Buprenex (buprenorphine) is a prescription drug that’s given to manage short-term, severe pain. Buprenex comes in an intravenous (IV) infusion or an injection into a muscle. Buprenex is only given by a healthcare professional.

Buprenex is given to relieve severe pain in adults and in some children ages 2 years and older.

To learn more, see the “Is Buprenex used for pain?” section below.

Buprenex basics

Buprenex is a partial opioid agonist that contains the active ingredient buprenorphine. The drug comes as a liquid solution. You’ll receive Buprenex from Mdoctor in one of the following ways:

  • an intravenous infusion, which is an injection into a vein over a period of time
  • an injection into a muscle

Buprenex is available in a generic form. If you’re comparing Buprenex versus buprenorphine, note that both work well and are safe to receive.

Buprenex has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What are Buprenex’s side effects?” and “What should be considered before receiving Buprenex?” sections below.

Read on to learn more about Buprenex’s side effects, dosage, and more.

Buprenex has been discontinued. This drug’s removal from the market was a business decision by the manufacturer and not due to concerns regarding the drug’s safety or effectiveness.

Your doctor will no longer prescribe Buprenex injections for pain. But Buprenex is still available in a generic version called buprenorphine. A generic contains an exact copy of the active drug in a brand-name medication. A generic is considered just as safe and effective as the original drug but tends to cost less. The information on Buprenex in this article also applies to generic buprenorphine injections unless otherwise stated.

For details about alternatives to buprenorphine injections for severe pain, talk with your doctor.

Like most drugs, Buprenex may cause mild or serious side effects. The lists below describe some of the more common side effects that Buprenex may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor can tell you more about the potential side effects of Buprenex. They can also suggest ways to help reduce side effects. For more details, you can also check out this article on Buprenex’s side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Buprenex can cause. To learn about other mild side effects, talk with your doctor or read Buprenex’s prescribing information.

Mild side effects that have been reported with Buprenex include:

  • constipation*
  • sedation (feeling drowsy and less alert than usual)*
  • nausea
  • dizziness

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects of Buprenex can occur, but they aren’t common. If you have serious side effects, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects that have been reported with Buprenex include:

* For more information about this side effect, see the “Side effect focus” section below.

Allergic reaction

For some people, Buprenex can cause an allergic reaction.

But it’s not clear how often this side effect occurred in the drug’s studies.

In general, symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.

What might help?

Buprenex is given by a healthcare professional in a hospital or clinic.

If you have mild symptoms of an allergic reaction, such as a mild rash, immediately let your healthcare team know. They may suggest a treatment to manage your symptoms.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call for medical attention right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Buprenex, they’ll determine whether another pain medication might work better for you.

Side effect focus

Learn more about some of the side effects that Buprenex may cause, including its boxed warnings.

Boxed warnings

Buprenex has boxed warnings. These are serious warnings from the Food and Drug Administration (FDA) about drug effects that may be dangerous. Boxed warnings for Buprenex include:

Addiction and misuse: Buprenex is an opioid. This means the drug can lead to opioid addiction and misuse, which can cause overdose and, in some cases, death.

Life threatening respiratory depression: Buprenex may affect your breathing. Some people have experienced serious, life threatening, and, in some cases, fatal respiratory depression (slow, ineffective breathing) while receiving Buprenex. These problems may occur at any time during the treatment. But your risk is highest when you first start having Buprenex treatment. Your risk is also increased if your doctor raises your dose.

Neonatal opioid withdrawal syndrome: You can receive Buprenex if you’re pregnant. But long-lasting Buprenex treatment throughout pregnancy can result in withdrawal symptoms in your newborn. Withdrawal symptoms may include a high-pitched cry, trouble gaining weight, and shaking. Neonatal opioid withdrawal syndrome can be life threatening if not treated quickly.

What might help

You’ll receive Buprenex at a hospital or clinic. Your doctor will take certain steps to help prevent the risks associated with Buprenex treatment. These steps may include:

  • For addiction and misuse: Before giving you Buprenex, your doctor will assess your risk of addiction or misuse. During your treatment, they will continue to regularly monitor you for this risk. Your doctor may stop prescribing Buprenex if you show signs of addiction or misuse.
  • For life threatening respiratory depression: While you’re receiving Buprenex, your doctor will check your breathing on a regular basis. Your risk of respiratory depression (slow, ineffective breathing) will increase when you first start receiving Buprenex and if your dose increases. After your receive your first dose, your doctor will closely monitor your breathing for 24 to 72 hours.
  • For neonatal opioid withdrawal syndrome: If you’re pregnant, talk with your doctor about the benefits and risks of Buprenex treatment. If you receive Buprenex for an extended period during pregnancy, your newborn may need treatment for neonatal opioid withdrawal syndrome. This treatment needs to be readily available at the time of delivery. Some options may include methadone, morphine, and buprenorphine.

