Buprenorphine patch

BUTRANS

Open Buprenorphine patch in the interactive console ↗

Pronunciation: byoo-pre-NOR-feen (BYOO-trans)

Buprenorphine patch ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Buprenorphine patch ballicule

Buprenorphine patch BUTRANS mascot mnemonic cartoon — Visual mnemonic: Buprenorphine patch mascot
**“Bup transdermal”**

What it isPartial mu-opioid agonist and kappa antagonist delivered by 7-day transdermal system; continuous treatment of chronic pain.

Why this oneUnlike sublingual buprenorphine, it carries a PAIN label, not OUD; weekly delivery provides continuous analgesia.

What limits itExternal heat can accelerate absorption; respiratory depression worsens with benzodiazepines, and the patch still carries addiction risk.

Buprenorphine patch molecular structure (skeletal formula) — Molecular structure: Buprenorphine patch

Buprenorphine patch prescription history

Animated chart of estimated U.S. prescriptions per year, Opioid analgesics (1900–2026). Buprenorphine patch enters in 2011 (estimated).

FDA-approved for

chronic pain (around-the-clock) (2010)

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger3 / 4

Weight-gain liability1 / 4

Sedation liability2 / 4

QT / Torsades1 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityRespiratory depression and dependence remain possible, especially with benzodiazepines, alcohol or other sedatives.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Addiction, abuse, and misuse; life-threatening respiratory depression; accidental exposure (fatal, especially in children); neonatal opioid withdrawal syndrome; risks from concomitant use with benzodiazepines or other CNS depressants.

FDA dosing	Population	Start	Target	Max
Severe and persistent pain requiring an around-the-clock opioid (alternatives inadequate); not for PRN use	Adults; opioid-nontolerant	5 mcg/hr patch every 7 days	Individualized	20 mcg/hr

Titration Minimum titration interval 72 hours (time to steady state)

Renal Undefined

Hepatic Not evaluated in severe hepatic impairment; consider an alternate analgesic

Apply a new patch every 7 days

Instructions

Transdermal use on intact skin; wear each patch 7 days
Wait a minimum of 3 weeks before applying to the same site; rotate sites
Do not cut the patch; avoid heat exposure (hot water, direct sun)
Do not abruptly discontinue in physically dependent patients — taper
Doses 7.5–20 mcg/hr only for patients on <=80 mg/day oral morphine equivalent for >=1 week

Available strengths

patch 5, 7.5, 10, 15, 20 mcg/hr
SL film 0.075, 0.15, 0.3, 0.45, 0.6, 0.75, 0.9 mg
SL tab 2, 4, 8, 12 mg
inj 0.3 mg/mL

Contraindications

Significant respiratory depression
Acute or severe bronchial asthma in an unmonitored setting or without resuscitative equipment
Known or suspected gastrointestinal obstruction, including paralytic ileus

Cautions

Opioid-induced hyperalgesia/allodynia
Life-threatening respiratory depression in chronic pulmonary disease or elderly/cachectic/debilitated patients
Adrenal insufficiency
Severe hypotension
Increased intracranial pressure/head injury/impaired consciousness
QTc prolongation
Hepatotoxicity

Adverse reactions

Nausea
Headache
Application-site pruritus/erythema/rash
Dizziness
Constipation
Somnolence
Vomiting
Dry mouth

Pregnancy Insufficient human data; prolonged use during pregnancy can cause neonatal opioid withdrawal syndrome; not recommended immediately before labor.

Lactation Breastfeeding not recommended (risk of excess sedation and respiratory depression); monitor infant for sedation/breathing and withdrawal.

Cost

Buprenorphine patch (BUTRANS)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/unit	CostPlus
5 mcg/hr	patch	per unit	$23.45/ea	not offered
7.5 mcg/hr	patch	per unit	$37.68/ea	not offered
10 mcg/hr	patch	per unit	$32.53/ea	not offered
15 mcg/hr	patch	per unit	$53.78/ea	not offered
20 mcg/hr	patch	per unit	$58.83/ea	not offered