BuTrans patches are transdermal, self-adhesive patches licensed for the treatment of constant, moderate, non-malignant pain when an opioid is necessary for obtaining adequate analgesia.

BuTrans patches contain buprenorphine and are available in 4 patch strengths: 5 μg/h, 10 μg/h, 15 μg/h and 20 μg/h. Either one or two patches of any strength may be applied simultaneously, for a total of eight dosage options up to a maximum of 40 µg/h.

Structure of the BuTrans patch

Structure of the BuTrans patch1

Buprenorphine is incorporated into an adhesive polymer matrix (acrylate vinyl acetate), from which it is continuously released into the systemic circulation over 7 days.

BuTrans is not licensed for the treatment of acute pain.

  • As with all opioids, side effects have been reported with the use of Butrans. Prior to prescribing Butrans, physicians should familiarise themselves with all of the adverse event and safety information provided in the SmPC
  • Patients should be carefully selected and regularly monitored to ensure that opioids are prescribed appropriately.2-4
  • Patients should be made aware of the potential opioid side effects and the potential for misuse, abuse and addiction.3,4
  • Clear treatment goals related to pain and function should be agreed with the patient.2-4
  • Start at lowest possible dose and up-titrate stepwise according to individual patient response.2
  • The lowest effective dose should be prescribed.2-4
  • Patients should be monitored throughout opioid treatment to reassess the benefits and risks of continued therapy. If benefits do not outweigh risks, reconsider the treatment plans and doses of opioids should be tapered down or discontinued.2-4
  • If discontinuing treatment, the dose should be gradually decreased by 10% every week or every 2 weeks (dependent on patient response) to prevent symptoms of withdrawal.4
  • Addiction is possible even when opioids are taken as directed. The exact prevalence of addiction in patients treated with opioids for chronic pain is difficult to determine.5 Signs of addictive behaviour should be monitored and addressed.3,4
References
  1. Evans HC, Easthope SE. Transdermal buprenorphine. Drugs 2003; 63: 1999-2010.
  2. O’Brien T, Christrup LL, Drewes AM et al. European Pain Federation position paper on appropriate use in chronic pain management. Eur J Pain 2017;21:3-19.
  3. Dowell D, Haegerich T, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain— United States, 2016.
  4. Faculty of Pain Medicine. Opioids Aware: A resource for patients and healthcare professionals to support prescribing of opioid medicines for pain https://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware [Accessed August 2017].
  5. Rosenblum A, Marsch LA, Joseph H et al. Opioids and the treatment of chronic pain: controversies, current status, and future directions. Exp Clin Psychopharmacol. 2008;16:405–16.