Buprenex: Uses, Dosage & Side Effects

If you or a loved one has been prescribed Buprenex, it is common to have questions. As an opioid, Buprenex is sometimes prescribed to treat pain. However, it can also carry a risk of abuse, addiction and dependence. As such, it is important to be aware of Buprenex’s risks and benefits when you take the medication.

What Is Buprenex?

Buprenex is the brand name for an injectable form of buprenorphine, a medication prescribed to treat moderate to severe pain. This medication belongs to the family of opioid drugs, which directly affect the brain and central nervous system. Buprenex helps reduce pain by disrupting the delivery of pain messages to the brain.

Buprenex should only be used as directed by a doctor and is usually only given in hospitals. Taking the correct dosage of Buprenex can help you avoid adverse side effects and lower the risk of developing a substance use disorder. Misusing or abusing Buprenex or other substances along with it can result in serious side effects or even overdose, as this medication is a strong pain reliever.

How Is Buprenex Used?

Buprenex treats moderate to severe pain in humans and, in some cases, animals and is administered by injection into a muscle or vein. Your doctor or a nurse will administer this shot, which is typically reserved for hospital inpatients.

This medication should start to improve pain symptoms within one hour of injection. Your doctor will prescribe a dosage of Buprenex that is the best fit to alleviate your pain levels. If you take Buprenex for a long period and suddenly stop, you may experience withdrawal symptoms.

How Buprenex Works

As an opioid, Buprenex works by blocking your perception of pain by binding to opioid receptors in your central nervous system. However, it is important to understand how the drug acts in your body and why your doctor may or may not prescribe other medications with Buprenex.

Drug Interactions With Buprenex

Buprenex interacts with many other medications. As the drug is reserved for administration in a hospital setting, your doctor and nurses will closely monitor any other medications you are taking alongside Buprenex. That said, some of the medications that can interact with Buprenex, enhancing its side effects, include:

• Other central nervous system depressants like opioids, benzodiazepines and muscle relaxants
• Drugs like ketoconazole, which act on the liver enzyme CYP3A4
• Antidepressants and other drugs that impact serotonin
• Monoamine oxidase inhibitors
• Diuretics
• Anticholinergic drugs
• Antiretroviral medications like HIV/AIDS medications

Pharmacology of Buprenex

Buprenex is a partial opioid agonist, which partially activates the mu opioid receptor of the brain and spinal cord. This makes it safer than other opioids like oxycodone or hydromorphone, which are full agonists and fully activate the opioid receptor. As a partial agonist, Buprenex can treat your pain, but there is a ceiling effect on its side effects, making it safer than other alternatives and helping prevent overdose.

Buprenex Dosage and Administration

Buprenex is restricted to a healthcare setting and, therefore, is unavailable for outpatient use. Your doctor or nurse will administer Buprenex in one of two ways: into a muscle or slowly through an IV. The starting dose of Buprenex is 0.3 mg every six hours as needed. If you still need pain relief 30–60 minutes after your dose, your doctor or nurse may give you a second dose.

Buprenex Side Effects

Buprenex can cause mild to severe side effects. Mild side effects include:

• Chills
• Headaches
• Lower back pain
• Stuffy nose
• Sneezing
• Sleep problems
• Coughing that leads to hoarseness
• Constipation
• Nausea

More serious side effects caused by Buprenex are:

• Increased sweating
• Lightheadedness
• Feeling of warmth in the face
• Redness of the face and neck
• Muscle weakness
• Slowed breathing

Tell your doctor or nurse immediately if any side effects worsen or persist. It is important to note that these are not all of the possible side effects of Buprenex. Please consult your doctor or pharmacist for a complete list for your unique situation. If you experience any of these side effects, it is important to talk to your doctor. They can help you determine if the side effects are serious and if you need to take any remedial action.

Precautions for Buprenex Use

Although most people can use Buprenex safely, your doctor may monitor you more closely if you have certain medical conditions like:

• Advanced age 
• Frailty
• Liver problems
• Biliary tract problems
• Lung problems
• Kidney problems
• Thyroid problems
• Adrenal cortical insufficiency 
• CNS depression or coma
• Psychosis
• Prostate problems in men
• Bladder problems
• Alcoholism
• Kyphoscoliosis

When Not To Use Buprenex

Some people should not take Buprenex at all. Your doctor will choose a different medication to relieve pain in such cases. Buprenex should not be taken if you have:

• Slowed breathing
• An asthma attack
• Gastrointestinal obstruction
• Hypersensitivity to any ingredient in Buprenex

Considerations Prior To Use

While doctors consider your medical history and conditions before Buprenex use, one of the biggest considerations doctors make is if you are pregnant. Buprenex has not been studied during labor and delivery, so your doctor may choose an alternate agent for pain control if you are a pregnant woman in labor.

Buprenex Addiction

Even though it is restricted to a hospital setting, painkillers like Buprenex are susceptible to misuse and abuse, even when used at the correct dosage. Using Buprenex while taking any other medications can also increase the risk of addiction, dependence or even overdose.

Tell your doctor or nurse immediately if you experience slowed heart rate, extreme drowsiness, weak pulse or clammy skin. These can be signs of an overdose that can be fatal.

Buprenex Overdose

As an opioid, Buprenex can slow down the central nervous system and an individual’s breathing. If too much Buprenex is taken, it can lead to a severe overdose, including respiratory depression, leading to a dangerous buildup of carbon dioxide in the body. 