Constipation

Buprenex and other opioid drugs can cause opioid-induced constipation. The drug reduces the movement of food and liquids through your stomach and intestines. This can affect how quickly your body digests food and how easy it is for you to pass stool.

What might help

Your doctor can tell you how to prevent and manage constipation while receiving Buprenex. To prevent constipation during your Buprenex treatment, your doctor may recommend:

  • adding more fiber to your diet
  • drinking plenty of water each day
  • exercising regularly

Your doctor may also recommend taking a stimulant laxative to help manage constipation. Stimulant laxatives include senna (Ex-Lax) or bisacodyl (Dulcolax). Stimulant laxatives might be prescribed with or without a stool softener, such as docusate sodium (Colace).

You can also try taking an osmotic laxative, such as polyethylene glycol 3350 (MiraLAX). This type of laxative treats constipation by drawing water into the bowels, which helps soften stool.

It’s important to note that you shouldn’t take bulk-forming laxatives (such as psyllium) during your Buprenex treatment. These laxatives can make constipation worse if you’re taking an opioid such as Buprenex.

In some cases, severe constipation may occur with Buprenex. If you experience severe constipation, let your doctor know. They’ll monitor your condition and suggest ways to treat it, if necessary.

Sedation

Sedation is the most common side effect of Buprenex. It involves feeling drowsy and less alert than usual. Although people in clinical studies experienced sedation while receiving Buprenex, it was easy for them to wake up and become alert.

Sedation can become a problem if you combine certain drugs or substances with Buprenex. These include benzodiazepines, alcohol, or other substances affecting areas of the brain that control breathing.

What might help

If you experience sedation with Buprenex, you shouldn’t drive or operate heavy machinery until this side effect has passed and you feel alert again. If you need to take any other medication that causes sedation, talk with your doctor first. They can tell you which medications are safe to take with Buprenex.

Your doctor will recommend the dosage of Buprenex that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.

Form and strengths

Buprenex is a liquid solution in a vial. It’s given as an injection into your muscle or an infusion into your vein.

It’s available in one strength: 0.3 milligrams per milliliter (mg/mL).

Recommended dosages

Buprenex injections are given as needed to manage severe pain. Your doctor will likely start with a one-time dose of Buprenex to see how well it works for you. They’ll give additional doses as necessary to relieve your pain. Ultimately, your doctor will give the fewest possible doses of Buprenex to get the desired effect.

Buprenex dosage for adults and children ages 12 years and older

Your doctor will likely start by giving you a single dose of 0.3 mg of Buprenex (1 mL of solution). If a single dose isn’t effective for your pain, you may be given a second 0.3-mg dose 30 to 60 minutes later.

If your pain doesn’t go away, your doctor may give you 0.3 mg of Buprenex every 6 hours.

For severe pain, the maximum dose of Buprenex is 0.6 mg every 6 hours.

Buprenex dosage for children ages 2 to 11 years old

The typical starting dose of Buprenex for children is 2 to 6 micrograms per kilogram (mcg/kg) of body weight. One kg equals about 2.2 pounds (lb). So, for a child who weighs 16 kg (about 36 lb), their maximum Buprenex dose for each injection would be 96 mcg.

If the child’s pain doesn’t go away after a single dose, their doctor may give additional doses of Buprenex every 4 to 6 hours. However, some children may need to wait at least 6 to 8 hours between each dose. Their doctor will determine the dosing frequency that’s safest for them.

To learn more about the dosage of Buprenex for you or your child, see this article.

Receiving Buprenex

You’ll receive Buprenex at a hospital or clinic. Your doctor will take certain measures to make sure you receive the drug safely. You’ll receive doses of Buprenex up to 6 hours apart, as needed. If your pain is not better after 30 to 60 minutes, your doctor may give you a second dose. The frequency of your doses will depend on how well Buprenex relieves your pain. It will also depend on other factors, such as other health conditions you have and other medications you’re taking.

Receiving Buprenex with other drugs

Your doctor may prescribe the lowest dose of Buprenex if you’re taking other medications that affect your breathing or alertness. If you have questions about receiving Buprenex with other drugs, talk with your doctor.

