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(bupe) buprenorphine patches
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2/27
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1.
buprenorphine patches
#1
leftwing
Bluelight Crew
Join DateOct 2005Posts17,411
04-03-2008 08:59
ive just been prescribed 10mg bupe patches (10mics/hr), leaving them onfor a few days a time. before this i was still unsure what type of patches iwould be recieving (for those who read my other thread a little whileago) but up until guessed it would be a fentanyl pacth. bupe never even
passed my mine, because i wasnt aware of it being prescribed for pain onmany ocassions.
has anyone else had any experience with these for pain management? ivespondylosis, curvature to the back and neck pain which is allcongenital...my blessed genes. ive just got off tramadol finally today 2weeks before i was scheduled to.
ive also now had the patch on for about 8 hours im guessing and amstarting to feel some pain dissipate, until now ive knocked myself outwith valium. which raises my next question. im fairly tolerant to valium(100mg+ as a start sometime) but only took 70 mgs around 6 hours agoand normally now i would still be hazed as shit and barely functional to
perform out of the way tasks, but i now feel somewhat less buzzed from
when id just before i dozed off and am feeling a little more alert.interactions with the bupe maybe?
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patcheshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page2http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page3http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page4http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page5http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page5http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?goto=newposthttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5781998&viewfull=1#post5781998http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page5http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page2http://www.bluelight.ru/vb/threads/366074-buprenorphine-patcheshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page2http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page3http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page4http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page5http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches/page5http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?goto=newposthttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5781998&viewfull=1#post5781998http://www.bluelight.ru/vb/members/72888-leftwing7/30/2019 Buprenorphine Patches
3/27
im somewhat of an opiate lover and am a little disheartened ive beengiven bupe. given ill be wanting to dabble with other opiates at time, buti guess thats a second to my pain at the moment.
Last edited by Captain.Heroin; 08-02-2010 at 08:59. Reason: added(bupe) title
2.
#2
phrozen
Bluelight Crew
Join DateMay 2004Posts15,902
04-03-2008 16:26
I'm guessing you're in Europe? Haven't heard of bupe patches here.
Anyway, they seem unnecessary. Bupe has a long half-life, and most are
fine dosing just once a day.
As for giving it for pain, it's not that popular, since it's not a full agonist.
3.
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5782558&viewfull=1#post5782558http://www.bluelight.ru/vb/members/57710-phrozenhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5782558http://www.bluelight.ru/vb/members/57710-phrozenhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5781998http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5782558&viewfull=1#post5782558http://www.bluelight.ru/vb/members/57710-phrozen7/30/2019 Buprenorphine Patches
4/27
#3
NickyBundles
Bluelighter
Join DateMay 2004LocationnyPosts361
04-03-2008 18:59
i dont think bupe is that good of a pain killer, once your tollerant to ityou berily feel it even at high doses not much happens, and the shitty
part is if you have breakthru pain or just a bad day were the bupes notcuttin it your not gonna be able to take something that will really help.
4.
#4
'medicine cabinet'
Bluelighter
Join DateJun 2006LocationBaltimorePosts4,389
04-03-2008 20:07
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5782886&viewfull=1#post5782886http://www.bluelight.ru/vb/members/57629-NickyBundleshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783066&viewfull=1#post5783066http://www.bluelight.ru/vb/members/82379-medicine-cabinethttp://www.bluelight.ru/vb/members/82379-medicine-cabinethttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5782886http://www.bluelight.ru/vb/members/57629-NickyBundleshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5782886&viewfull=1#post5782886http://www.bluelight.ru/vb/members/57629-NickyBundleshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783066&viewfull=1#post5783066http://www.bluelight.ru/vb/members/82379-medicine-cabinet7/30/2019 Buprenorphine Patches
5/27
i was in a clinical trial for a bupe skin patch a few years ago at johnshopkins here in baltimore. i know they have them in europe already, iforget what they are called tho....the one that i got to try looked like aflying saucer, like it had a little dish on the inside with the bupe gel in it.it lasted for 2 days and after that i started to get sick. it didnt seem like it
worked as well as sublingual bupe tho, i wouldnt be surpirsed if it nevergets to market.
5.
#5
euphoricnod
Bluelight Crew
Join DateOct 2004Posts9,629
04-03-2008 20:31
i dislike drugs that absorb through the skin like fent or bupe for me italways felt like I got way less out of it.
6.
