Drug info - Has anyone heard of Butran patches??

[mikzemaj]

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??

[Photobug]

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.

[kailey_elise]

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

[Ghetto_Chem]

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

[Photobug]

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.

[toxinreleased]

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!

[Photobug]

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

[toxinreleased]

Originally Posted by Photobug

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.

[Photobug]

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.

[toxinreleased]

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.

[Photobug]

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.

[toxinreleased]

Originally Posted by Photobug

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.