The symptoms of a Buprenex overdose include:

• Pinpoint pupils
• Decreased level of consciousness
• Severe respiratory depression
• Blue lips and fingernails
• Loss of consciousness
• Coma

Because Buprenex is restricted to a hospital setting, if someone is experiencing a Buprenex overdose, hit the call bell and tell the nurse immediately. Naloxone, a medication that can reverse the effects of an opioid overdose, may be administered.

If you are concerned that you or someone you know may have taken too much Buprenex, it is important to seek medical attention immediately. Buprenex overdose can be fatal, but it is important to remember that help is available.

Buprenex Withdrawal and Detox

If someone struggling with Buprenex misuse or addiction stops taking the medication, they will experience withdrawal. Common withdrawal symptoms of Buprenex are:

• Diarrhea
• Runny nose and sneezing
• Tremors
• Vomiting
• Irritability
• Insomnia
• Muscle soreness
• Anxiety

Buprenex Withdrawal Timeline

Buprenex withdrawal symptoms can happen within 12 hours after quitting the medication and can sometimes last for days or even weeks. Withdrawal typically lasts three to five days, with symptoms peaking after 24–48 hours.

Buprenex Withdrawal Management

Managing Buprenex withdrawal symptoms can be challenging. It can lead to people relapsing or switching to a more potent opioid. The most effective way to manage withdrawal symptoms is to speak with a doctor or enroll in a treatment program. Doctors will typically taper their patients off Buprenex if they are dependent on the opioid. When you are discharged from the hospital, your doctor may switch you to an oral form of buprenorphine or another opioid. Tapering involves gradually reducing the dosage of Buprenex over time rather than quitting cold turkey. This process successfully relieves the severity of withdrawal symptoms and can sometimes eliminate them. 

Buprenex Detox

Detoxing from Buprenex abuse can be dangerous. People often experience even worse cravings than before, which can tempt them to relapse. It is not safe for someone with a substance abuse disorder to try detoxing alone without the help of a rehabilitation facility or a doctor’s supervision.

A facility can provide medications to help with severe withdrawal symptoms. Buprenex withdrawal symptoms can be similar to the flu, including insomnia, anxiety, vomiting, diarrhea and irritability. A facility can offer medications to help with these symptoms and provide counseling and support to help people through medical detox.

Detoxing from Buprenex is an important step in the recovery process. However, it is not the only step. After medical detox, people must continue treatment to address the underlying issues that led to their addiction. This may include therapy, counseling or 12-step programs.

Treatment for Buprenex Addiction

The best treatment for Buprenex addiction depends on the individual’s needs and circumstances. Some people may benefit from inpatient treatment, while others may do well in an outpatient program. It is important to talk to a doctor or addiction specialist to determine the best course of treatment.

Inpatient Buprenex Rehab

Inpatient treatment for Buprenex addiction is typically voluntary but may be mandated by the courts as an alternative to jail time. Inpatient programs provide a safe, drug-free environment where patients can gain an awareness of how substance abuse has affected their lives.

Inpatient programs typically last four weeks but may be longer in cases of severe addiction. Patients live onsite 24/7 and attend several counseling sessions daily and group and individual activities. This type of treatment allows patients to focus on their recovery without the distractions of everyday life.

Outpatient Buprenex Rehab

Outpatient programs are a good option for people who cannot commit to an inpatient program. Outpatient programs typically meet for one to two-hour sessions three days per week. This type of treatment allows patients to continue living at home and working while they receive treatment.

Outpatient programs offer many of the same benefits as inpatient programs, including counseling and group and individual therapy. Outpatient programs also provide patients with a home base for recovery where they can develop relationships with people who will hold them accountable.

How Long Does Buprenex Stay In Your System?

Buprenex’s half-life is 1.2–7.2 hours, with an average of 2.2 hours. This means that it takes, on average, 2.2 hours for the amount of Buprenex in your body to be cut in half. The length of time Buprenex stays in your system will also depend on several factors, including metabolism, weight and liver function. Generally, it takes 7–40 hours for Buprenex to be eliminated from the body.

If you are taking Buprenex for pain, you should talk to your doctor about how long the drug will stay in your system. This is important to know if you are planning to undergo surgery or taking other medications that interact with Buprenex.

Mixing Buprenex and Alcohol

Buprenex is a powerful opioid medication that can be dangerous when mixed with alcohol or other central nervous system depressants. Combining Buprenex and alcohol can lead to severe respiratory depression and an increased risk of overdose.

The primary signs of opioid overdose include pinpoint pupils, a severely reduced level of consciousness and acute respiratory depression. If you or someone you know is experiencing any of these symptoms after taking Buprenex and alcohol, call 911 immediately.

Alcohol interferes with the liver’s ability to process Buprenex, leading to elevated plasma concentrations of the drug and an increased risk for opioid toxicity. This means that even if you take a normal dose of Buprenex, the effects of the drug can be amplified when you also drink alcohol.

In addition to alcohol, other medications should not be mixed with Buprenex. These include MAO inhibitors for depression and first-generation antihistamines. If you take any of these medications, talk to your doctor before taking Buprenex.

It is important to follow your doctor’s instructions carefully when taking Buprenex. If you have any questions or concerns, talk to your doctor.

Help for Buprenex Addiction

Are you or a loved one misusing a Buprenex prescription? Buprenex addiction is extremely dangerous and can even lead to death. You don’t have to live your life being controlled by a prescription. Find out how recovery can completely transform your life. Visit The Recovery Village or call us toll-free at 855-548-9825 to learn how recovery can work for you. Your sobriety can start by picking up the phone and calling us today.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more