Thursday, August 8, 2013

Butrans

What is Butrans?

Butrans (buprenorphine)is an opioid pain medication. An opioid is sometimes called a narcotic.
Butrans transdermal (skin patch) is used to treat moderate to severe chronic pain when treatment is needed around the clock.
Butrans is not for treating pain just after surgery, or for treating occasional short-term pain.
Butrans transdermal may also be used for purposes not listed in this medication guide.

Important information about Butrans

You should not use Butrans if you are allergic to buprenorphine, or if you have a severe breathing disorder such as asthma, or a bowel obstruction called paralytic ileus.
Never wear more than one Butrans skin patch at a time unless your doctor has told you to.
Do not expose the Butrans skin patch to heat while you are wearing it. Heat can increase the amount of drug you absorb through your skin and may cause harmful effects.
Call your doctor at once if you have weak or shallow breathing, snoring that is new or unusual, slow heart rate, confusion, severe dizziness, seizure, or feeling like you might pass out.
Avoid letting another person handle your Butrans skin patches. Keep both used and unused patches out of the reach of children or pets. The amount of buprenorphine in a used skin patch could be fatal to a child or pet who accidentally sucks or chews on it. Seek emergency medical attention if this happens. Do not stop using Butrans suddenly, or you could have unpleasant withdrawal symptoms.
Ask your doctor how to avoid withdrawal symptoms when you stop using Butrans.

Before using Butrans

You should not use Butrans if you are allergic to buprenorphine, or if you have:
  • asthma or severe breathing disorder; or
  • a bowel obstruction called paralytic ileus.
Do not use Butrans if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use Butrans before the MAO inhibitor has cleared from your body.
To make sure you can safely use Butrans, tell your doctor if you have any of these other conditions:
  • COPD (chronic obstructive pulmonary disease), sleep apnea, or other breathing disorders;
  • a personal or family history of Long QT syndrome:
  • hepatitis B or C;
  • liver or kidney disease;
  • a thyroid disorder;
  • gallbladder disease;
  • curvature of the spine;
  • a history of head injury or brain tumor;
  • epilepsy or other seizure disorder;
  • Addison's disease or other adrenal gland disorders;
  • enlarged prostate, urination problems;
  • depression or other mental illness; or
  • a history of drug or alcohol addiction.
Butrans may be habit-forming and should be used only by the person it was prescribed for. Never share Butrans patches with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
FDA pregnancy category C. It is not known whether buprenorphine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Butrans. Buprenorphine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Butrans.

Your dose needs may be different if you have recently used an opioid pain medicine and your body is tolerant to it. Opioids include Tylenol #3, Lortab, Vicodin, Exalgo, OxyContin, Percocet, Actiq, Duragesic, Methadose, Dolophine, Kadian, MS Contin, Oramorph, Opana, and many others. Talk with your doctor if you are not sure you are opioid-tolerant.

How should I use Butrans?

Use Butrans exactly as prescribed. Never use Butrans patches in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Butrans patches comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
If you are switching to Butrans transdermal from another narcotic pain medicine, you may need to slowly stop using the other medicine. Follow your doctor's instructions.
Apply the Butrans skin patch only to clean, dry skin. Use only clear water to wash the skin before you apply a skin patch. Soaps or other chemicals could increase the amount of buprenorphine your skin absorbs.
Apply the Butrans patch to a flat and hairless area of the chest, back, side, or outer side of your upper arm. Wear the patch around the clock for 7 days. Never wear more than one Butrans skin patch at a time unless your doctor has told you to.
Do not use a Butrans transdermal skin patch if it has been cut or damaged.
After removing a skin patch fold it in half, sticky side in, and flush the patch down the toilet or use the Patch-Disposal Unit provided with this medication. Apply a new patch to a different skin area on the chest, back, side, or upper arm. Do not use the same skin area twice in a row.
Never share Butrans with another person, even if they have the same symptoms you have. Ask your doctor how to avoid withdrawal symptoms when you stop using Butrans. Keep both used and unused Butrans skin patches out of the reach of children or pets. The amount of buprenorphine in a used skin patch could be fatal to a child or pet who accidentally sucks or chews on the patch. Seek emergency medical attention if this happens.
Keep track of how many skin patches have been used from each new package of this medication. Buprenorphine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
Store Butrans at room temperature. Keep each patch in its foil pouch until you are ready to use it.

What happens if I miss a dose?

If you forget to change a patch on your scheduled day, remove the patch and apply a new one as soon as you remember. Do not wear extra patches to make up a missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. The amount of buprenorphine in a used or unused skin patch can be fatal to a child who accidentally sucks or chews on the patch.
Overdose symptoms may include extreme drowsiness, weak or limp feeling, weak pulse, cold and clammy skin, fainting, shallow breathing, snoring, or breathing that stops.

What should I avoid while using Butrans?

Do not drink alcohol or you may have serious, life-threatening side effects. Buprenorphine may impair your thinking or reactions. Avoid driving or operating machinery until you know how Butrans will affect you. Do not expose the skin patch to heat while you are wearing it. This includes a hot tub, heating pad, electric blanket, sauna, heated water bed, or a hot bath. Avoid exposure to sunlight or tanning beds. Heat can increase the amount of drug you absorb through your skin and may cause harmful effects.
Avoid letting another person handle your Butrans skin patches. If the sticky side of a skin patch comes into contact with another person, wash the skin with clear water and seek medical care at once.

Butrans side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Butrans: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Stop using Butrans and call your doctor at once if you have a serious side effect such as:
  • slow heart rate, weak or shallow breathing, deep sighs, snoring that is new or unusual;
  • confusion, severe dizziness, feeling like you might pass out;
  • blisters, swelling, or severe irritation where the patch was worn;
  • seizure (convulsions); or
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious Butrans side effects may include:
  • headache;
  • vomiting, dry mouth, upset stomach, constipation;
  • mild dizziness or drowsiness; or
  • redness, itching, or mild skin rash where the patch was worn.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Butrans?

Tell your doctor if you regularly use other medicines that can make you sleepy or slow your breathing (such as cold or allergy medicine, sedatives, anti-nausea medicine, other narcotic pain medicines, sleeping pills, muscle relaxers, heart rhythm medications, and medicine for seizures, depression, or anxiety). They can add to the side effects of buprenorphine and dangerous side effects may result.
  • dexamethasone (Decadron, Hexadrol);
  • St. John's wort;
  • rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), or rifapentine (Priftin);
  • phenobarbital (Solfoton) or other barbiturates;
  • diazepam (Valium) or similar medicines such as alprazolam (Xanax), lorazepam (Ativan), clorazepate (Tranxene), and others;
  • a heart rhythm medication such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), flecaininde (Tambocor), procainamide (Pronestyl), propafenone, (Rythmol), quinidine (Quin-G), sotalol (Betapace), and others;
  • HIV medication such as efavirenz (Sustiva), etravirine (Intelence), nevirapine (Viramune), or ritonavir (Kaletra, Norvir); or
  • seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline).
This list is not complete and other drugs may interact with Butrans. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.