Questions about receiving Buprenex

Below are some common questions about receiving Buprenex.

  • What if I miss a dose of Buprenex? Your doctor will give you each dose of Buprenex. If you miss an appointment, you should call their office right away to reschedule.
  • Will I need to receive Buprenex long term? No, you won’t receive Buprenex long term. Your doctor will prescribe the lowest effective dose of Buprenex for the shortest time possible. If you need long-term pain relief, your doctor may suggest a different medication instead.
  • Should I have Buprenex with food? You can have Buprenex with or without food. You’ll receive the drug through injections into a muscle or as an IV infusion. Eating won’t have an effect on how Buprenex is absorbed.
  • How long does Buprenex take to work? It depends on how you receive the drug. When injected into a muscle, Buprenex may start working within 15 minutes. The effect can last for 6 hours or longer. If you’re receiving Buprenex through an IV infusion, you’ll experience faster pain relief.
Questions for your doctor

You may have questions about Buprenex and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • How will Buprenex affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare providers are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

Buprenex injections for pain are no longer available. However, buprenorphine (the active ingredient in Buprenex) is still available as a skin patch for severe pain. This buprenorphine patch is available as a generic and as the brand-name drug Butrans. Because Buprenex has been discontinued, the following cost information will focus on buprenorphine patches for pain.

Whether you have health insurance or not, cost may be a factor when you’re considering buprenorphine patches. What you’ll pay for buprenorphine may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for buprenorphine patches when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
  • Generic form: Buprenex injections and Butrans skin patches are available as generic drugs. Generics usually cost less than brand-name drugs. Talk with your doctor if you’d like to know whether generic buprenorphine patches may be an option for you.

You can also check out this article to learn more about saving money on prescriptions.

Find answers to some commonly asked questions about Buprenex.

How long does Buprenex last in your system?

If you receive Buprenex by injection into a muscle, the drug’s effect lasts for at least 6 hours. If you receive an intravenous infusion (an injection into a vein over a period of time), the drug’s effect will last for a shorter time. The drug will also be removed from your system faster. However, it will start to work faster. On average, Buprenex is eliminated from your system in 8 to 10 hours.

Will Buprenex make me feel ‘high’?

Yes, it’s possible to feel high during or after Buprenex treatment. Buprenex contains an active ingredient called buprenorphine, which is an opioid. Opioids have a warning for addiction and misuse. Your doctor will prescribe the lowest possible dosage. But addiction and misuse can occur even at recommended dosages.

If you’ve experienced addiction or misuse of opioids or other substances, talk with your doctor before receiving Buprenex. Your doctor may still prescribe it, but they may recommend frequent counseling and close monitoring during your treatment.

Do I have to store Buprenex at home?

No, you will not keep Buprenex in your home. You’ll receive it at a hospital or clinic.

Buprenex is used to treat severe pain in adults and in children ages 2 years and older who have previously tried other pain relievers. Buprenex can be given if past treatments didn’t provide enough relief or if they caused too many side effects or any serious side effects.

Buprenex is a partial opioid agonist, which is a type of drug that helps relieve pain. It works by targeting pain receptors (a type of protein) in the brain and provides pain relief.

When you’ve been injured, your body uses these pain receptors to send a signal to your brain that you’re hurt. Then your brain allows you to start feeling the pain. When Buprenex targets the pain receptors, it changes the message that your brain receives and the way your body feels the pain. This allows you to not feel the pain as strongly as you would have.

If you have questions about how Buprenex is used to treat pain, talk with your doctor.

Some important things to discuss with your doctor when considering treatment with Buprenex include your overall health and any medical conditions you have.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before receiving Buprenex, be sure to tell your doctor about all prescription and over-the-counter (OTC) medications you take. Also describe any vitamins, herbs, or supplements you use. Your doctor can tell you about any interactions these items may cause with Buprenex.

Interactions with drugs or supplements

Buprenex can interact with several types of drugs. These include:

This list does not contain all types of drugs that may interact with Buprenex. Your doctor can tell you more about these interactions and any others that may occur.

