{"id":3756,"date":"2025-03-31T18:11:49","date_gmt":"2025-03-31T18:11:49","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/buprenorphine-txt\/"},"modified":"2025-03-31T18:11:49","modified_gmt":"2025-03-31T18:11:49","slug":"buprenorphine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/buprenorphine-txt\/","title":{"rendered":"Buprenorphine.txt"},"content":{"rendered":"

Buprenorphine<\/h1>\n

CLINICAL USE <\/H3>
\nOpioid analgesic

DOSE IN NORMAL RENAL FUNCTION <\/H3><\/p>\n
  • Sublingual: 200\u2013400 mcg every 6\u20138 hours\n
  • IM, Slow IV: 300\u2013600 mcg every 6\u20138 hours\n
  • Transdermal:\n
  • Transtec: 35\u2013140 mcg\/hour every 96 hours\n
  • Butrans: 5\u201340 mcg\/hour, change patch every 7 days

    PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :467.6<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :96<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : Minimal<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :2.5<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :20\u201325 (Transdermal 30 hours)\/Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function, but avoid very large doses
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Reduce dose by 25\u201350% initially and increase as tolerated; avoid very large single doses Transdermal: Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\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\n
  • Antifungals: metabolism inhibited by ketoconazole \u2013reduce buprenorphine dose\n
  • Sodium oxybate: avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Sublingual, IM, IV, transdermal

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>\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\n
  • Do not give another opiate for 24 hours after the Transtec or Butrans patch has been removed\n
  • Naloxone 5\u201312 mg may reverse the effects of Transtec or Butrans but the effect may be delayed by 30 minutes\n
  • Patches are not suitable for acute pain
    \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":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3756","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\/3756","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=3756"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3756\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}