Do you suffer from long-term, unbearable pain? Sometimes, the usual painkillers we take are not enough to control such severe pain. In such cases, your doctor may prescribe you a special, strong painkiller. Today we are going to talk about one such drug, Buprenorphine, which is used by applying it to the inside of the cheek.
What is this drug called Buprenorphine?
Simply put, Buprenorphine is a medication used to treat severe, chronic pain. Doctors usually prescribe it when other painkillers don't work or when the body can't tolerate the medication. It belongs to a class of drugs called opioids . It works by blocking pain signals from reaching the brain, reducing the sensation of pain.
The most important thing is that this is a long-acting medication. This means that it is not used for sudden pain. It is given to control chronic pain that lasts throughout the day.
Things you need to tell your doctor before taking this medicine
Before starting this medication, it is extremely important to inform your doctor about your complete health history . Be sure to tell him/her if you have any of the following conditions:
| Health status | Description |
|---|---|
| Brain-related problems | Conditions such as a brain tumor and head injury. |
| Mouth problems | Dental or gum disease, mouth sores. |
| Liver, gallbladder, pancreas | Liver disease, gallbladder disease, pancreatic disease. |
| Respiratory system problems | Lung disease, asthma, or breathing problems. |
| Heart disease | Heart disease, irregular heartbeat. |
| Other situations | Drug or alcohol addiction, low adrenal gland function, seizures, intestinal problems. |
| Other medications being taken | If you have taken an MAOI (e.g. Marplan, Nardil) medication within the last 14 days. |
| Special occasions | If you are pregnant, trying to get pregnant, or breastfeeding. |
| Allergies | If you are allergic to buprenorphine or any other medicine, food, or dye. |
How exactly do I use this medicine?
Since this is a film that is applied to the inside of the cheek, special care must be taken in how it is used.
1. Preparation: Before taking the medicine, rinse your mouth with water and remove it. Or, wet the inside of your cheek with your tongue.
2. Opening the packet: Open the packet with dry hands . Only open the packet just before taking the medicine.
3. Applying the film: Take the film with the tip of your dry finger and place it on the inside of your cheek with the yellow side touching the cheek .
4. Press for 5 seconds: Hold it like that and press gently with your finger for about 5 seconds.
5. Let it melt: Then remove your finger and let the film melt. This usually takes about 30 minutes.
6. Important: Do not touch or move the film with your tongue or fingers until it has dissolved. Also, avoid eating or drinking until the film has dissolved. Do not cut, chew, or swallow this film.
Continue to use this medicine as directed until your doctor tells you to stop.
Overdosage
If you think you have taken too much of this medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Department (ETU) of the nearest hospital.
This medicine has been prescribed for you only. Do not share it with anyone else for any reason.
Interactions with other drugs
Because buprenorphine is a powerful drug, it can interact with other medications you are taking. Therefore, it is important to tell your doctor about all medications you are taking (including vitamins and herbal remedies).
| Do not take Buprenorphine with these medications! | |
|---|---|
| Cisapride | Dronedarone |
| Pimozide | Safinamide |
| Samidorphan | Thioridazine |
| Be especially careful when taking Buprenorphine with these things. | |
Alcohol, antihistamines, some antibiotics , HIV /Hepatitis medications, anxiety or sleep medications, psychiatric medications, antifungals, migraine medications, seizure medications (e.g., Carbamazepine), anesthetics, other opioid painkillers, muscle relaxants, and many other medications. | |
Things to keep in mind when taking this medicine
Pain and tolerance
Tell your doctor if your pain does not go away, if it gets worse, or if you have a new type of pain. After taking this medicine for a while, the dose you were taking before may no longer be enough to control your pain. This is called tolerance . This is normal and is not an addiction. Addiction is a behavioral problem in which you use a medicine without a medical reason. Your doctor will adjust your dose as needed.
Stopping the medication
Never stop taking this medicine suddenly. Doing so may cause severe side effects (withdrawal symptoms ). If you need to stop taking the medicine, your doctor will gradually reduce the dose.
Sleepiness and alcohol
This medicine may make you feel sleepy and dizzy . Therefore , do not drive, operate machinery, or do anything that requires alertness until you know how it affects you. Especially if you are elderly, do not get up from a sitting position suddenly, as this may cause dizziness and fall. Avoid drinking alcohol completely.
Constipation
Constipation is a very common side effect of this medication. If you have difficulty having a bowel movement for more than 3 days, let your doctor know.
Opioid Overdose and Naloxone
Overdose of opioids is very dangerous. Symptoms of an overdose include difficulty breathing, extreme drowsiness, and difficulty waking up. Naloxone is an emergency drug that is given to reverse this type of overdose. It is important for the family of a person who has taken this medication to be aware of this. Even if Naloxone is given, it is only a temporary solution. The patient should be taken to the Emergency Treatment Unit (ETU) immediately.
Side Effects to Know
| If you have these symptoms, see a doctor immediately! | |
|---|---|
| Allergies | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS depression) | Slow or shallow breathing, difficulty breathing, excessive sleepiness, confusion. |
| Changes in heart rate | Fast or irregular heartbeat, dizziness, chest pain. |
| Liver injury | Pain in the upper right side of the abdomen, loss of appetite, yellowing of the skin or eyes, dark yellow/brown urine. |
| Decreased adrenal function | Nausea, vomiting, loss of appetite, extreme fatigue, dizziness. |
| Tooth decay | Tooth discoloration, bad breath, gum or tooth sensitivity. |
| Common side effects that you should tell your doctor about if they are bothersome | |
| Constipation | Dizziness |
| Drowsiness | Dry mouth |
| Headache | Nausea/vomiting |
Take-Home Message
- Buprenorphine is a strong opioid analgesic used for severe, chronic pain. It is not used for emergency pain.
- Before taking this medicine, tell your doctor about all your medical conditions and all other medications you are taking.
- Stick the film directly to the inside of your cheek. Do not chew, swallow, or cut it.
- Avoid driving and other activities that require alertness while taking this medicine as it may cause drowsiness and dizziness. Avoid drinking alcohol completely.
- Be aware of serious side effects (difficulty breathing, excessive sleepiness, changes in heart rate). If any of these occur, seek medical advice immediately.
- Keep this medicine in a safe place, out of the reach of children and pets. Never share it with others.
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