Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Application of heat: Heat applied to or around the area of the patch can cause an unpredictable release and absorption of this medication. Avoid applying external heat such as heating pads or electric blankets, or soaking in hot tubs while wearing the buprenorphine patch.
Application site skin reactions: In rare cases, there have been severe skin reactions at the site of application. If you experience signs of inflammation, including a burning feeling, discharge, or raised bumps, stop using the medication and talk to your doctor as soon as possible.
Blood pressure: Buprenorphine can cause decreases in blood pressure, especially when a person rises from a lying or sitting position (orthostatic hypotension). To minimize the feeling of dizziness or lightheadedness upon standing, get up slowly from a lying or sitting position. If you have a condition that increases your risk of low blood pressure (hypotension) such as certain heart conditions, cerebrovascular disease (e.g., strokes), are prone to dehydration, or are being treated with blood pressure medications, discuss with your doctor how this medication may affect your medical condition or medications you are taking and whether any special monitoring is needed.
Central nervous system: The effects of buprenorphine on the brain are increased when taken with other medications with similar effects, such as opioids (codeine, morphine, oxycodone), anesthetic agents, haloperidol, promethazine, or phenobarbital. Taking any of these medications at the same time as using buprenorphine may cause an increase in drowsiness, dizziness, breathing difficulty, and awareness of surroundings. Tell your doctor if you are using any of these other medications.
Dependence and withdrawal: Physical dependence, psychological dependence, and abuse have occurred with the use of buprenorphine. People with a history of past or current substance use problems may be at greater risk of developing abuse or addiction while using buprenorphine. Talk to your doctor about the risks and benefits of taking this medication. It is important to keep this medication in a safe place to prevent theft. It is against the law to sell or give this medication to other people.
Drowsiness/reduced alertness: Buprenorphine may impair the mental or physical abilities needed for certain potentially hazardous activities such as driving a car or operating machinery. Avoid driving or operating heavy machinery until you have determined how this medication affects you.
Heart conditions: Buprenorphine can cause an abnormal heart rhythm. If you have certain heart rhythm problems (especially long QT syndrome, congenital QT interval prolongation, and low heart rate), irregular heart rhythms caused by other medications in the past, low blood potassium or magnesium levels, or are taking certain medications used to treat irregular heart rhythms (e.g., quinidine, procainamide, amiodarone, sotalol), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience an irregular heartbeat, stop taking this medication and contact your doctor. Your doctor will monitor your heart rhythm regularly while you are taking this medication with a test called an electrocardiogram (ECG).
Medical conditions: If you have addiction problems, Addison's disease, blood pressure problems, enlarged prostate, problems urinating, mental health problems (e.g., depression or hallucinations), reduced pituitary function, reduced thyroid function, kidney disease or reduced kidney function, liver disease or reduced liver function, or a history of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Medication transfer to others: People using this medication should be careful while hugging or sharing a bed to ensure that the buprenorphine patch does not get transferred to others. If the patch comes loose and accidentally sticks to the skin of another person, take the patch off the person's skin immediately and call a doctor. This applies to both fresh and used patches (some drug remains in the patch even after it has been used).
Respiratory conditions: This medication affects breathing and may cause respiratory depression. If you experience difficulty breathing, including slow, shallow breathing, seek medical attention immediately. If you have breathing difficulties (e.g., asthma, chronic obstructive pulmonary disease [COPD], sleep apnea), are severely overweight, are taking medications that may affect breathing (e.g., codeine, morphine, oxycodone, anesthetic agents, haloperidol, phenobarbital), or are a senior, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Stopping the medication: Stopping this medication suddenly may lead to withdrawal symptoms such as anxiety, sweating, difficulty sleeping, rigors, pain, nausea, tremors, diarrhea, difficulty breathing, goose bumps, or, rarely, hallucinations. If you are thinking of stopping the medication, check with your doctor first. This medication should be stopped gradually as recommended by your doctor.
Use of buprenorphine patch: Buprenorphine should not be used on broken or damaged skin. This can lead to higher than normal levels of buprenorphine in the blood stream thus increasing the risk of side effects. In addition, you should not put the buprenorphine patch in your mouth, chew or swallow it, or use it in any way other than applying on skin. This may cause choking and lead to death.
Pregnancy: Taking this medication during pregnancy can harm the developing baby and cause a withdrawal syndrome in the baby after birth. Buprenorphine should not be used during pregnancy. If you become pregnant while using this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are using buprenorphine patches, it may affect your baby. Women taking this medication should not breast-feed.
Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age.
Seniors: Seniors may be more sensitive to the effects of buprenorphine and may require a lower dose and monitoring by their doctor as a result.