Butrans Facts

Buprenorphine is a partial mu opioid agonist that has higher binding affinity
but lower intrinsic activity at the mu opioid receptor than traditional full mu
opioid agonists. The partial mu opioid activity allows buprenoprhine to have
sufficient analgesic activity while also providing a ceiling effect for
respiratory depression, making it preferable in patients with comorbidities that
increase their risk with full mu opioid agonists (e.g. high BMI, OSA,
concomitant psychiatric diagnoses, pulmonary disease, concomitant CNS depressant
medications). Buprenorphine also has a unique mechanism of action at other
receptors, such as ORL1 which may contribute to analgesia, and antagonistic
effects at the delta and kappa opioid receptors which theoretically lessens
constipation, and lessens dysphora, abuse potential, and depression.

More information on the pharmacokinetics of Butrans:
-Initial analgesic response: ~17 hours (shown with 10mcg/hr patch)
-Steady-state/therapeutic drug concentration: ~3 days after application
-After removal of patch: concentration decreases by ~50% in 12hr (range 10-24hr)
-Elimination half-life: 24-48 hours

**Butrans medication administration counseling
- total 8 application sites (R&L upper outer arm, upper chest, upper
back, side of chest)
- Wait at least 21 days before going back to same skin spot
- Clean, dry, hairless/nearly hairless skin
- Clean application site with lukewarm water, air dry
- Avoid soaps, alcohol, oils, lotions, or abrasives on site
- Avoid shaving site or applying to hairy/sweaty areas
- Do not apply to irritated skin
- Do not cut patch
- During dose adjustments, use no more than 2 patches at a time
(adjacent to each other)
- Avoid external heat sources, prolonged hot water, direct sunlight
Ok to tape edges
- Disposal: fold adhesive edges on self, flush down toilet