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  #1  
Old 16-03-2011, 03:56
mikzemaj mikzemaj is offline
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Has anyone heard of Butran patches??

I was surfing through the Purdue Pharma website and found this drug called, Butrans Patch. Now, what I don't understand about this product is that the main ingredient in it is buprenorphine. From my understanding, buprenorphine is supposed to help patients come off of opiates and to help minimize the w/d effects, such as products like Suboxone,subutex, etc.

What Purdue Pharma describes this Butrans Patch as: " a transdermal formulation of buprenorphine indicated for the management of moderate to severe chronic pain in patients requiring a continuous, around-the-clock opioid analgesic for an extended period of time." Butrans is also classified as a SC III.

So my question is...If Suboxone and Butrans have the same exact ingredients, then why do they both have different descriptions??
  #2  
Old 17-03-2011, 17:37
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Re: Has anyone heard of Butran patches??

Suboxone is an opioid called Buprenorphine mixed with an opiate antagonist called Naloxone. In low doses Bupe will kill some kinds of pain. It also has the advantage that you don't develop a tolerance to it like you do with pain meds. So you can take the same dose of Bupe for 5 years. My cat did. It works fine for up to 5 years. My cat found 3 - 6 mg a day of Subutex to be a good dose for 5 years. So now the Butran patch is just Buprenorphine aka Subutex (in pill form). The patch comes in 3 strengths 5, 10, and 20 mcg an hour, which is released and absorbed into the skin. Patches don't work well if you sweat a lot or if you have a lot of hair on your skin. So my cat prefers the pills. I have also heard that until the doc gives you at least the 10 mcg patch you won't feel anything. Most people say you need the 10 or 20 patch. But then it works well for certain kinds of pain. Mostly upper back pain, and some nerve damage pain. It doesn't seem to work on lower back pain.

So that's what the Butran patch is. It's the opiate Buprenorphine in pure form. Any more questions just ask. My cat has a lot of experience with this med.
  #3  
Old 17-03-2011, 20:17
kailey_elise Gold member kailey_elise is offline
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Re: Has anyone heard of Butran patches??

I imagine because they're using it for a different reason. Methadone is also used for both pain relief & as an antiaddictive; the methods used for each purpose is different & thus it would list different instructions based upon it's potential use.

Buprenorphine, iirc, was initially developed to be used for pain - they're ALWAYS on the lookout for non-euphoric painkillers. That it has such a long half-life also made it attractive as an antiaddictive.

Bupe's been around & in use a good deal longer than the Suboxone formulation.

~Kailey
  #4  
Old 17-03-2011, 20:26
Ghetto_Chem Ghetto_Chem is offline
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Re: Has anyone heard of Butran patches??

K_E is right.

Swims friends father got methadone for awhile in attempt to manage is immense neck pain (no luck). So he can definitely see it being used for such.

In fact he has met a person that gets it prescribed for that very reason. He only met this individual a few times, but he told swim that he found it superior to other opiates for him in treating his chronic back pain. Yet it still makes people functional in normal society.

This is an interesting medicine though, wonders how many people have actually been prescribed this. Probably not one of the top choices, when there are so many other opiates out there.

Peace
  #5  
Old 17-03-2011, 22:06
Photobug Photobug is offline
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Re: Has anyone heard of Butran patches??

Actually until this patch came out, and before the pills were in use, Buprenorphine was used for pain as Buprenex. The main drawback was it has to be injected daily, or every other day. So that made it no good for Heroin addicts, many of whom are also needle freaks. However, even if you weren't an addict, how many people want to have to inject themselves daily. Not too many. My cat didn't want to, and that was why he used the pills for 5 years. But Bupe doesn't seem to work on lower back pain. And that became a big problem 1 & 1/2 years ago.

I found 1 of the big advantages of Bupe is that it doesn't create a tolerance to itself. But if you need to go off it and onto reg pain meds you then need massive doses of the reg pain meds. So it does make a tolerance go up for them. But not for itself. My Cat used 5 mg of Subx for 5 years and was fine with it. Never needed more. I think that's 1 of the top benefits.
  #6  
Old 19-02-2012, 15:36
St Dismas Novitiate St Dismas Novitiate is offline
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Re: Has anyone heard of Butran patches??

Well, it doesn't look like anyone has touched this thread for a while, and it was kind of thin even then!

Does anyone have more to add on their experiences with the Butrans patch?

For chronic pain only, please! There are already quite a few other threads on how to abuse opiates and I really don't need any help there. Unless you want lessons yourself!

We have one member who says this does not work well for lower back pain, but seems to be fine for upper back and neck pain. What are the mechanisms of that? I don't see how that would work!