#6
rave23
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783125&viewfull=1#post5783125http://www.bluelight.ru/vb/members/61878-euphoricnodhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783161&viewfull=1#post5783161http://www.bluelight.ru/vb/members/90944-rave23http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783125http://www.bluelight.ru/vb/members/61878-euphoricnodhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783066http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783125&viewfull=1#post5783125http://www.bluelight.ru/vb/members/61878-euphoricnodhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783161&viewfull=1#post5783161http://www.bluelight.ru/vb/members/90944-rave237/30/2019 Buprenorphine Patches
6/27
Bluelighter
Join DateFeb 2007Location
Canada / GermanyPosts1,622
04-03-2008 20:50
^^way less and usuall a lot longer, right?
7.
#7
jykkE
Bluelighter
Join DateJan 2007LocationAtlanta, GAPosts961
04-03-2008 20:51
bupe patches...that would be awesome if they had them here. whats theprice on them compared to the pills? especially since they are 10mg. ofcourse it might not be as fun since its only 10mics/hr. That would kindasuck.
since bupe seems to have a ceiling dose, what will you be prescribedonce you reach that? especially since you are getting them for pain, it
kinda seems pointless in that light since you will probably have to switchto opiates. then when you want to get off the opiates, what will there be
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783166&viewfull=1#post5783166http://www.bluelight.ru/vb/members/89791-jykkEhttp://www.bluelight.ru/vb/members/89791-jykkEhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783161http://www.bluelight.ru/vb/members/90944-rave23http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783166&viewfull=1#post5783166http://www.bluelight.ru/vb/members/89791-jykkE7/30/2019 Buprenorphine Patches
7/27
to goto if you become psychologically addicted, an extremely high doseof methadone?
8.
#8
leftwing
Bluelight Crew
Join DateOct 2005Posts17,411
04-03-2008 23:36
phrozen - no im in australia. my guess is he gave me them for abusepotential, plus theyre on the pbs here.
to the other guys - they cost me $5 for 2 patches for 2 weeks. the brandname is norspan. they come in 5mg, 10mg and 20mg patches.
ive had the patch on for just under 24 hrs now and am pretty much painfree with a nice little buzz going on.
i read somewhere if your on a dose less than 2mg a day you can get away
with taking other low doses of other opiates on top without going intowithdrawal. it seemed to work last night when i dosed some codeine withit, ~240mg after a cwe.
i talked to my dr about breakthrough pain but he gave me codeine forthese first 2 weeks, but ill be asking me to either take me off patches and
put me on a better pill or be asking for a higher dose.
9.
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783649&viewfull=1#post5783649http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783649http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783166http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783649&viewfull=1#post5783649http://www.bluelight.ru/vb/members/72888-leftwing7/30/2019 Buprenorphine Patches
8/27
#9
NickyBundles
Bluelighter
Join DateMay 2004Locationny
Posts361
05-03-2008 00:03
hmm, im pretty sure that no matter what dose of buprenorphine yourtakeing it will block other opiates from working, if your tollerant to the
bupe and take codiene you wont get sic, you just wont feel the codiene,weird that he would even prescribe that with bupe.
10.
#10
leftwing
Bluelight Crew
Join DateOct 2005Posts17,411
05-03-2008 00:10
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783764&viewfull=1#post5783764http://www.bluelight.ru/vb/members/57629-NickyBundleshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783802&viewfull=1#post5783802http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783764http://www.bluelight.ru/vb/members/57629-NickyBundleshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783764&viewfull=1#post5783764http://www.bluelight.ru/vb/members/57629-NickyBundleshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783802&viewfull=1#post5783802http://www.bluelight.ru/vb/members/72888-leftwing7/30/2019 Buprenorphine Patches
9/27
yer i was very suprise as well. im just going to get something good offhim that makes me happy then move onto someone else whos not such aquack.
heres what the patches are like
11.
#11
jykkE
Bluelighter
Join Date
Jan 2007LocationAtlanta, GAPosts961
05-03-2008 00:25
when you need to switch meds will it be necessary to taper before theswitch, or are you able to switch over without withdrawing? i wouldassume the latter as you are taking codeine without (obvious) problems.
also, im guessing you have to take a high amount of a time release opiate(oxycontin, mscotton morphine, etc) when you do eventually switch to adifferent med since bupe has a ceiling dose, since your body is used to aconstant supply of bupe that is in the patch?
12.
