Buprenorphine

Buprenorphine is an opioid medication used to treat opioid use disorder (OUD), acute pain, and chronic pain. 

Buprenorphine is used for opioid addiction to reduce cravings and withdrawal symptoms without causing euphoria or dangerous side effects and helps prevent relapse. It works by being a substitute for the drug being abused, so the patient has minimal discomfort, which allows the patient to focus on their recovery. Buprenorphine for OUD is used as part of a complete treatment program that also includes counseling and behavioral therapy.

For opioid use disorder, buprenorphine is available as long-acting injections (Sublocade, Brixadi) and sublingual tablets (Subutex discontinued, generics available). 

Buprenorphine is used to treat acute pain that is severe enough to require an opioid analgesic and moderate to severe chronic pain that is not controlled by other medicines. For chronic around-the-clock pain, it is available as buprenorphine skin patches (Butrans) and buprenorphine buccal films (Belbuca), and for acute pain is available as an injection (Buprenex).

Buprenorphine-naloxone combinations are also available to be used for opioid addication and include sublingual film (Bunavail), sublingual film and sublingual tablets (Suboxone), and sublingual tablets (Zubsolv).

Buprenorphine's mechanism of action is that is a partial agonist at the mu-opioid receptor and an antagonist at the kappa-opioid receptor.

阿片类药物的误用可能导致成瘾、过量或死亡。请将丁丙诺啡放在他人无法接触的地方。

患者使用纳洛酮治疗阿片类药物过量的可及性。基于患者过量风险因素（如目前使用中枢神经系统抑制剂、有阿片类药物使用障碍史或以前发生过阿片类药物过量），患者应能获得纳洛酮来治疗阿片类药物过量。如果患者有家庭成员（包括儿童）或其他密切接触者存在意外暴露或过量的风险，纳洛酮的可用性非常重要。

在怀孕期间服用此药可能会导致新生儿出现危及生命的戒断症状。

如果您与其他导致嗜睡或减缓呼吸的药物一起使用本品，可能会发生致命的副作用。

如果您出现对丁丙诺啡的过敏反应迹象，请立即寻求紧急医疗帮助：荨麻疹；呼吸困难；脸部、嘴唇、舌头或喉咙肿胀。

阿片类药物可能会减慢或停止您的呼吸，甚至可能导致死亡。如果您呼吸缓慢且有长时间停顿、嘴唇发青或难以唤醒，照顾您的人应给予纳洛酮和/或寻求紧急医疗救助。

如果出现以下情况，请立即联系您的医生：

• 阿片类戒断症状 - 寒战、鸡皮疙瘩、出汗增多、感觉冷热交替、流鼻涕、流眼泪、腹泻、肌肉疼痛；
• 呼吸声大、叹气、呼吸浅、睡眠中呼吸暂停；
• 心跳过缓或脉搏微弱；
• 感到头晕，像要昏倒；
• 胸痛、呼吸困难；
• 低皮质醇水平 - 恶心、呕吐、食欲不振、头晕、疲劳加剧或虚弱加剧；或
• 肝脏问题 - 恶心、上腹部疼痛、瘙痒、食欲不振、尿色深、粪便颜色变浅、黄疸（皮肤或眼睛发黄）。

如果您出现血清素综合征的症状，如：烦躁不安、幻觉、发热、出汗、寒战、心动过速、肌肉僵硬、抽搐、协调障碍、恶心、呕吐或腹泻，请立即就医。

丁丙诺啡的常见副作用可能更常发生，例如：

• 便秘、恶心、呕吐；
• 头痛；
• 出汗增多；
• 睡眠问题（失眠）；或
• 身体任何部位的疼痛。

这并非副作用的完整列表，其他副作用也可能发生。有关副作用的医疗建议，请咨询您的医生。

你不应该使用这种药物，如果你对丁丙诺啡过敏或：

• 在过去的4小时内使用了另一种麻醉性镇痛药。

为了确保这种药物对你安全，请告知你的医生你是否有以下情况：

• 美沙酮治疗；
• 呼吸问题，睡眠呼吸暂停；
• 影响呼吸的脊柱异常弯曲；
• 肝脏疾病（特别是乙型或丙型肝炎）；
• 肾脏疾病；
• 前列腺肥大，排尿问题；
• 头部受伤或脑肿瘤；
• 酒精成瘾，幻觉，精神疾病；或
• 胃、胆囊、肾上腺或甲状腺的问题。

怀孕

如果你在怀孕期间使用丁丙诺啡，你的宝宝可能会对药物产生依赖。这可能导致婴儿出生后出现危及生命的戒断症状。出生时依赖于成瘾性药物的婴儿可能需要数周的医疗治疗。

不孕不育

长期使用阿片类药物可能会导致具有生育能力的女性和男性的生育能力下降。目前尚不清楚这些对生育能力的影响是否可逆。

哺乳

丁丙诺啡可以通过母乳传递，并可能导致婴儿嗜睡和呼吸问题。请咨询你的医生有关对你婴儿的风险。

如果您开始或停止使用某些其他药物，可能会出现呼吸问题或戒断症状。请告知您的医生您是否还使用了以下药物：抗生素、抗真菌药、心脏或血压药物、抗癫痫药或用于治疗HIV 或丙型肝炎的药物。