I am getting ready to make the jump from Fentanyl to Butrans, and I would like as much info as I can get on the patch itself, experience-driven reports on its effectiveness as a reliever of chronic back pain, and reports from anyone who may have actually made this specific type of jump in the past.

Anything anyone could share on this would be appreciated!
  #7  
Old 20-02-2012, 01:48
Photobug Photobug is offline
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Re: Has anyone heard of Butran patches??

Hi Toxinreleased,

It seems as if the Butrans patch is still not in very widespread use. So getting 1st hand accounts remains difficult. As you may know I'm back on SL Subutex, and having a hard time because the pharmaceutical companies have been playing with the formula. I also have a buddy who's on Butrans.

I'm wondering why you're going from Fentanyl to Butrans? I guess you know that Buprenorphine is such a strange drug that I no longer make generalizations about it. I'll say this much because I've heard it from several Butrans users. That patch doesn't reach maximum pain killing properties for several days to 1 or 2 weeks. It has to build up in you. That makes sense to me also. I think they always give you a pill for BT pain, and for the 1st week you may need them more than later on. There have also been several people now who have reported getting that optimistic attitude from the patch also. That's a good thing.

I hope it works well for you
  #8  
Old 20-02-2012, 19:55
St Dismas Novitiate St Dismas Novitiate is offline
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Re: Has anyone heard of Butran patches??

Quote:
Originally Posted by Photobug View Post
Hi Toxinreleased,

It seems as if the Butrans patch is still not in very widespread use. So getting 1st hand accounts remains difficult. As you may know I'm back on SL Subutex, and having a hard time because the pharmaceutical companies have been playing with the formula. I also have a buddy who's on Butrans.

I'm wondering why you're going from Fentanyl to Butrans? I guess you know that Buprenorphine is such a strange drug that I no longer make generalizations about it. I'll say this much because I've heard it from several Butrans users. That patch doesn't reach maximum pain killing properties for several days to 1 or 2 weeks. It has to build up in you. That makes sense to me also. I think they always give you a pill for BT pain, and for the 1st week you may need them more than later on. There have also been several people now who have reported getting that optimistic attitude from the patch also. That's a good thing.

I hope it works well for you
I'm trying to get to as small a dose of pain meds as possible. BuTrans seems like a logical choice for the next step down, as it is roughly 1/2 as strong as Fentanyl, and it should, being Bupe, help with some of the absolutely horrible WD's that you get from Fentanyl. Currently, I'm down to 25 mcg/hr fentanyl and I was thinking about dropping down to 12.5 (which is the lowest dose patch available, I believe), staying there for 30 days (I drop by 25 mcg/hr every 30 days), and then jumping to a 20 mcg/hr BuTrans patch. At that point, I can further reduce to 10, and finally to 5, if necessary, and then jump off that and go on (probably) oxymorphone/oxycodone combination. That's IF I can get that low again without being a total cripple! Otherwise< I might just stay on the BuTrans patch for keeps. Plus, the BuTrans patch is good for 7 days, instead of just 3, like the Fentanyl is.

One of my concerns was meds for the break-thru pain or pain that occurs before the patch has reached full effectiveness. Again, because it is Bupe, how does that work? Being an antagonist/agonist combination, wouldn't it
prevent other opiates from working? I was also thinking about having my doctor prescribe Subutex for a couple of days, just to get it built up in my system and "jump-start" the process, until the patch has a chance to become fully effective. Then, I can pull the oral meds and just stay with the patch. 3 or 4 days of two to four mg pills should be enough, I would think.

Still, I would like to hear from others on this, If you are out there! Any info on these patches or on my proposed methods would be appreciated.
  #9  
Old 20-02-2012, 20:20
Photobug Photobug is offline
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Re: Has anyone heard of Butran patches??

Don't go on Subutex, 4 mg of that stuff is a lot, and then other opiates really can't be used much at all.

Go onto the 20 mcg patch and make sure your Doc gives you something for BT pain. I didn't think this would work neither. But my buddy who's on Butrans also gets 3 Percs a day for BT pain and he says it works. So apparently when the Bupe dose is low enough you can take other opiates and still get pain relief. So I say stick with plan A.
  #10  
Old 21-02-2012, 19:31
St Dismas Novitiate St Dismas Novitiate is offline
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Re: Has anyone heard of Butran patches??

You said in an earlier post that it could take from several days to up to two weeks before the Bupe in the patch has built up enough in your body to be effective, yes? Then wouldn't taking a generic Buprenorphine (Subs, etc.) in a low-say, 2 to 4 mg-dose for a short period of time, like two days, cause the drug to be built up much more rapidly? Then, levels would gradually fall, until they reached equilibrium with the patch, at which point you have gotten past the worst of any Fentanyl WD on a 2 mg dose which was decreased to a 20 mcg/hr dose over a period of 2 or 3 days.