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783863&viewfull=1#post5783863http://www.bluelight.ru/vb/members/89791-jykkEhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783863http://www.bluelight.ru/vb/members/89791-jykkEhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783802http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783863&viewfull=1#post5783863http://www.bluelight.ru/vb/members/89791-jykkE7/30/2019 Buprenorphine Patches
10/27
#12
leftwing
Bluelight Crew
Join DateOct 2005Posts17,411
05-03-2008 00:33
the withdrawals will depend how long im on them till i switch. this isonly my 2nd day on it. so the sooner the better. i have and will be able toget more diazepam at the very least to help with withdrawals and otherotc products.
i have to admit theyre working great for the pain so far, as well mehaving a not too great of an opiate tolerance im getting a nice buzz withsome cones and diazepam on top of it. im also feeling quite energetic as idid when i was using oxycontin
13.
#13
euphoricnod
Bluelight Crew
Join DateOct 2004Posts9,629
05-03-2008 01:07
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783899&viewfull=1#post5783899http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784028&viewfull=1#post5784028http://www.bluelight.ru/vb/members/61878-euphoricnodhttp://www.bluelight.ru/vb/members/61878-euphoricnodhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5783899http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5783899&viewfull=1#post5783899http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784028&viewfull=1#post5784028http://www.bluelight.ru/vb/members/61878-euphoricnod7/30/2019 Buprenorphine Patches
11/27
How did you get those patches? That looks like a delightful alternative totaking a pill everyday twice a day... Are you in the United States?
14.
#14
leftwing
Bluelight Crew
Join DateOct 2005Posts17,411
05-03-2008 02:32
^no im in australia. ive been on tramadol for the last 3 and a bit years forback pain. my dr then decided to switch me over to patches. hes dodgyon hisinformation but is letting me give my say in what i want and letting mesay my bit without acting like a prick.
i went and tried to find a few water0proof patches for showering justbefore and they were all fucking fail. i think itll be glad wrap from now
15.
#15
nabollocks
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784417&viewfull=1#post5784417http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784621&viewfull=1#post5784621http://www.bluelight.ru/vb/members/91854-nabollockshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5784417http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5784028http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784417&viewfull=1#post5784417http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784621&viewfull=1#post5784621http://www.bluelight.ru/vb/members/91854-nabollocks7/30/2019 Buprenorphine Patches
12/27
Bluelighter
Join DateMar 2007
Posts1,130
05-03-2008 03:23
Hey leftwing... I suggested these patches to you a while back... good tosee you finally got them.
You can still take your Tram while on the Bup patch which is a goodthing ;-)
The only thing that I dislike about the patch is the doctors are only aloudto prescribe 2 weeks worth at any 1 time... kind of a bugger when youhavent the time to visit the doc every other week...
Keep us posted on how they go, you can always ask for the next dose upif they are not cutting your pain...
Can you let us know how they compare to your Tram SR? Both in termsof pain relief and antidepressant activity.
I still taking the Tram SR as I can get 4 months prescribed at once...
16.
#16
swybs
Bluelighter
Join DateJan 2004Locationnyc area
Posts2,292
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784927&viewfull=1#post5784927http://www.bluelight.ru/vb/members/52317-swybshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5784621http://www.bluelight.ru/vb/members/91854-nabollockshttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5784927&viewfull=1#post5784927http://www.bluelight.ru/vb/members/52317-swybs7/30/2019 Buprenorphine Patches
13/27
05-03-2008 05:08
Without getting into specifics, I will say that the united states is about tohave 2 separate bupe patch products hit market very soon. They bothseem very mild in dose and (as far as I know) are indicted for mild to
moderate persistent pain (think half step between scehdule 3 andschedule 2 pain meds or, as one company is trying to market it as thesafe alternative to the boogeyman slow-release opiates/oids).
I reviewed the data for both-their landmark clinical trials that will getthem approval and be in their PIs-and wasn't impressed. Further, I thinkthe physician population is underestimating how difficult it is for long-term bupe users to quit-very few are sucessful.
Swybs
17.
#17
leftwing
Bluelight Crew
Join DateOct 2005Posts17,411
05-03-2008 08:13
Originally Posted by nabollocks
Hey leftwing... I suggested these patches to you a while back... good tosee you finally got them.
You can still take your Tram while on the Bup patch which is a goodthing ;-)
The only thing that I dislike about the patch is the doctors are only aloudto prescribe 2 weeks worth at any 1 time... kind of a bugger when you
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5785351&viewfull=1#post5785351http://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/members/72888-leftwinghttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5784927http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5785351&viewfull=1#post5785351http://www.bluelight.ru/vb/members/72888-leftwing7/30/2019 Buprenorphine Patches
14/27
havent the time to visit the doc every other week...
