Bupe buprenorphine patches

[Jabberwocky]

ive just been prescribed 10mg bupe patches (10mics/hr), leaving them on for a few days a time. before this i was still unsure what type of patches i would be recieving (for those who read my other thread a little while ago) 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 on many ocassions.

has anyone else had any experience with these for pain management? ive spondylosis, curvature to the back and neck pain which is all congenital...my blessed genes. ive just got off tramadol finally today 2 weeks before i was scheduled to.

ive also now had the patch on for about 8 hours im guessing and am starting to feel some pain dissipate, until now ive knocked myself out with valium. which raises my next question. im fairly tolerant to valium (100mg+ as a start sometime) but only took 70 mgs around 6 hours ago and 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?

im somewhat of an opiate lover and am a little disheartened ive been given bupe. given ill be wanting to dabble with other opiates at time, but i guess thats a second to my pain at the moment.

 

[phr]

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.

 

[NickyBundles]

i dont think bupe is that good of a pain killer, once your tollerant to it you 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 not cuttin it your not gonna be able to take something that will really help.

 

['medicine cabinet']

i was in a clinical trial for a bupe skin patch a few years ago at johns hopkins here in baltimore. i know they have them in europe already, i forget what they are called tho....the one that i got to try looked like a flying 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 never gets to market.

 

[VerbalTruist]

i dislike drugs that absorb through the skin like fent or bupe for me it always felt like I got way less out of it.

 

[rave23]

^^
way less and usuall a lot longer, right?

 

[jykkE]

bupe patches...that would be awesome if they had them here. whats the price on them compared to the pills? especially since they are 10mg. of course 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 prescribed once you reach that? especially since you are getting them for pain, it kinda seems pointless in that light since you will probably have to switch to opiates. then when you want to get off the opiates, what will there be to goto if you become psychologically addicted, an extremely high dose of methadone?

 

[Jabberwocky]

phrozen - no im in australia. my guess is he gave me them for abuse potential, plus theyre on the pbs here.

to the other guys - they cost me $5 for 2 patches for 2 weeks. the brand name 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 pain free 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 into withdrawal. it seemed to work last night when i dosed some codeine with it, ~240mg after a cwe.

i talked to my dr about breakthrough pain but he gave me codeine for these 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.

 

[NickyBundles]

hmm, im pretty sure that no matter what dose of buprenorphine your takeing 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.

 

[Jabberwocky]

yer i was very suprise as well. im just going to get something good off him that makes me happy then move onto someone else whos not such a quack.

heres what the patches are like

 

[jykkE]

when you need to switch meds will it be necessary to taper before the switch, or are you able to switch over without withdrawing? i would assume 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 a different med since bupe has a ceiling dose, since your body is used to a constant supply of bupe that is in the patch?

 

[Jabberwocky]

the withdrawals will depend how long im on them till i switch. this is only my 2nd day on it. so the sooner the better. i have and will be able to get more diazepam at the very least to help with withdrawals and other otc products.

i have to admit theyre working great for the pain so far, as well me having a not too great of an opiate tolerance im getting a nice buzz with some cones and diazepam on top of it. im also feeling quite energetic as i did when i was using oxycontin

 

[VerbalTruist]

How did you get those patches? That looks like a delightful alternative to taking a pill everyday twice a day... Are you in the United States?

 

[Jabberwocky]

^no im in australia. ive been on tramadol for the last 3 and a bit years for back pain. my dr then decided to switch me over to patches. hes dodgy on his
information but is letting me give my say in what i want and letting me say my bit without acting like a prick.

i went and tried to find a few water0proof patches for showering just before and they were all fucking fail. i think itll be glad wrap from now8)

 

[nabollocks]

Hey leftwing... I suggested these patches to you a while back... good to see you finally got them.

You can still take your Tram while on the Bup patch which is a good thing ;-)

The only thing that I dislike about the patch is the doctors are only aloud to prescribe 2 weeks worth at any 1 time... kind of a bugger when you 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 up if they are not cutting your pain...

Can you let us know how they compare to your Tram SR? Both in terms of pain relief and antidepressant activity.

I still taking the Tram SR as I can get 4 months prescribed at once...

 

[swybs]

Without getting into specifics, I will say that the united states is about to have 2 separate bupe patch products hit market very soon. They both seem very mild in dose and (as far as I know) are indicted for mild to moderate persistent pain (think half step between scehdule 3 and schedule 2 pain meds or, as one company is trying to market it as the safe alternative to the boogeyman slow-release opiates/oids).

