Generic name: buprenorphine transdermal (skin patch) [ BUE-pre-NOR-feen ]
Brand name: Butrans
Drug class: Opioids (narcotic analgesics)

Medically reviewed by Melisa Puckey, BPharm. Last updated on Mar 1, 2024.

What is Butrans?

Butrans skin patches contain buprenorphine, an opioid pain medication. An opioid is sometimes called a narcotic.

Butrans skin patches are used for around-the-clock treatment of moderate to severe chronic pain that is not controlled by other medicines.

Butrans is not for use on an as-needed basis for pain.

Warnings

You should not use Butrans skin patches if you have severe asthma or breathing problems, or a blockage in your stomach or intestines.

Buprenorphine can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using Butrans without a prescription. Keep the medication in a place where others cannot get to it.

Using this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use Butrans with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Before taking this medicine

You should not use Butrans if you are allergic to buprenorphine, or if you have:

• breathing problems, sleep apnea;

• a blockage in your stomach or intestines.

To make sure Butrans is safe for you, tell your doctor if you have ever had:

• any type of breathing problem or lung disease;

• a head injury, brain tumor, or seizures;

• alcoholism, drug addiction, mental illness;

• urination problems;

• liver or kidney disease;

• heart rhythm problems, long QT syndrome; or

• problems with your gallbladder, pancreas, or thyroid.

If you use Butrans while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Buprenorphine can pass into breast milk and cause drowsiness, breathing problems, or death in a nursing baby. You should not breast-feed while you are using Butrans.

How should I use Butrans?

Use Butrans exactly as prescribed. Follow all directions on your prescription label. Buprenorphine can slow or stop your breathing. Never use Butrans in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Buprenorphine may be habit-forming, even at regular doses. Never share Butrans with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away Butrans is against the law.

The Butrans skin patch is for use only on the skin. Do not allow the medicine to come into contact with your eyes, nose, mouth, or lips.

Keep both used and unused Butrans patches out of the reach of children or pets. Even the amount of buprenorphine in a used skin patch could be fatal to a child or pet who accidentally sucks or chews on the patch. Seek emergency medical attention if this happens.

Use only clear water (not soap or other chemicals) to wash the skin before you apply a patch.

Apply the Butrans patch to clean, dry skin on the chest, back, side, or outer side of your upper arm. Wear the patch around the clock for 7 days. Never wear more than 1 patch at a time unless your doctor has told you to. Remove and replace the patch after 7 days. Apply the new patch to a different skin area on the chest, back, side, or upper arm.

If the sticky side of a skin patch comes into contact with your hands, wash the skin with clear water and seek medical care at once. Do not use a Butrans skin patch if it has been cut or damaged.

Do not wear a skin patch on a part of your body where a child could reach or remove the patch from your skin. Avoid allowing children to watch you put on a skin patch. Never tell a child that the buprenorphine skin patch is a "bandage".

Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Butrans.

Store the Butrans skin patches at room temperature. Keep each patch in its foil pouch until you are ready to use it. Keep track of how many skin patches have been used from each new package. Buprenorphine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

After removing a skin patch: fold it in half firmly with the sticky side in, and flush the patch down the toilet or use the Patch-Disposal Unit provided with this medication. Do not place a used skin patch into a trash can.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, dispose of any unused skin patches in the same folded manner. Do not flush the foil pouch or patch liners; place them in a trash container out of the reach of children and pets.

What happens if I miss a dose?

If you forget to change a patch on your scheduled day, remove the patch and apply a new one as soon as you remember. Do not wear extra patches to make up a missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A buprenorphine overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, a weak pulse, very slow breathing, or coma.

Buprenorphine can cause death in a child who gets a hold of a skin patch and places it in the mouth or on the skin.

What should I avoid while using Butrans?

Avoid sources of heat while wearing the patch. Tell your doctor if you have a fever. Do not use a heating pad or electric blanket, tanning bed or sauna. Do not sit in hot water, sunbathe, or raise your body temperature with vigorous activity. Heat can increase the amount of drug you absorb through your skin and may cause an overdose or death.

Do not drink alcohol. Dangerous side effects or death could occur.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how buprenorphine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Butrans side effects

Get emergency medical help if you have signs of an allergic reaction to Butrans: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Stop using Butrans and call your doctor at once if you have:

• weak or shallow breathing, deep sighs, snoring that is new or unusual;

• breathing that stops during sleep;

• chest pain, fast heart rate, seizure (convulsions);

• a light-headed feeling, like you might pass out;

• blisters, swelling, or severe irritation where the patch was worn;

• adrenal gland problems - nausea, vomiting, loss of appetite, dizziness, feeling weak or tired; or

• liver problems - upper stomach pain, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Common Butrans side effects may include:

• constipation, nausea, vomiting;

• headache, dizziness, drowsiness, tiredness; or

• redness, itching, or rash where the patch was worn.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Butrans Skin Patches?

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

• other narcotic medications - opioid pain medicine or prescription cough medicine;

• a sedative like Valium - diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others;

• drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, tranquilizer, antidepressant, or antipsychotic medicine; or

• drugs that affect serotonin levels in your body - medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with buprenorphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Butrans only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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