Keep us posted on how they go, you can always ask for the next dose upif they are not cutting your pain...
Can you let us know how they compare to your Tram SR? Both in termsof pain relief and antidepressant activity.
I still taking the Tram SR as I can get 4 months prescribed at once...
yer man i was quite suprised when he bought up the patch straight ,though i didnt think it would be bupe, i was thinking fent. and yer it doessuck only getting 2 at a time, but i have to go see my psych every weekand hes at the same practice so its not a big hassle.
ive had it on for nearly 2 days now and its been nothing but success. i
had codeine earlier in the morning with a small dose of 30mg of valiumand ive been more hazed than i should be. probably from the vodka stillin my system.
the antidepressant values have been the same if not better than tramadolso far, ive been f=more energetic and motivated
Last edited by leftwing; 31-10-2009 at 00:16.
18.
#18
ifonly
Bluelighter
Join DateJun 2006Posts1,091
05-03-2008 09:51
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5785504&viewfull=1#post5785504http://www.bluelight.ru/vb/members/82889-ifonlyhttp://www.bluelight.ru/vb/members/82889-ifonlyhttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5785351http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5785504&viewfull=1#post5785504http://www.bluelight.ru/vb/members/82889-ifonly7/30/2019 Buprenorphine Patches
15/27
Originally Posted by leftwing
yer i was very suprise as well. im just going to get something good offhim that makes me happy then move onto someone else whos not such aquack.
heres what the patches are like
zoom:
good to see my msn window in the background my friend
keep me updated on how u feel as the week contuinues
im actually interested. i know a lot of people on bupe maintenence (8mbpills) but never the patches.
19.
#19
canj00feelit?
Bluelighter
Join DateMay 2004LocationJersey ShorePosts748
07-04-2008 08:25
http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5888015&viewfull=1#post5888015http://www.bluelight.ru/vb/members/57467-canj00feelithttp://www.bluelight.ru/vb/members/57467-canj00feelithttp://www.bluelight.ru/vb/threads/366074-buprenorphine-patches#tophttp://www.bluelight.ru/vb/newreply.php?do=newreply&p=5785504http://www.bluelight.ru/vb/threads/366074-buprenorphine-patches?p=5888015&viewfull=1#post5888015http://www.bluelight.ru/vb/members/57467-canj00feelit7/30/2019 Buprenorphine Patches
16/27
Glad to hear they are workimg out for you man
20.
#20
nabollocks
Bluelighter
Join DateMar 2007Posts1,130
18-04-2008 06:49
In light of this article:
Effectiveness and tolerance of tramadol in cancer pain. A comparativestudy with respect to buprenorphine
byBono AV, Cuffari SService d'Urologie, Hopital di Circolo, Varese, Italie.Drugs 1997; 53 Suppl 2:40-9
ABSTRACTOpioid analgesics represent one of the most important tools in a
sequential pharmacological approach to oncological pain relief. They arerecommended by the WHO when nonsteroidal anti-inflammatory drugs(NSAIDs) no longer provide adequate analgesia. However, the use ofopioids is limited because of their numerous and often severe adverseeffects. This aspect of opioids has motivated continuous research
projects aimed at discovering drugs that can provide maximum painrelief but with improved tolerability. Tramadol is a new, centrally actinganalgesic with a dual mechanism of action. It shows a selectiveinteraction with mu receptors, which are responsible for nociception, andhas weak pharmacodynamic activity on other opioid receptors. At thesame time, it acts synergistically on neuroamine transmission by
inhibiting synaptic noradrenaline (norepinephrine) reuptake and inducingintrasynaptic serotonin (5-hydroxytryptamine; 5-HT) release. From a
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pharmacokinetic standpoint, tramadol offers high bioavailability, withsimilar patterns after oral or parenteral administration (half-life 5 to 7hours, time to peak plasma concentration 3.1 hours, and approximately20% plasma protein binding). Although the efficacy of tramadol iscomparable to that of other drugs with similar modes of action, the
incidence of side effects such as constipation and respiratory depressionis lower. The frequency of euphoria and dysphoria is negligible, resultingin little risk of abuse or dependence. It therefore seemed appropriate tofurther investigate the efficacy and tolerability of tramadol, defined ashaving only weak potency, in comparison with a widely used opioid, inoncological pain. Buprenorphine was selected as an opioid with a
