{"id":1685,"date":"2023-06-25T17:31:26","date_gmt":"2023-06-25T17:31:26","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/buprenorphine\/"},"modified":"2023-06-25T19:48:05","modified_gmt":"2023-06-25T19:48:05","slug":"buprenorphine","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/buprenorphine\/","title":{"rendered":"Buprenorphine"},"content":{"rendered":"

<\/p>\n

Buprenorphine<\/h1>\n

CLINICAL USE<\/h3>\n

Opioid analgesic<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n
  • Sublingual: 200\u2013400 mcg every 6\u20138 hours<\/li>\n
  • IM, Slow IV: 300\u2013600 mcg every 6\u20138 hours<\/li>\n
  • Transdermal:<\/li>\n
  • Transtec: 35\u2013140 mcg\/hour every 96 hours<\/li>\n
  • Butrans: 5\u201340 mcg\/hour, change patch every 7 days
    \n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :467.6<\/li>\n
  • %Protein binding                           :96<\/li>\n
  • %Excreted unchanged in urine     : Minimal<\/li>\n
  • Volume of distribution (L\/kg)       :2.5<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :20\u201325 (Transdermal 30 hours)\/Unchanged
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function, but avoid very large doses<\/li>\n
  • <10           : Reduce dose by 25\u201350% initially and increase as tolerated; avoid very large single doses Transdermal: Dose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Dialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/min<\/li>\n
  • HD                     :Dialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/min<\/li>\n
  • HDF\/high flux   :Dialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/min<\/li>\n
  • CAV\/VVHD      :Not dialysed. Dose as in GFR=10\u201320 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Antidepressants: possible CNS excitation or depression (hypotension or hypertension) if administered with MAOIs or moclobemide \u2013 avoid concomitant use; sedative effects possibly increased when given with tricyclics<\/li>\n
  • Antifungals: metabolism inhibited by ketoconazole \u2013reduce buprenorphine dose<\/li>\n
  • Sodium oxybate: avoid concomitant use
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Sublingual, IM, IV, transdermal<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • It may take up to 30 hours for plasma buprenorphine concentration to decrease by 50% after the Transtec or Butrans patch has been removed<\/li>\n
  • Do not give another opiate for 24 hours after the Transtec or Butrans patch has been removed<\/li>\n
  • Naloxone 5\u201312 mg may reverse the effects of Transtec or Butrans but the effect may be delayed by 30 minutes<\/li>\n
  • Patches are not suitable for acute pain<\/li>\n","protected":false},"excerpt":{"rendered":"

    Buprenorphine CLINICAL USE Opioid analgesic DOSE IN NORMAL RENAL FUNCTION<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1685","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1685","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1685"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1685\/revisions"}],"predecessor-version":[{"id":2875,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1685\/revisions\/2875"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1685"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1685"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1685"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}