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The dose of the buprenorphine patch (Butrans®) your healthcare provider recommends will vary, depending on a number of factors, including:
- The type and severity of your pain
- The type and dosage of other pain medications you have taken
- How you respond to the drug
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dosage unless your healthcare provider specifically tells you to do so.
The starting dosage of the buprenorphine patch your healthcare provider recommends will be highly individualized. It will depend largely on the type and dosage of the other opioids you have been taking.
After calculating the dosage of your other opioid medications, your healthcare provider will convert that to an initial buprenorphine patch dose. It is best to underestimate the dose initially in order to avoid potentially dangerous side effects. If you have not been taking other opioids, the standard starting dosage is one buprenorphine 5 mcg/hour patch applied once a week.
Your healthcare provider may also recommend a short-acting pain medication to be used on an "as needed" basis when your pain is especially severe (sometimes called "breakthrough pain"). You may find that you need more of the breakthrough pain medication when you first start using buprenorphine patches. This is because it can take several days to feel the full effects.
Because initial dosages are often underestimated, many people find they need an increase. If your pain is not adequately controlled after three days, your healthcare provider may increase your buprenorphine patch dosage. The increase will be based on the amount of short-acting pain medication you needed in the two to three days after starting the patches.
The absolute maximum dosage for the buprenorphine patch is one 20-mcg/hour patch applied once a week. Higher doses increase the risk for dangerous changes in the heart rhythm.
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