First of all, you have to be in a state of WD before you start any formulation of Bupe, to prevent precipitated withdraw syndrome. Bupe, then meds-OK. Meds, then Bupe-bad WD's! So how can you continue to take break-through meds while you are waiting for the BuTrans patch to start to work? Seems to me that you would just be sending yourself into a PWS!

Is there something here that I am not seeing? Either you build up the Bupe rapidly and then let it fall to the level in the patch, or you go with NO pain relief and NO opiates in your system for from a few days to a week or two? I'm not really liking the sound of that option!

Again, the subutex would only be for a couple of days, say 3 max. Just to get rid of the initial fentanyl WD's and to get the levels built up more rapidly than the patch alone would, then they would stop.

As far as break-through meds, I have Opana, Oxycodone, Dilaudid, etc., so I'm sure that one of them would work.
  #11  
Old 21-02-2012, 21:48
Photobug Photobug is offline
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Re: Has anyone heard of Butran patches??

Well, this is starting to get complicated. I'm making the assumption that your Doc is an expert with all this, and knows what he's doing?

You don't need to be in full blown wds to go on a low dose of Bupe, but you do for 4 mg, and maybe 2 mg also. Bupe also needs to build up in the body at high doses. It just feels and acts differently as you keep using it. I think taking 2 - 4 mg a few days will just confuse your body more. I also think that while Bupe builds up you can stay out of pain with the BT meds. It sounds like you have quite a few of them saved up. I don't think you have anything to worry about. I only told you about Bupe building up because my buddy had told me that. He said the pain killing effect got better as the weeks went on. But then again, his Doc started him on the 5 mcg patch, not the 20 mcg, so maybe that was why.

I was just trying to say that if you don't feel much pain relief right away don't give up on it. I didn't mean it won't do anything right away, it will, but it should get better.

I think you're starting to over analyze the situation. I know the feeling, because I do it too.
  #12  
Old 21-02-2012, 22:43
St Dismas Novitiate St Dismas Novitiate is offline
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Re: Has anyone heard of Butran patches??

Quote:
Originally Posted by Photobug View Post
Well, this is starting to get complicated. I'm making the assumption that your Doc is an expert with all this, and knows what he's doing?

You don't need to be in full blown wds to go on a low dose of Bupe, but you do for 4 mg, and maybe 2 mg also. Bupe also needs to build up in the body at high doses. It just feels and acts differently as you keep using it. I think taking 2 - 4 mg a few days will just confuse your body more. I also think that while Bupe builds up you can stay out of pain with the BT meds. It sounds like you have quite a few of them saved up. I don't think you have anything to worry about. I only told you about Bupe building up because my buddy had told me that. He said the pain killing effect got better as the weeks went on. But then again, his Doc started him on the 5 mcg patch, not the 20 mcg, so maybe that was why.

I was just trying to say that if you don't feel much pain relief right away don't give up on it. I didn't mean it won't do anything right away, it will, but it should get better.

I think you're starting to over analyze the situation. I know the feeling, because I do it too.
Well, I'm doing this on my own, with my doctors knowledge. Does that make sense? She is not an addiction specialist or a pain management doc, just a professional with whom I have developed a relationship of trust. She knows that I do all my own research and when I bring a plan to her, she will review it for obvious problems, but she understands that I'm doing this my way.

So, I'm not really "over-analyzing" this, I am collecting information as part of my research into the next step of my program. I know very little about Buprenorphine or its methods of action, and I am trying to decide A) if it would be appropriate for my situation, and B) how to start and continue it most effectively if I do decide to try it.

I have been informed, both here and on other sites, that the introduction of Bupe at any amount into a system which already contains opiates with cause precipitated withdraw syndrome. Most have said that you should be in WD for 24 to 36 hours before using the BuTrans patch to prevent this. Again, this makes little sense to me. You have to BE in WD to PREVENT WD?

I guess to someone who has had experience with a mixed agonist/antagonist these might seem like silly questions, but for me it is part of a learning process. I understand now about the long half/life and how it builds up in the body. I am just trying to get as many different "experience reports" as possible to help me make an informed decision.
  #13  
Old 12-06-2013, 20:09
thair7391 thair7391 is offline
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Re: Has anyone heard of Butran patches??