I reviewed the data for both-their landmark clinical trials that will get them approval and be in their PIs-and wasn't impressed. Further, I think the physician population is underestimating how difficult it is for long-term bupe users to quit-very few are sucessful.

Swybs

 

[Jabberwocky]

Hey leftwing... I suggested these patches to you a while back... good to see you finally got them.

You can still take your Tram while on the Bup patch which is a good thing ;-)

The only thing that I dislike about the patch is the doctors are only aloud to prescribe 2 weeks worth at any 1 time... kind of a bugger when you 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 up if they are not cutting your pain...

Can you let us know how they compare to your Tram SR? Both in terms of 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 does suck only getting 2 at a time, but i have to go see my psych every week and 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 valium and ive been more hazed than i should be. probably from the vodka still in my system.

the antidepressant values have been the same if not better than tramadol so far, ive been f=more energetic and motivated

 

[ifonly]

yer i was very suprise as well. im just going to get something good off him that makes me happy then move onto someone else whos not such a quack.

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 (8mb pills) but never the patches.

 

[canj00feelit?]

Glad to hear they are workimg out for you man

 

[nabollocks]

In light of this article:

Effectiveness and tolerance of tramadol in cancer pain. A comparative study with respect to buprenorphine
by
Bono AV, Cuffari S
Service d'Urologie, Hopital di Circolo, Varese, Italie.
Drugs 1997; 53 Suppl 2:40-9

ABSTRACT
Opioid analgesics represent one of the most important tools in a sequential pharmacological approach to oncological pain relief. They are recommended by the WHO when nonsteroidal anti-inflammatory drugs (NSAIDs) no longer provide adequate analgesia. However, the use of opioids is limited because of their numerous and often severe adverse effects. This aspect of opioids has motivated continuous research projects aimed at discovering drugs that can provide maximum pain relief but with improved tolerability. Tramadol is a new, centrally acting analgesic with a dual mechanism of action. It shows a selective interaction with mu receptors, which are responsible for nociception, and has weak pharmacodynamic activity on other opioid receptors. At the same time, it acts synergistically on neuroamine transmission by inhibiting synaptic noradrenaline (norepinephrine) reuptake and inducing intrasynaptic serotonin (5-hydroxytryptamine; 5-HT) release. From a pharmacokinetic standpoint, tramadol offers high bioavailability, with similar patterns after oral or parenteral administration (half-life 5 to 7 hours, time to peak plasma concentration 3.1 hours, and approximately 20% plasma protein binding). Although the efficacy of tramadol is comparable to that of other drugs with similar modes of action, the incidence of side effects such as constipation and respiratory depression is lower. The frequency of euphoria and dysphoria is negligible, resulting in little risk of abuse or dependence. It therefore seemed appropriate to further investigate the efficacy and tolerability of tramadol, defined as having only weak potency, in comparison with a widely used opioid, in oncological pain. Buprenorphine was selected as an opioid with a potency equivalent to half that of morphine, but with tolerability that is partially limited by the fact that it frequently gives rise to adverse reactions considered typical of stronger opioids. To compare the analgesic 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 with randomised sequences. Patients took both drugs, each for a week, with a 24-hour washout period between treatments. Tramadol was prescribed at the daily dose of 300mg, orally, and buprenorphine at 0.6 mg/day, as a sublingual preparation. Assessments were made of Karnofsky performance status and severity of pain before and during the 4 hours after taking the 2 drugs. Each patient also completed a daily diary recording the severity of pain 1 hour after the dose, the evolution of pain during the day and its severity compared with that on the previous day. They also assessed the duration and quality of sleep. The Karnofsky index changed little with either treatment, but all other variables showed worthwhile 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 1 hour of administration (p < 0.05 compared with baseline) and more marked (p < 0.05 on day 2 compared with buprenorpine). At the end of tramadol treatment, sleep had also improved, both quantitatively and qualitatively (both p < 0.05). The final assessment was significantly in favour of tramadol as regards efficacy (p < 0.05) and patient acceptability (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 reference therapy. Tramadol, although theoretically less potent, nevertheless brought about as much pain relief as the comparator opioid. In conclusion, 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 still considering the move due to drug drug interactions with Tramadol.