potency equivalent to half that of morphine, but with tolerability that ispartially limited by the fact that it frequently gives rise to adversereactions considered typical of stronger opioids. To compare theanalgesic effect and tolerability of tramadol and buprenorphine, 60
patients (44 men, 16 women; average age 61.4 years), all presenting with
advanced tumours, were treated orally in a controlled crossover trial withrandomised sequences. Patients took both drugs, each for a week, with a24-hour washout period between treatments. Tramadol was prescribed atthe daily dose of 300mg, orally, and buprenorphine at 0.6 mg/day, as asublingual preparation. Assessments were made of Karnofsky
performance status and severity of pain before and during the 4 hoursafter taking the 2 drugs. Each patient also completed a daily diaryrecording the severity of pain 1 hour after the dose, the evolution of painduring the day and its severity compared with that on the previous day.They also assessed the duration and quality of sleep. The Karnofskyindex changed little with either treatment, but all other variables showedworthwhile improvement, indicating the significant analgesic effect of
both drugs. Buprenorphine and tramadol had a similar analgesic effect,although the improvement with the test drug was significant within 1hour of administration (p < 0.05 compared with baseline) and moremarked (p < 0.05 on day 2 compared with buprenorpine). At the end oftramadol treatment, sleep had also improved, both quantitatively andqualitatively (both p < 0.05). The final assessment was significantly infavour of tramadol as regards efficacy (p < 0.05) and patientacceptability (p < 0.01). Thus, tramadol was better tolerated than
buprenorphine, and caused fewer and milder adverse reactions. Only 1
patient discontinued tramadol, compared with 18 using referencetherapy. Tramadol, although theoretically less potent, neverthelessbrought about as much pain relief as the comparator opioid. Inconclusion, for this class of drug, tramadol provides an excellent balance
between efficacy and tolerability, confirming preliminary studies.
Would the OP still recommend the change from Tramadol to Bup?
I know the MOA is different in the study above, but I am stillconsidering the move due to drug drug interactions with Tramadol.
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21.
#21
tadfish
Ex-Bluelighter
Join DateFeb 2005Posts1,568
14-02-2009 00:35
Originally Posted byjykkE
bupe patches...that would be awesome if they had them here. whats theprice on them compared to the pills? especially since they are 10mg. ofcourse it might not be as fun since its only 10mics/hr. That would kinda
suck.
since bupe seems to have a ceiling dose, what will you be prescribedonce you reach that? especially since you are getting them for pain, itkinda seems pointless in that light since you will probably have to switchto opiates. then when you want to get off the opiates, what will there beto goto if you become psychologically addicted, an extremely high doseof methadone?
Well i got patches but i wondering what is this about ceiling dose?
How long does it take to work?
I was thinking as long as it doesn't go over 2mg a day cause i gto 10mgpatches which are costly can i have other opiates with it to potentiate orwill they compete?Also wondering what happens if you mix kanna with bupe?
22.
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#22
tadfish
Ex-Bluelighter
Join DateFeb 2005Posts1,568
14-02-2009 00:37
This might helpTHose finding info on mixing it with kanna is hard. Anyone got anyideas?
doc gave me stemzine wonder hgow that will add to the mix anyone?From MIMS:
Uses/Indications: Partial opioid agonist. Mod to severe pain
Contraindications: Severe respiratory impairment; nonselective MAOIs(within 14 days of stopping MAOI)
Precautions: Not for narcotic dependence treatment, postop use,situations with a narrow therapeutic index, rapidly varying analgesianeed; inflammatory bowel, convulsive disorders; head injury; impairedconsciousness (undiagnosed); intracranial lesion; raised ICP; respiratory,hepatic, renal, biliary disease; hypotension, hypovolaemia, shock;
pancreatitis; prostatic hypertrophy; adrenocortical insufficiency; debility;
24 hrs prior to pain relieving surgery incl cordotomy; after abdominalsurgery; drug, alcohol abuse; serious mental illness; congenital QTprolongation; severe febrile illness; hypothyroidism; withdrawal;narcotic dependence; opioid naive; avoid excess heat to patch site;debility; pregnancy, lactation, children < 18 yrs