Boxed warnings

Buprenex has four boxed warnings. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

Boxed warnings for Buprenex include:

  • Addiction and misuse.*
  • Life threatening respiratory depression (slow, ineffective breathing).*
  • Neonatal opioid withdrawal syndrome (symptoms of opioid withdrawal in a newborn).*
  • Risks of use with benzodiazepines or other central nervous system (CNS) depressants: Taking CNS depressants (including alcohol and certain prescription drugs) with Buprenex may slow down your CNS to a dangerous degree. This can lead to extreme sleepiness, severe breathing problems, coma, and in some cases, death. Before receiving Buprenex, tell your doctor if you’re taking a benzodiazepine or another CNS depressant. They’ll monitor you more closely during your Buprenex treatment.

* For more information about this boxed warning, see the “What are Buprenex’s side effects?” section above.

Other warnings

Buprenex may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you receive Buprenex. Factors to consider include:

  • Significant breathing problems: Buprenex can affect your breathing. If you already have a condition that affects your breathing, such as chronic obstructive pulmonary disease (COPD) or asthma, receiving Buprenex may make these conditions worse.
  • Allergic reaction: If you’ve had an allergic reaction to Buprenex or any of its ingredients, you shouldn’t receive Buprenex. Ask your doctor what other medications are better options for you.
  • Diseases in your digestive system: If you have a blockage in your digestive system, receiving Buprenex may worsen your condition. For example, Buprenex can cause spasms in your sphincter of Oddi (a muscle that releases digestive proteins from your pancreas into your small intestine). This can lead to pancreatitis (inflammation in your pancreas).

Use with alcohol

Alcohol affects certain functions of your brain. This means it can be dangerous to drink alcohol while receiving Buprenex treatment. Doing so could cause serious side effects. These include deep sedation (a state of decreased consciousness when you’re not easily awakened), serious breathing problems, coma, and in some cases, death.

If you have questions about the risks of drinking alcohol while receiving Buprenex, talk with your doctor.

Pregnancy and breastfeeding

If you’re pregnant, long-term treatment with Buprenex may cause neonatal opioid withdrawal syndrome. With this condition, newborns experience symptoms of opioid withdrawal. Neonatal opioid withdrawal syndrome can be life threatening if doctors don’t treat it quickly.

If you’re receiving Buprenex for a long period of time during pregnancy, it’s important to be aware of the risks to the fetus. Your doctor should be prepared to provide treatment for neonatal opioid withdrawal syndrome at delivery, if needed.

You should not breastfeed your child during Buprenex treatment. Buprenex contains the active ingredient buprenorphine. Studies of buprenorphine sublingual tablets show that the drug can pass into breast milk. (A sublingual medication is one that dissolves under your tongue.)

Although Buprenex doesn’t come as a sublingual tablet, there may also be a risk of its active ingredient passing into breast milk.

If you are breastfeeding your child, talk with your doctor. They can suggest a different medication to treat your pain.

Yes, it’s possible. Buprenex can be misused because it’s an opioid. And taking or receiving an opioid can make you more likely than others to experience addiction and misuse. Buprenex is a controlled substance, so even at recommended doses, there’s still a risk of addiction and misuse. Before your doctor prescribes it, they’ll review your health history and assess your risk. They’ll also monitor you closely while you’re receiving the drug.

Having too much Buprenex can cause very serious side effects. For this reason, your doctor will carefully determine your Buprenex dosage. This is especially important when switching from another opioid, which can be fatal if the first Buprenex dose is too high.

Symptoms of overdose

Symptoms of overdose can include:

In severe cases, an overdose of Buprenex can cause death.

What to do in case you receive too much Buprenex

If you’re given too much Buprenex, your doctor will carefully monitor your breathing. If you’re having breathing problems, your doctor might give you medication or other treatments. Keep in mind that these problems are rare, and your doctor is trained to give you the appropriate amount of a drug.

If you have questions about receiving Buprenex, talk with your doctor. Your doctor can tell you about other treatment options for your condition. Below are some articles you might find helpful.

Some questions to ask your doctor about Buprenex may include:

  • Can I use natural painkillers with Buprenex?
  • Can I use buprenorphine patches instead of receiving the drug as an injection or infusion?
  • Which alternative pain relievers can I receive instead of Buprenex if I’m pregnant?
  • If I don’t experience pain relief with Buprenex, what are my other treatment options?

Q:

Can I receive Buprenex with other opioid pain relievers if Buprenex isn’t working?

Anonymous

A:

You shouldn’t receive Buprenex with other opioid pain relievers. Combining these medications increases your risk of severe respiratory depression (slow, ineffective breathing) and, in some cases, death. If you aren’t having adequate pain management, talk with your doctor. They can tell you about options for safely treating your pain.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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