20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function, but avoid very large doses
<10           : Reduce dose by 25–50% initially and increase as tolerated; avoid very large single doses Transdermal: Dose as in normal renal function
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Dialysed. Dose as in GFR
<10           : mL/min
HD                     :Dialysed. Dose as in GFR
<10           : mL/min
HDF/high flux   :Dialysed. Dose as in GFR
<10           : mL/min
CAV/VVHD      :Not dialysed. Dose as in GFR=10–20 mL/min
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Antidepressants: possible CNS excitation or depression (hypotension or hypertension) if administered with MAOIs or moclobemide – avoid concomitant use; sedative effects possibly increased when given with tricyclics
Antifungals: metabolism inhibited by ketoconazole –reduce buprenorphine dose
Sodium oxybate: avoid concomitant use
ADMINISTRATION
Reconstition
–
Route
Sublingual, IM, IV, transdermal
Rate of Administration
–
Comments
–
OTHER INFORMATION
It may take up to 30 hours for plasma buprenorphine concentration to decrease by 50% after the Transtec or Butrans patch has been removed
Do not give another opiate for 24 hours after the Transtec or Butrans patch has been removed
Naloxone 5–12 mg may reverse the effects of Transtec or Butrans but the effect may be delayed by 30 minutes