丁丙诺啡可能与其他许多药物发生相互作用，导致危险的副作用甚至死亡。请务必让您的医生知道您是否还使用了：

• 感冒或过敏药物、支气管扩张剂哮喘/COPD 药物或利尿剂（“水丸”）；
• 用于晕动病、肠易激综合症或膀胱过度活动症的药物；
• 其他阿片类药物 - 阿片类止痛药或处方止咳药；
• 镇静剂，如安定 - 地西泮、阿普唑仑、劳拉西泮、阿普唑仑、克罗米帕马、咪达唑仑等；
• 让您感到困倦或减缓呼吸的药物 - 安眠药、肌肉松弛剂、用于治疗情绪障碍或精神疾病的药物；或
• 影响您体内血清素水平的药物 - 兴奋剂或用于治疗抑郁症、帕金森病、偏头痛、严重感染或急性恶心和呕吐的药物。

此列表并不完整。其他药物可能与丁丙诺啡发生相互作用，包括处方药和非处方药、维生素 和 草本产品。此处未列出所有可能的相互作用。

Use buprenorphine exactly as it was prescribed for you. Follow the directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Never use this medication in larger amounts, or for longer than prescribed.

Opioid Use Disorder

Buprenorphine Sublingual (for OUD)

Buprenorphine sublingual is usually taken only at the start of treatment for addiction (induction phase). Most people are later switched to long-acting buprenorphine (Sublocade injection or Brixadi injection) or another medicine that contains buprenorphine with naloxone (Bunavail, Suboxone, Zubsolv). You may receive your first doses of buprenorphine sublingual in a hospital or clinic setting until your condition improves. Use dry hands when handling the tablet. Place the tablet under your tongue and allow it to dissolve with your mouth closed. Do not chew the tablet or swallow it whole. If your doctor has prescribed more than 2 tablets per dose, place the correct number of tablets under your tongue at the same time and allow them to dissolve completely. Do not eat or drink anything until the tablet has completely dissolved in your mouth. Never crush or break a pill to inhale the powder or mix it into a liquid to inject the drug into your vein. Doing so could result in death.

Extended-release buprenorphine subcutaneous injection (for OUD)

Buprenorphine extended-release injection is given subcutaneously (just under the skin). Sublocade is given in the abdomen monthly, and Brixadi can be given in your buttock, thigh, upper arm, or stomach and can be given weekly or monthly. 

Sublocade should only be used when patients have received treatment with an oral transmucosal (used under the tongue or inside the cheek) buprenorphine-containing medicine for 7 days and are taking a dose that controls withdrawal symptoms for at least seven days. Sublocade is injected as a liquid. After the injection, Sublocade changes to a solid form called a depot. The depot may be seen or felt as a small bump under your skin at the injection site on your abdomen for several weeks. The depot will get smaller over time. Do not try to remove the depot, and do not rub or massage the injection site. Sublocade is part of a complete treatment plan that should include counseling.

Brixadi should only be used if you are currently receiving buprenorphine treatment or if your healthcare provider has given you a test dose of buprenorphine first to see if you are able to tolerate it. If you are new to Brixadi treatment, the upper arm should only be used after 4 doses of Brixadi in your buttock, thigh, or stomach. Brixadi is injected as a liquid; after the injection, the liquid changes to a gel form called a depot. The depot is not always felt under the skin. Do not try to remove the depot. Brixadi is part of a complete treatment plan that should include counseling.

Pain

Buprenex (buprenorphine injection) is used for pain, it is given by deep intramuscular or slow (over at least 2 minutes) intravenous injection at up to 6-hour intervals, as needed.

Butrans skin patch is used for chronic around-the-clock pain. It is applied once a week and worn continuously for 1 week. Do not change your dose. Apply Butrans exactly as prescribed by your healthcare provider. Your doctor will prescribe you the lowest effective dose for the shortest time needed. Do not take hot baths or sunbathe, use hot tubs, saunas, heating pads, electric blankets, heated waterbeds, or tanning lamps as these can cause an overdose that can lead to death.

Belbuca buccal films are used for around-the-clock treatment of moderate to severe chronic pain. Using a finger, place the yellow side of the Belbuca buccal film against the inside of your moistened cheek. Press and hold the Belbuca buccal film in place for 5 seconds and then take your finger away. Once in place, the film will dissolve completely in about 30 minutes. Do not eat or drink anything until the Belbuca film has completely dissolved in your mouth. Rinse your mouth with water after the medicine dissolves. Wait one hour after the film dissolves to brush your teeth to prevent damage to the teeth and gums. Do not chew the Belbuca film or swallow it whole. You should receive regular dental checkups while using Belbuca.

General information about using this medicine.

Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.

You may need frequent blood tests to check your liver function.

If you need surgery, tell the surgeon ahead of time that you are using this medicine.

Any medical care provider who treats you should know that you are being treated for opioid addiction and that you are on buprenorphine. Make sure your family members know how to provide this information in case they need to speak for you during an emergency.

Do not stop using this medication suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat. Keep track of your medicine. Buprenorphine is a drug of abuse, and you should be aware if anyone is using your medicine improperly or without a prescription.

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, flush the unused medicine down the toilet.

For detailed dosing information click the link below.

尽快服药，但如果接近下次服药的时间，则跳过漏服的剂量。不要同时服用两剂。

请立即寻求紧急医疗救助。布比卡因过量可能是致命的，尤其是在儿童或未经处方使用该药物的其他人身上。

过量症状可能包括极度嗜睡或无力、皮肤发冷或潮湿、瞳孔缩小、心跳缓慢、脉搏微弱、呼吸非常缓慢或昏迷。

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