Formulary
Buprenorphine: Indications, Dosing, Side Effects and Interactions
Buprenorphine is an opioid-receptor partial agonist (it has opioid agonist and antagonist properties).
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Buprenorphine: Indications, Dosing, Side Effects and Interactions
Buprenorphine is an opioid-receptor partial agonist (it has opioid agonist and antagonist properties).
Drug action
Buprenorphine is an opioid-receptor partial agonist (it has opioid agonist and antagonist properties).
Indications and dose
**Moderate to severe pain for buprenorphine**
- **Child (body-weight 16-25 kg)** (By sublingual administration): 100 micrograms every 6-8 hours.
- **Child (body-weight 25-37.5 kg)** (By sublingual administration): 100-200 micrograms every 6-8 hours.
- **Child (body-weight 37.5-50 kg)** (By sublingual administration): 200-300 micrograms every 6-8 hours.
- **Child (body-weight 50 kg and above)** (By sublingual administration): 200-400 micrograms every 6-8 hours.
- **Child 6 months-11 years** (By intramuscular injection, or by slow intravenous injection): 3-6 micrograms/kg every 6-8 hours (max. per dose 9 micrograms/kg).
- **Child 12-17 years** (By intramuscular injection, or by slow intravenous injection): 300-600 micrograms every 6-8 hours.
Interactions
**Severe interactions:**
- Clomipramine should be used cautiously when co-administered with: Buprenorphine/ opioids as the risk of serotonin syndrome, a potentially life-threatening condition is increased (see section 4.4).
- Trimipramine should be used cautiously when co-administered with: Buprenorphine/opioids, as the risk of serotonin syndrome, a potentially life-threatening condition, is increased (see section 4.4).
- Based on drug interaction studies conducted with Biktarvy or the components of Biktarvy, no clinically significant drug interactions are expected with: amlodipine, atorvastatin, buprenorphine,...
- Buprenorphine/naloxone/Efavirenz Buprenorphine: AUC: 50% Norbuprenorphine: AUC: 71% Efavirenz: No clinically significant pharmacokinetic interaction Despite the decrease in buprenorphine...
- Serotonin syndrome : Molipaxin/Trazodone should be used cautiously when co-administered with: Buprenorphine/opioids, as the risk of serotonin syndrome, a potentially life-threatening condition, is...
- Additional drug-drug interaction studies were performed with the following medical products and showed no clinically significant interactions with Glecaprevir/Pibrentasvir: abacavir, amlodipine,...
- Manerix should be used cautiously when co-administrated with buprenorphine as the risk of serotonin syndrome, a potentially life-threatening condition (see section 4.4).
**Other interactions (21):**
- Medications to consider are those which inhibit reuptake of serotonin (SSRIs, SNRIs, tricyclics, and opioids); those which inhibit catabolism of serotonin (MAOIs, triptans, St John's Wort); those...
- Buprenorphine Not studied, no interaction expected.
- Maraviroc 300 mg twice daily and buprenorphine can be co-administered without dose adjustment.
- Buprenorphine/Naloxone (16/4 to 24/6 mg)/ Elvitegravir (150 mg once daily)/ Cobicistat (150 mg once daily) Buprenorphine: AUC: 35% C min : 66% C max : Naloxone: AUC: 28% C max : 28%...
- Opioids Buprenorphine, 16 mg QD Buprenorphine: No dose adjustment necessary.
- John's Wort [ Hypericum perforatum ], opioids [e.g., fentanyl and its analogues, tramadol, dextromethorphan, tapentadol, pethidine, methadone, pentazocine, buprenorphine and buprenorphine/naloxone...
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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