New transdermal narcotic patch

Pick a new site to place the patch and make sure skin is clean, intact, and free from hair. Carefully take off one side of the back and stick it to the skin and then take off the other side of the backing. Firm press down the patch for at least 15 to 20 seconds make sure it has no bumps, folds, or bubbles. You may have to reinforce it with extra tape. More Nursing Skills. Disclosure and Privacy Policy This website provides entertainment value only, not medical advice or nursing protocols.

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Buprenorphine patches are used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. It is in a class of medications called opiate narcotic analgesics.

It works by changing the way the brain and nervous system respond to pain. Transdermal buprenorphine comes as a patch to apply to the skin. The patch is usually applied to the skin once every 7 days. Change your patch at about the same time of day every time you change it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Apply buprenorphine patches exactly as directed. Your doctor may start you on a low dose buprenorphine patch and gradually increase your dose, not more often than once every 3 days. If this increase involves the use of two patches, remove your current patch and at the same time, place the two new patches next to each other at a new site.

If your doctor tells you to use two patches, you should always change and apply them at the same time. Your doctor may decrease your dose if you experience side effects. Contact your doctor if the dose you are taking does not control your pain. Talk to your doctor about how you are feeling during your treatment with buprenorphine patches.

Buprenorphine skin patches are only for use on the skin. Do not place patches in your mouth or chew or swallow the patches.

Do not stop using buprenorphine patches without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop using buprenorphine patches you may have symptoms of withdrawal. Call your doctor if you experience any of these symptoms of withdrawal: restlessness, teary eyes, runny nose, yawning, sweating, chills, hair standing on end, muscle aches, large pupils black circles in the center of the eyes , irritability, diarrhea, nausea, vomiting, anxiety, pain in the joints, weakness, fast heartbeat, or rapid breathing.

Do not use a buprenorphine patch that is cut, damaged, or changed in any way. If you use cut or damaged patches, you may receive most or all of the medication at once, instead of slowly over 7 days. This may cause serious problems, including overdose and death. If your buprenorphine patch is exposed to extreme heat, it may release too much medication into your body at once. This can cause serious or life-threatening symptoms.

Do not expose your patch or the skin around it to direct heat such as heating pads, electric blankets, heat lamps, saunas, hot tubs, and heated water beds. Do not take long, hot baths or sunbathe while you are wearing the patch. You may bathe or shower while you are wearing a buprenorphine patch. If the patch falls off during these activities, dispose of it properly. Then dry your skin completely and apply a new patch.

Leave the new patch in place for 7 days after you apply it. You can apply a buprenorphine patch to your upper outer arms, upper chest, upper back, or the side of your chest. Choose an area of skin that is flat and hairless. Do not apply the patch to parts of the body that irritated, broken, cut, damaged, or changed in any way.

If there is hair on the skin, use scissors to clip the hair as close to the skin as possible. Do not shave the area. Wait at least 3 weeks before applying a new patch to same site. Buprenorphine should not be used to treat mild or moderate pain, short-term pain, or pain that can be controlled by medication that is taken as needed. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. If you forget to apply or change a buprenorphine patch, apply the patch as soon as you remember it.

Be sure to remove your used patch before applying a new patch. Wear the new patch for the period of time prescribed by your doctor usually 7 days and then replace it. Do not wear two patches at once unless your doctor has told you that you should. Buprenorphine patches may cause other side effects. Call your doctor if you have any unusual problems while using this medication. Keep this medication out of reach of children.

Store it at room temperature and away from excess heat and moisture not in the bathroom. Discard any patches that are outdated or as soon as they are no longer needed. Use a Patch Disposal Unit provided to you by the manufacturer to safely dispose of the unneeded or outdated patch s in the trash. Do not put unneeded or outdated buprenorphine patches in a garbage can without first sealing them in a Patch Disposal Unit. Alternatively, you may dispose of the patches by carefully removing the adhesive backing, folding the sticky sides of each patch together so that it sticks to itself, and flushing the patches down the toilet.

