphine Buccal (Chronic Pain)

Buprenorphine Buccal (chronic Pain)
Buprenorphine Buccal (chronic Pain)


Buprenorphine buccal (chronic pain) is used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. Buprenorphine buccal (chronic pain) should not be used to treat pain that can be controlled by medication that is taken as needed. Buprenorphine buccal (chronic pain) in a class of medications called opiate partial agonists. It works by changing the way the brain and nervous system respond to pain.

Side Effects Of Buprenorphine Buccal (Chronic Pain)

Buprenorphine buccal (chronic pain) may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • diarrhea
  • dry mouth
  • sleepiness
  • headache

Some side effects can be serious. If you experience any of these symptoms or those listed in the WARNING section, call your doctor immediately or get emergency medical treatment:

  • changes in heartbeat
  • agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
  • nausea, vomiting, loss of appetite, weakness, or dizziness
  • inability to get or keep an erection
  • irregular menstruation
  • decreased sexual desire
  • chest pain
  • swelling of your face, tongue, or throat
  • rash
  • hives

Buprenorphine buccal (chronic pain) may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Warnings & Precautions

Before using buprenorphine buccal (chronic pain):

  • tell your doctor and pharmacist if you are allergic to buprenorphine, any other medications, or any of the ingredients in buprenorphine buccal (chronic pain) films. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take with buprenorphine buccal (chronic pain). Be sure to mention the medications listed in the WARNING section and any of the following: amiodarone (Nexterone, Pacerone); anticholinergics (atropine, belladonna, benztropine, dicyclomine, diphenhydramine, isopropamide, procyclidine, and scopolamine); butorphanol; carbamazepine (Carbatrol, Tegretol, Teril, others); clarithromycin (Biaxin, in Prevpac); cyclobenzaprine (Amrix); dextromethorphan (found in many cough medications; in Nuedexta); disopyramide (Norpace); diuretics (‘water pills’); dofetilide (Tikosyn); enzalutamide (Xtandi); human immunodeficiency virus (HIV) medications such as atazanavir (Reyataz, in Evotaz), delavirdine (Rescriptor), efavirenz (Sustiva, in Atripla), etravirine (Intelence), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); itraconazole (Onmel, Sporanox); ketoconazole (Nizoral); lithium (Lithobid); medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), and zolmitriptan (Zomig); mirtazapine (Remeron); nalbuphine; nefazodone; pentazocine (Talwin); phenobarbital; phenytoin (Dilantin, Phenytek); pioglitazone (Actos); procainamide; quinidine (in Nuedexta); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane); 5HT3 serotonin blockers such as alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz), or palonosetron (Aloxi); selective serotonin-reuptake inhibitors such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft); serotonin and norepinephrine reuptake inhibitors such as duloxetine (Cymbalta), desvenlafaxine (Khedezla, Pristiq), milnacipran (Savella), and venlafaxine (Effexor); tramadol (Conzip, Ultram, in Ultracet); trazodone ; sotalol (Betapace, Sotylize, others); or tricyclic antidepressants (‘mood elevators’) such as amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Also tell your doctor or pharmacist if you are taking or receiving the following monoamine oxidase (MAO) inhibitors or if you have stopped taking them within the past two weeks: isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with buprenorphine buccal (chronic pain), so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
  • tell your doctor what herbal products you are taking, especially St. John’s wort and tryptophan.
  • tell your doctor if you have any of the conditions listed in the WARNING section or paralytic ileus (a condition in which food does not move through the intestines) or a blockage in the stomach or intestines. Your doctor may tell you not to use buprenorphine buccal (chronic pain).
  • tell your doctor if you or an immediate family member have or have ever had prolonged QT syndrome (a condition that increases the risk of developing an irregular heartbeat that may cause loss of consciousness or sudden death); if you have low levels of potassium or magnesium in the blood; and if you have or have ever had a slow or irregular heartbeat; heart failure; low blood pressure; any condition that causes difficulty urinating; seizures; mouth sores; or gallbladder, pancreas, kidney, thyroid, or liver disease.
  • tell your doctor if you are breastfeeding.
  • you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of using buprenorphine.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are using buprenorphine buccal (chronic pain).
  • you should know that buprenorphine buccal (chronic pain) may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • you should know that buprenorphine buccal (chronic pain) may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
  • you should know that buprenorphine buccal (chronic pain) may cause constipation. Talk to your doctor about changing your diet or using other medications to prevent or treat constipation while you are using buprenorphine buccal (chronic pain).

Dosage Of Buprenorphine Buccal (Chronic Pain)

Buprenorphine buccal (chronic pain) comes as a buccal film to apply inside the cheek. It is usually applied twice a day. Apply buprenorphine buccal (chronic pain) at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use buprenorphine buccal (chronic pain) exactly as directed.

Your doctor will probably start you on a low dose of buprenorphine buccal (chronic pain), either once daily or every 12 hours and gradually increase your dose, not more than once every 4 days. Your doctor may decrease your dose if you experience side effects. Tell your doctor if you feel that your pain is not controlled or if you experience side effects during your treatment with buprenorphine buccal (chronic pain). Do not change the dose of your medication without talking to your doctor.

Do not stop using buprenorphine buccal (chronic pain) without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop usingbuprenorphine buccal (chronic pain), you may have symptoms of withdrawal. Call your doctor if you experience any of these symptoms of withdrawal: restlessness, teary eyes, runny nose, yawning, sweating, chills, muscle and backaches, large pupils (black circles in the center of the eyes), irritability, anxiety, difficulty falling asleep or staying asleep, diarrhea, nausea, vomiting, decreased appetite, stomach cramps, pain in the joints, weakness, fast heartbeat, or rapid breathing.

Buprenorphine buccal (chronic pain) is sealed in a foil package. Do not open the package until ready to use. Do not apply buprenorphine buccal (chronic pain) if the package seal is broken or the buccal film is cut, damaged, or changed in any way.

To apply the buprenorphine buccal (chronic pain) film, follow these steps:

  • Fold along the dotted line at the top of the foil package. Keep folded and tear down or cut with scissors at the notch in the direction of the scissors on the dotted line. Tear all the way to the bottom. Be careful to avoid cutting and damaging the buccal film when using scissors.
  • Use your tongue to wet the inside of your cheek or rinse your mouth with water to moisten the area in your mouth where you will apply the buccal film. Avoid placing the buccal film in areas with open sores.
  • Remove the buccal film from the package and hold it with clean, dry fingers with the yellow side facing up.
  • Immediately place the yellow side of the buccal film against the inside of your moistened cheek. Press and hold the buccal film in place for 5 seconds and then take your finger away.
  • The buccal film should stick against your cheek. Leave the buccal film in place until it has completely dissolved, usually within 30 minutes after you apply it. Avoid touching or moving the buccal film with your tongue or fingers after you apply it. Do not eat or drink anything until the buccal film has dissolved completely. Do not chew or swallow the buccal film.


Keep all appointments with your doctor and laboratory. Your doctor may order certain lab tests to check your body’s response to buprenorphine.

Before having any laboratory test (especially those that involve methylene blue), tell your doctor and the laboratory personnel that you are using buprenorphine.

Do not let anyone else use your medication. Buprenorphine buccal (chronic pain) is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.