Adverse Reactions: Respiratory depression; QT prolongation; euphoria;dependence; GI upset esp constipation; anorexia; sweating; dizziness;headache; somnolence; confusion; pruritus; erythema; rash; applicationsite reaction; anxiety; insomnia; nervousness; paraesthesia; depression;
vasodilation; oedema; dyspnoea; taste perversion; asthenia; pain; others,see full PI
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Drug Interactions: Nonselective MAOIs (see Contra); selective MAOIs;CNS depressants (eg sedatives, hypnotics, general anaesthetics, otheropioids, phenothiazines, centrally acting antiemetics, benzodiazepines,
alcohol); drugs that prolong QT (eg antiarrhythmics), cause respiratorydepression, hypotension; drugs affecting hepatic metabolism; CYP3A4inhibitors (eg protease inhibitors, azole antimycotics, Ca channelantagonists, macrolides); enzyme inducers (eg phenobarbitone,carbamazepine, phenytoin, rifampicin); warfarin (poss)
NORSPAN 5 TRANSDERMAL PATCH (Transdermal patch)Prescription required. S8 This product may cause drowsiness.Buprenorphine (equiv. 5 mcg/hr); gluten free;Dose: Apply patch every 7 days to intact skin (sites, skin prep,
application, removal: see full PI); initially commence with Norspan 5.Titrate; incr at intervals greater than or equal to 3 days as needed byreplacing or adding patch (max 2 concurrent patches). Give otheranalgesics during initiation, titration; change to other analgesic ifanalgesia inadequate on max Norspan dose. Rotate sites, avoid otheropioids 24 hrs after patch removal (see full PI)
Uses/Indications: Partial opioid agonist. Mod to severe pain
Contraindications: Severe respiratory impairment; nonselective MAOIs(within 14 days of stopping MAOI)
Precautions: Not for narcotic dependence treatment, postop use,situations with a narrow therapeutic index, rapidly varying analgesianeed; inflammatory bowel, convulsive disorders; head injury; impairedconsciousness (undiagnosed); intracranial lesion; raised ICP; respiratory,hepatic, renal, biliary disease; hypotension, hypovolaemia, shock;
pancreatitis; prostatic hypertrophy; adrenocortical insufficiency; debility;24 hrs prior to pain relieving surgery incl cordotomy; after abdominal
surgery; drug, alcohol abuse; serious mental illness; congenital QTprolongation; severe febrile illness; hypothyroidism; withdrawal;narcotic dependence; opioid naive; avoid excess heat to patch site;debility; pregnancy, lactation, children < 18 yrs
Adverse Reactions: Respiratory depression; QT prolongation; euphoria;dependence; GI upset esp constipation; anorexia; sweating; dizziness;headache; somnolence; confusion; pruritus; erythema; rash; applicationsite reaction; anxiety; insomnia; nervousness; paraesthesia; depression;vasodilation; oedema; dyspnoea; taste perversion; asthenia; pain; others,
see full PI
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Drug Interactions: Nonselective MAOIs (see Contra); selective MAOIs;CNS depressants (eg sedatives, hypnotics, general anaesthetics, otheropioids, phenothiazines, centrally acting antiemetics, benzodiazepines,alcohol); drugs that prolong QT (eg antiarrhythmics), cause respiratory
depression, hypotension; drugs affecting hepatic metabolism; CYP3A4inhibitors (eg protease inhibitors, azole antimycotics, Ca channelantagonists, macrolides); enzyme inducers (eg phenobarbitone,carbamazepine, phenytoin, rifampicin); warfarin (poss)
NORSPAN 5 TRANSDERMAL PATCH (Transdermal patch)Prescription required. S8 This product may cause drowsiness.Buprenorphine (equiv. 5 mcg/hr); gluten free;Dose: Apply patch every 7 days to intact skin (sites, skin prep,application, removal: see full PI); initially commence with Norspan 5.
Titrate; incr at intervals greater than or equal to 3 days as needed byreplacing or adding patch (max 2 concurrent patches). Give otheranalgesics during initiation, titration; change to other analgesic ifanalgesia inadequate on max Norspan dose. Rotate sites, avoid otheropioids 24 hrs after patch removal (see full PI)
Chemical name: (2S)-2-[17-(cyclopropylmethyl)- 4, 5alpha-epoxy-3-hydroxy-6-methoxy-6alpha, 14-ethano-14alpha- morphinan-7alpha-yl]-3, 3-dimethylbutan-2-ol. Molecular formula: C29H41NO4. MW: 467.6.CAS: 52485-79-7. Buprenorphine is a white or almost white powder andis very slightly soluble in water, freely soluble in acetone, soluble inmethanol and ether and slightly soluble in cyclohexane. The pKa is 8.5.
