Buprenorphine 5,10 and 20 μg/h Transdermal Patch: A Guide to Its Use in Chronic Non-Malignant Pain
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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.
KeywordsBuprenorphine Analgesic Efficacy Oral Paracetamol Sublingual Buprenorphine Impaired Gastrointestinal Function
Acknowledgements and Disclosures
This article was adapted from Drugs 2011; 71 (18): 2491-509, 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.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
- 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.Scoping document for WHO treatment guidelines on chronic non-malignant pain in adults. Geneva: World Health Organization, 2008 OctGoogle Scholar
- 6.BuTrans 5, 10 and 20ug/h transdermal patch: EU summary of product characteristics. Cambridge, UK: Napp Pharmaceuticals Limied, 2010 Mar 11Google Scholar
- 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.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
- 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.American College of Rheumatology. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [online]. Available from URL: http://www.rheumatology.org/practice/clinical/clinicianresearchers/outcomes-instrumentation/WOMAC.asp [Accessed 2011 Dec 22]
- 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
- 22.Butrans (buprenorphine) transdermal system for transdermal administration: US prescribing information. Stamford (CT): Purdue Pharma L.P., 2010 JunGoogle Scholar