Talk to your pharmacist about the proper disposal of your medication. Avoid the use of Butrans in patients with circulatory shock. In patients who may be susceptible to the intracranial effects of CO 2 retention e. Monitor such patients for signs of sedation and respiratory depression, particularly when initiating therapy with Butrans. Opioids may also obscure the clinical course in a patient with a head injury. Avoid the use of Butrans in patients with impaired consciousness or coma. For patients at increased risk of hepatotoxicity, obtain baseline liver enzyme levels and monitor periodically and during treatment with Butrans.

Time of onset varies, ranging from days to months following the initiation of Butrans treatment. Instruct patients to promptly report the development of severe application site reactions and discontinue therapy. The most common signs and symptoms include rashes, hives, and pruritus.

Cases of bronchospasm, angioneurotic edema, and anaphylactic shock have been reported. A history of hypersensitivity to buprenorphine is a contraindication to the use of Butrans. Do not abruptly discontinue buprenorphine in a patient physically dependent on opioids. When discontinuing Butrans in a physically dependent patient, gradually taper the dosage. Rapid tapering of buprenorphine in a patient physically dependent on opioids may lead to a withdrawal syndrome and return of pain.

Avoid concomitant use of Butrans with a full opioid agonist analgesic. Advise patients and their caregivers to avoid exposing the Butrans application site and surrounding area to direct external heat sources, such as heating pads or electric blankets, heat or tanning lamps, saunas, hot tubs, and heated water beds while wearing the system because an increase in absorption of buprenorphine may occur.

Advise patients against exposure of the Butrans application site and surrounding area to hot water or prolonged exposure to direct sunlight. There is a potential for temperature-dependent increases in buprenorphine released from the system resulting in possible overdose and death. Monitor patients wearing Butrans systems who develop fever or increased core body temperature due to strenuous exertion for opioid side effects and adjust the Butrans dose if signs of respiratory or central nervous system depression occur.

Butrans is contraindicated in patients with known or suspected gastrointestinal obstruction, including paralytic ileus. The buprenorphine in Butrans may cause spasm of the sphincter of Oddi. Opioids may cause increases in the serum amylase. Monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms. The buprenorphine in Butrans may increase the frequency of seizures in patients with seizure disorders, and may increase the risk of seizures in other clinical settings associated with seizures.

Monitor patients with a history of seizure disorders for worsened seizure control during Butrans therapy. Butrans may impair the mental and physical abilities needed to perform potentially hazardous activities such as driving a car or operating machinery. Warn patients not to drive or operate dangerous machinery unless they are tolerant to the effects of Butrans and know how they will react to the medication. Butrans has not been studied and is not approved for use in the management of addictive disorders.

Provide Resources to. Use the Dose. Conversion Tool. Butrans is a Schedule III transdermal extended-release opioid. Butrans has an abuse potential similar to other Schedule III opioids Butrans can be abused and is subject to misuse, addiction, and criminal diversion.

Life-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression may occur with use of Butrans. Accidental Exposure Accidental exposure to even one dose of Butrans, especially in children, can result in a fatal overdose of buprenorphine [see Warnings and Precautions 5.

Neonatal Opioid Withdrawal Syndrome Prolonged use of Butrans during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. Reserve concomitant prescribing of Butrans and benzodiazepines or other CNS depressants for use in patients for whom alternative treatment options are inadequate.

Limit dosages and durations to the minimum required. Follow patients for signs and symptoms of respiratory depression and sedation. Limitations of Use Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve Butrans for use in patients for whom alternative treatment options e.

Butrans is not indicated as an as-needed prn analgesic. Neonatal Opioid Withdrawal Syndrome Prolonged use of Butrans during pregnancy can result in withdrawal in the neonate. Life-Threatening Respiratory Depression in Patients with Chronic Pulmonary Disease or in Elderly, Cachectic, or Debilitated Patients The use of Butrans in patients with acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment is contraindicated.

Adrenal Insufficiency Cases of adrenal insufficiency have been reported with opioid use, more often following greater than one month of use.