Norspan Transdermal Patch is a rectangular (10 microgram/hour) orsquare (5 and 20 microgram/hour) beige coloured matrix patch withrounded corners, marked with the trade name and consisting of a
protective liner and functional layers. Proceeding from the outer surfacetowards the surface adhering to the skin, the layers are (1) a beigecoloured web backing layer of polyester material; (2) an adhesive matrixrim without buprenorphine; (3) a separating foil over the adhesivematrix; (4) the buprenorphine containing adhesive matrix; and (5) a
release liner (see Figure 1). Before use the release liner covering theadhesive layer is removed and discarded. Please refer to figure 1.
Norspan Transdermal Patch transdermal system is available in threedifferent strengths: 5, 10 and 20 microgram/hour. The composition of allthree strengths is identical except for size. The proportion of
buprenorphine in the adhesive matrix is the same in each strength (10%by weight). The amount of buprenorphine released from each system perhour is proportional to the surface area of the system. The skin is thelimiting barrier to diffusion from the system into the bloodstream.
topActions
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Pharmacology. Buprenorphine is a partial opioid agonist, acting at themu-opioid receptor. It also has antagonistic activity at the kappa-opioidreceptor. The opioid agonist activities of buprenorphine are dose related.
Like other opioid agonists, buprenorphine produces dose related
analgesia, however a ceiling effect to analgesia is well documented.Buprenorphine binds to and dissociates from the mu receptor slowly,which may account for the prolonged duration of analgesia and, in part,for the limited physical dependence potential observed with the drug.
Buprenorphine produces similar effects to other opioids on the centralnervous system, and the cardiovascular, respiratory and gastrointestinalsystems, although the intensity and duration of the effects may varywhen compared with other opioids. Opioids may also influence thehypothalamic pituitary adrenal or hypothalamic pituitary gonadal axes,including an increase in serum prolactin and decreases in plasma cortisol
and testosterone, which can manifest in clinical symptoms.
Since kappa receptor agonist activity is related to psychotomimetic anddysphoric effects, buprenorphine is expected to produce fewer
psychotomimetic and dysphoric effects than drugs with kappa agonistactivities.
Like other opioid agonists, buprenorphine may produce increases incerebrospinal fluid pressure, cause altered mentation, mental clouding oramnesia.
Buprenorphine acts to reduce blood pressure in a manner similar to otheropioids. Norspan Transdermal Patch application resulted in transientdecreases in blood pressure in healthy young and elderly subjects,without clinical adverse events.
Respiratory depression is less common than with full mu agonists, suchas morphine, and there appears to be a ceiling effect. When respiratorydepression occurs it appears to have a slower onset and longer durationcompared to morphine.
Like other opioids buprenorphine may cause nausea, vomiting,constipation and an increase in biliary tract pressure. Effects on theimmune system were seen with natural opioids like morphine in in vitroand animal studies, although the clinical significance of these isunknown. It is not known whether buprenorphine, a semisyntheticopioid, has immunological effects similar to morphine.
Buprenorphine can cause dose related miosis and urinary retention insome patients.
Pharmacokinetics. Each Norspan Transdermal Patch provides a steady
delivery of buprenorphine for up to seven days. Steady state is achievedby day 3 following the first application. After removal of the Norspan
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Transdermal Patch, buprenorphine concentrations decline, decreasingapproximately 50% in 12 hours (range 10 to 24 hours).
Norspan Transdermal Patch 5, 10 and 20 microgram/hour provide doseproportional increases in total exposure (AUC (area under the curve))
over the seven day application period. Dose proportional increases inplasma concentrations occur at steady state with Norspan TransdermalPatch application for up to 60 days. Accumulation of plasma
buprenorphine did not occur during the 60 days.
The rate of buprenorphine release from each patch is proportional to thesurface area. Each Norspan Transdermal Patch 5 microgram/hourreleases buprenorphine 5 microgram per hour and contains a total of
buprenorphine 5 mg. Each Norspan Transdermal Patch 10microgram/hour releases buprenorphine 10 microgram per hour andcontains a total of buprenorphine 10 mg. Each Norspan Transdermal
Patch 20 microgram/hour releases buprenorphine 20 microgram per hourand contains a total of buprenorphine 20 mg.
Absorption. Following Norspan Transdermal Patch application,buprenorphine diffuses from the patch through the skin. In clinicalpharmacology studies, the median time for Norspan Transdermal Patch10 microgram/hour to deliver detectable buprenorphine concentrations(25 picogram/mL) was approximately 17 hours. The bioavailability of
buprenorphine from a Norspan Transdermal Patch relative to IV(intravenous) is 15% (for all three strengths).