Hello everyone,
I know I'm a bit late chiming into this thread but I suppose its never too late to add new information to new and undiscovered topics! I have personally been on the BuTrans 10 g/hour patch for about 5 months now and for my condition, it's helped tremendously. Of course, my condition can be well controlled by even low doses of opioids fortunately, due to both the nature of my condition, and my efforts to minimize tolerance over the years.
I have very severe, refractory, idiopathic Restless Leg Syndrome. I've tried over a dozen other medications and drug classes, both typical for RLS and atypical, and the only class that's ever made a difference are the opioids. As bizarre as it may sound, it actually isn't unheard of for a person to be treated long term with an opioid solely for RLS, and there's much research going on at the moment (some of which I've been part of) implicating an endogenous opioid-related component to the pathogenesis of the disease. Let me emphasize that my case of Restless Leg Syndrome developed spontaneously before ever using an opioid, however it's undoubtedly of equal intensity to the RLS experienced by opioid-dependent persons in the midst of abstinence, which as quite often mentioned as the worst symptom of withdrawal.
I certainly know what taking an opioid recreationally is all about, but I've taken great care to remain equipped and educated over the years in such a fashion that I minimize my susceptibility to tolerance so that opioids continue to remain effective throughout my lifetime. I've come to appreciate the drugs for the relief they provide, which has resulted in more responsible use. I was on hydrocodone prior to the BuTrans and requested the BuTrans myself for it's higher potency (in regards to analgesia) and especially for its uniquely superior pharmacology in terms of tolerance development, long half-life, ease of availability (CIII), and the convenience of a 7-day transdermal patch.

So enough about me, and more to the information I have to offer and the questions I have specifically about BuTrans: I switched from 7.5 mg of hydrocodone 3 x a day to BuTrans because trying to maintain pain/discomfort relief from RLS with an 8 hour dosing schedule with a short acting drug like hydrocodone (my Dr. preferred to keep it to 8 hours) was just not adequate and the acetaminophen was unnecessary. I began on the 5 g/hour patch but my metabolism is too rapid so as soon as I'd begin getting relief, I'd burn off the buprenorphine before the patch could accumulate sufficient levels in my blood to maintain relief so my relief was not consistent. I requested to move up to the 10 g/hour patch and ever since, I've maintained consistent control and relief of RLS symptoms. As far as subjective effects go, I definitely do notice a mild opioid-like effect, somewhere between the intensity of hydrocodone and morphine, although just...different, and it remains pretty constant, although because it's so constant, I become so accustomed to the feeling throughout the week that I can hardly distinguish it from normality until it starts wearing off and I apply a new patch lol. I also have zero experience with buprenorphine prior to the BuTrans so I don't have a good standard of what to expect and look for in terms of euphoria. I will say however that I have taken an old patch removed after the 7th day, and placed it in my mouth, such that the medicated side was touching my gums and my cheek. My intention of doing this was to continue using left-over medication for relief beyond 7 days so I could accumulate spare patches in the event of a vacation, theft, or a judgmental pharmacist lol. Doing this definitely resulted in an INTENSE rush of opioidergic activity, unlike any other opioid I've really ever tried. Not necessarily the best by any means, but just different. It was also very sedating and had me nodding off throughout the day, even from just letting it absorb inside my mouth for only 15 minutes (long half-life!). Obviously the extra heat inside of the mouth and the increased bioavailability of the buccal region and blood vessels of the sublingual mucosa compared to transdermal bioavailability were to blame (or thank lol) for the increased intensity in effect. However, this process also has instigated a question amongst my inquisitive, resourceful way of thinking....

I read on the patch packaging the other day that each 10mcg/hour patch contains a total of 10 mg (that's MILIgrams, not micro!). How the hell is this the case? If the patch itself is rated to release 10 MICROgrams per hour, that would result in 240 MICROgrams (or .24 MILIgrams) per day that accumulate (which isn't hard to accept given the long half-life of buprenorphine), (I figure this by multiplying 24 daily hours by the 10mcg released per hour). If you extend that to the full 7 days that the patch is intended to be worn and released, then (multiplying the 240 MICROgrams by 7) you get a total of 1,680 MICROgrams, or 1.68 MILIgrams. If a total of only 1.68 MILIgrams are released in 7 days, then why in the hell would they put 10 entire MILIgrams in a single patch, over 8 extra mg than necessary?? Is there something that I don't understand about transdermal delivery that I've failed to take into account here or what? Is the rated 10 mcg/hour regarding the actual amount that reaches the bloodstream, and not just the amount released from the patch into the skin? On that same note, for the drug to reach the bloodstream in significant quantities, does a much larger amount of the drug have to be dumped into and saturate the dermis before smaller amounts can get through to the bloodstream? What am I missing??!! And thus, if there are an extra 8.32 mg in the patch when I remove it, how can I take advantage of it instead of letting it go to waste? I believe that I'm at least somewhat putting it to use when I use it buccally, but could the patch be worn for longer? I guess I should experiment! Based on this logic, a single patch could be worn for an entire month before running out of medication.

