CNS Drugs

, Volume 26, Issue 4, pp 367–373 | Cite as

Buprenorphine 5,10 and 20 μg/h Transdermal Patch: A Guide to Its Use in Chronic Non-Malignant Pain

  • Greg L. Plosker
  • Katherine A. Lyseng-Williamson
Adis Drug Clinical Q&A


Buprenorphine lower-dose (5, 10 and 20 mg/h) transdermal patches, which are administered once every 7 days, are indicated in the management of chronic non-malignant pain. This review focuses on the labelling of this formulation (BuTrans®) in the EU. The analgesic efficacy of transdermal buprenorphine in patients with osteoarthritis of the hip and/or knee has been demonstrated to be equivalent to sublingual buprenorphine, noninferior to prolonged-release tramadol and generally superior to a matching transdermal placebo patch. When used together with regularly scheduled oral paracetamol (acetaminophen), transdermal buprenorphine was noninferior to codeine plus paracetamol. Transdermal buprenorphine has also shown analgesic efficacy in patients with chronic non-malignant pain of various causes.


Buprenorphine Analgesic Efficacy Oral Paracetamol Sublingual Buprenorphine Impaired Gastrointestinal Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Acknowledgements and Disclosures

This article was adapted from Drugs 2011; 71 (18): 2491-509,[7] and was reviewed by: R. Day, Therapeutics Centre, St Vincent’s Hospital, Sydney, NSW, Australia; J.J. Hernández, Pain Medicine and Palliative Care, Rosario University, Bogata, Colombia.

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on the articles. Changes resulting from the comments received were made by the authors on the basis of scientific and editorial merit.


  1. 1.
    Kumar N. WHO normative guidelines on pain management: report of a delphi study to determine the need for guidelines and to identify the number and topics of guidelines that should be developed by WHO. Geneva: World Health Organization, 2007 JunGoogle Scholar
  2. 2.
    Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 2009 Feb; 10(2): 113–30PubMedCrossRefGoogle Scholar
  3. 3.
    Gourlay DL, Heit HA, Almahrezi A. Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Med 2005; 6(2): 107–12PubMedCrossRefGoogle Scholar
  4. 4.
    Pergolizzi J, Boger RH, Budd K, et al. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract 2008; 8(4): 287–313PubMedCrossRefGoogle Scholar
  5. 5.
    Scoping document for WHO treatment guidelines on chronic non-malignant pain in adults. Geneva: World Health Organization, 2008 OctGoogle Scholar
  6. 6.
    BuTrans 5, 10 and 20ug/h transdermal patch: EU summary of product characteristics. Cambridge, UK: Napp Pharmaceuticals Limied, 2010 Mar 11Google Scholar
  7. 7.
    Plosker GL. Buprenorphine 5, 10 and 20mg/h transdermal patch: a review of its use in the management of chronic non-malignant pain. Drugs 2011; 71(18): 2491–509PubMedCrossRefGoogle Scholar
  8. 8.
    Breivik H, Ljosaa TM, Stengaard-Pedersen K, et al. A 6-months, randomised, placebo-controlled evaluation of efficacy and tolerability of a low-dose 7-day buprenorphine transdermal patch in osteoarthritis patients naive to potent opioids. Scand J Pain 2010; 1(3): 122–41CrossRefGoogle Scholar
  9. 9.
    James IG, O’Brien CM, McDonald CJ. A randomized, double-blind, double-dummy comparison of the efficacy and tolerability of low-dose transdermal buprenorphine (BuTrans seven-day patches) with buprenorphine sublingual tablets (Temgesic) in patients with osteoarthritis pain. J Pain Symptom Manage 2010 Aug; 40(2): 266–78PubMedCrossRefGoogle Scholar
  10. 10.
    Karlsson M, Berggren AC. Efficacy and safety of lowdose transdermal buprenorphine patches (5, 10, and 20microg/h) versus prolonged-release tramadol tablets (75, 100, 150, and 200mg) in patients with chronic osteoarthritis pain: a 12-week, randomized, open-label, controlled, parallelgroup noninferiority study. Clin Ther 2009 Mar; 31(3): 503–13PubMedCrossRefGoogle Scholar
  11. 11.
    Munera C, Drehobl M, Sessler NE, et al. A randomized, placebo-controlled, double-blinded, parallel-group, 5-week study of buprenorphine transdermal system in adults with osteoarthritis. J Opioid Manag 2010; 6(3): 193–202PubMedCrossRefGoogle Scholar
  12. 12.
    Conaghan PG, O’Brien CM, Wilson M, et al. Transdermal buprenorphine plus oral paracetamol vs an oral codeineparacetamol combination for osteoarthritis of hip and/or knee: a randomised trial. Osteoarthritis Cartilage 2011; 19: 930–8PubMedCrossRefGoogle Scholar
  13. 13.
    Gordon A, Callaghan D, Spink D, et al. Buprenorphine transdermal system in adults with chronic low back pain: a randomized, double-blind, placebo-controlled crossover study, followed by an open-label extension phase. Clin Ther 2010 May; 32(5): 844–60PubMedCrossRefGoogle Scholar
  14. 14.
    Gordon A, Rashiq S, Moulin DE, et al. Buprenorphine transdermal system for opioid therapy in patients with chronic low back pain. Pain Res Manag 2010; 15(3): 169–78PubMedGoogle Scholar
  15. 15.
    Landau CJ, Carr WD, Razzetti AJ, et al. Buprenorphine transdermal delivery system in adults with persistent noncancer-related pain syndromes who require opioid therapy: a multicenter, 5-week run-in and randomized, double-blind maintenanceof-analgesia study. Clin Ther 2007 Oct; 29(10): 2179–93PubMedCrossRefGoogle Scholar
  16. 16.
    American College of Rheumatology. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [online]. Available from URL: [Accessed 2011 Dec 22]
  17. 17.
    Schutter U, Ritzdorf I, Heckes B. 7-day buprenorphine patch-an option when therapy with tramadol or tilidine/ naloxone is inadequate: results of a non-intervention study [in German]. MMW-Fortschr Med 2010; 152(II): 62–9PubMedGoogle Scholar
  18. 18.
    Böhme K, Heckes B, Thomitzek K. Seven-day buprenorphine transdermal patch in multimorbid patients on longterm ibuprofen or diclofenac [in German]. MMW-Fortschr Med 2010; 152(IV): 125–32Google Scholar
  19. 19.
    Dahan A, Yassen A, Romberg R, et al. Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth 2006 May; 96(5): 627–32PubMedCrossRefGoogle Scholar
  20. 20.
    Kress HG. Clinical update on the pharmacology, efficacy and safety of transdermal buprenorphine. Eur J Pain 2009 Mar; 13(3): 219–30PubMedCrossRefGoogle Scholar
  21. 21.
    Dahan A. Opioid-induced respiratory effects: new data on buprenorphine. Palliat Med 2006; 20 Suppl. 1: S3–8PubMedCrossRefGoogle Scholar
  22. 22.
    Butrans (buprenorphine) transdermal system for transdermal administration: US prescribing information. Stamford (CT): Purdue Pharma L.P., 2010 JunGoogle Scholar

Copyright information

© Adis Data Information BV 2012

Authors and Affiliations

  • Greg L. Plosker
    • 1
  • Katherine A. Lyseng-Williamson
    • 1
  1. 1.AdisMairangi Bay, North Shore 0754, AucklandNew Zealand

Personalised recommendations