Accidental oral ingestion. Measurable systemic levels of buprenorphinewere demonstrated in dogs given Norspan Transdermal Patch by oraladministration.
Distribution. Buprenorphine is approximately 96% bound to plasmaproteins.
In a study of IV buprenorphine in healthy subjects, the volume ofdistribution at steady state was 430 L, which is indicative of the highlipophilicity of the drug.
Following IV administration, buprenorphine and its metabolites aresecreted into bile, and within several minutes distribute into thecerebrospinal fluid (CSF). CSF concentrations appear to beapproximately 15 to 25% of concurrent plasma concentrations.
Metabolism and elimination. Buprenorphine metabolism in the skinfollowing Norspan Transdermal Patch application is negligible.Buprenorphine is eliminated via hepatic metabolism, with subsequent
biliary excretion and renal excretion of soluble metabolites. Hepaticmetabolism through CYP3A4 and UGT1A1/1A3 enzymes results in two
the primary metabolites, norbuprenorphine and buprenorphine 3-O-glucuronide, respectively. Norbuprenorphine is also glucuronidated prior
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to elimination. Buprenorphine is also eliminated in the faeces withinseven days.
In a study in postoperative patients the total clearance of buprenorphinewas 55 L/hour.
Norbuprenorphine is the only known active metabolite of buprenorphine.It has been shown to be a respiratory depressant in rats at concentrationat least 50-fold those seen following application of Norspan TransdermalPatch 20 microgram/hour.
Specific inhibitors of CYP450 (e.g. ketoconazole, gestodene, nifedipine,norfluoxetine, ritonavir) inhibited formation of the buprenorphinemetabolite norbuprenorphine in human microsomes.
Application site. A study in healthy subjects demonstrated that the
pharmacokinetic profile of buprenorphine delivered by NorspanTransdermal Patch is similar when applied to the upper outer arm, upperchest, upper back or the side of the chest (midaxillary line, 5th intercostalspace).
In a study of healthy subjects applying Norspan Transdermal Patchrepeatedly to the same site, immediate reapplication caused increasedabsorption, without clinical adverse events. For this reason, rotation ofapplication sites is recommended (see Dosage and Administration).
In another study in healthy subjects application of a heating pad directlyon the Norspan Transdermal Patch caused a transient 26 to 55% increasein blood concentrations of buprenorphine. Concentrations returned tonormal within five hours after the heat was removed. For this reason,applying heat sources such as hot water bottles, heat pads or electric
blankets directly to the Norspan Transdermal Patch is not recommended.A heating pad applied to a Norspan Transdermal Patch site directly after
patch removal did not alter absorption from the skin depot.
23.
#23
cvillian
Bluelighter
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Join DateDec 2008Location
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14-02-2009 01:54
Originally Posted by leftwing
temgesics are something i would like to try before fentanyl.
Temgesic are the sublingual version of buprenorphine in a pill form. I'mnot sure if you knew that or not. I'm sure that you could put the patchunder your tongue and it will absorb just like people do with the fentanyl
patches by putting it against their cheeks and gums. I wouldn't adviseyou to do these since you seem to really need it for pain but it seems thatyou dabble in the abuse department of your meds, so you could give it ashot with the remainder of your bupe patches. I'm not sure if you willachieve a high of any sort though. It seems people get tolerant to
buprenorphine pretty fast.
24.
#24
tadfish
Ex-Bluelighter
Join DateFeb 2005Posts1,568
16-02-2009 07:43
i Meant having kratom with bupe. Had an 8 mg bupe sub with patch theother day. I think as long as as bupe dose below 2mg it doesn't compete
as strongly for the position.Fuck it i going to put another patch on now.
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I read tramadol mixes good with bupe.But i hate tramadol although i might try some tommorrow.it doesn't make sense this patch i only on 10mg ones that last a week 10ug/h that doesn't make sense.i got 2 patches on. getting more soon i'll be covered in patches.
25.
#25
leftwing
Bluelight Crew
Join DateOct 2005Posts
17,411
16-02-2009 07:55
^an 8mg sub with a patch = 2 x doses of buprenorphine
i cant really understand what you're trying to say but the patch has a totalof 10mg of bupe on it. they transdermally release 10ug/h. 1 day worth of
bupe = 24 hours x .01mg = 0.24mg/day. over a week = 7 x 0.24 =1.68mg.
is that what you meant by it not making sense? they actually put moredrug in the patch than is released?
with my 2 x 20mg patches on i absorb just under 8mg of buprenorphine aweek
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