Someone, anyone, share your thoughts, feelings, and ideas, please!

thair7391 added 34 Minutes and 20 Seconds later...

Quote:
Originally Posted by toxinreleased View Post
I'm trying to get to as small a dose of pain meds as possible. BuTrans seems like a logical choice for the next step down, as it is roughly 1/2 as strong as Fentanyl, and it should, being Bupe, help with some of the absolutely horrible WD's that you get from Fentanyl. Currently, I'm down to 25 mcg/hr fentanyl and I was thinking about dropping down to 12.5 (which is the lowest dose patch available, I believe), staying there for 30 days (I drop by 25 mcg/hr every 30 days), and then jumping to a 20 mcg/hr BuTrans patch. At that point, I can further reduce to 10, and finally to 5, if necessary, and then jump off that and go on (probably) oxymorphone/oxycodone combination. That's IF I can get that low again without being a total cripple! Otherwise< I might just stay on the BuTrans patch for keeps. Plus, the BuTrans patch is good for 7 days, instead of just 3, like the Fentanyl is.

One of my concerns was meds for the break-thru pain or pain that occurs before the patch has reached full effectiveness. Again, because it is Bupe, how does that work? Being an antagonist/agonist combination, wouldn't it
prevent other opiates from working? I was also thinking about having my doctor prescribe Subutex for a couple of days, just to get it built up in my system and "jump-start" the process, until the patch has a chance to become fully effective. Then, I can pull the oral meds and just stay with the patch. 3 or 4 days of two to four mg pills should be enough, I would think.

Still, I would like to hear from others on this, If you are out there! Any info on these patches or on my proposed methods would be appreciated.
Oi mate,

Having been on the BuTrans 10 g/hour patch myself for several months now, I can confirm that (on this dose at least) taking another full agonist in combination with the patch will still work with at least 80% effectiveness, if not complete effectiveness, even with a weaker agonist like hydrocodone which I have indeed tried. With the 10 g/hour patch, and assuming a 24-hour half life of buprenorphine for convenience sake, you're getting an accumulated dose of .240 mg of buprenorphine per day, the equivalent of one-eighth of a 2 mg Suboxone tablet. I don't have any experience with buprenorphine apart from BuTrans (used therapeutically), but everything I've ever read, both in medical journals and personal experience, suggests that in doses less than 1 mg of buprenorphine (even less than 2 mg in some places), the blockade effect is not significant enough to prevent the additive effectiveness of concomitant opioid agonists. I don't know if you're familiar with Dr. Jeffrey T. Junig and his work and experiences, but he's been pushing and publishing the use of buprenorphine combined with typical agonists in chronic pain management to prevent development of tolerance and psychological dependency to opioids. He says that the dose of buprenorphine must be at least 2 mg to block the rewarding effects, however, even in his trials at this dose of buprenorphine, the analgesic effects of oxycodone were not inhibited and in fact, were compounded. Obviously you probably don't want to prevent euphoria (nor would I), and I can confirm that at the low doses of BuTrans, euphoria is not inhibited, but I'm mentioning Dr. Junig's work because it shows that even at 2 mg of buprenorphine, other opioid agonists are still effective at relieving pain and would also, therefore, prevent any withdrawal symptoms so I don't think you'd have anything to worry about. I say just start the BuTrans at whatever dose you think would be necessary (I can personally vouch for the 10 mcg/hour to be much more effective than you probably expect) and maybe initially have some typical opioid agonists of your preference handy for potential breakthrough pain in the event that the BuTrans is not adequate, or if your tolerance is high enough, to prevent withdrawal. If you didn't read my previous post, you can also take the patch, cut the adhesive sides off (leaving only the medicated rectangle) and then fold it in half with the skin-side facing outward (of course lol) then place it in your gums so that one folded side is touching your gum, and the other touching the inside of your cheek. Doing this results in more rapid release of buprenorphine as well as more rapid bioavailability/absorption which I'm confident would rid you of any withdrawal symptoms that may occur and likely most pain. You also don't have to compromise the integrity of the transdermal system to do this. I will mention though that if you use a patch this way from the start of the patch instead of applying it to the skin, it will only last you about 4 days instead of 7 since the release of medication is more rapid and will unfortunately bring you up short of medication before your expected refill date :/

Last edited by thair7391; 12-06-2013 at 20:09. Reason: Automerged Doublepost

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