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What happens if I miss a dose (Butrans)?

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 (Butrans)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. The amount of buprenorphine in a used or unused skin patch can be fatal to a child who accidentally sucks or chews on the patch.

Overdose symptoms may include extreme drowsiness, weak or limp feeling, weak pulse, cold and clammy skin, fainting, shallow breathing, snoring, or breathing that stops.

What should I avoid while using this drug (Butrans)?

Buprenorphine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid letting another person handle your buprenorphine skin patches. If the sticky side of a skin patch comes into contact with another person, wash the skin with clear water and seek medical care at once.

What other drugs will affect this drug (Butrans)?

Tell your doctor if you regularly use other medicines that can make you sleepy or slow your breathing (such as cold or allergy medicine, sedatives, anti-nausea medicine, other narcotic pain medicines, sleeping pills, muscle relaxers, heart rhythm medications, and medicine for seizures, depression, or anxiety). They can add to the side effects of buprenorphine and dangerous side effects may result.

• dexamethasone (Decadron, Hexadrol);
• St. John's wort;
• rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), or rifapentine (Priftin);
• phenobarbital (Solfoton) or other barbiturates;
• diazepam (Valium) or similar medicines such as alprazolam (Xanax), lorazepam (Ativan), clorazepate (Tranxene), and others;
• a heart rhythm medication such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), flecaininde (Tambocor), procainamide (Pronestyl), propafenone, (Rythmol), quinidine (Quin-G), sotalol (Betapace), and others;
• HIV medication such as efavirenz (Sustiva), etravirine (Intelence), nevirapine (Viramune), or ritonavir (Kaletra, Norvir); or
• seizure medication such as carbamazepine (Carbatrol, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline).

This list is not complete and other drugs may interact with buprenorphine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about buprenorphine.

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

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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