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Butrans Patch Anyone? Just Got Mine Filled

LaCansadaLLaCansada Posts: 35
edited 06/11/2012 - 7:56 AM in Pain Medications
Hi all. I have been in PM for the past 4-5 years for SI joint pain. I used to be on Oxycotin and, briefly a Duragesic patch, and then the pain got more bearable and I have been taking Percocet 5 mg, four times daily + Lyrica. Just went to PM dr. I am two months post an SI joint Rhizotomy and having a bad pain flare. I really felt that I needed better pain relief when I was seen today and was given the Butrans Patch 5 mcg, to be increased to 10 mcg after 3 days if no results. I did some research on the internet and realized that this is Suboxone! Wow. At first, I was freaked out thinking it would do nothing for pain, that it's for opiate withdrawal. Then I read more and have heard that it does help even severe pain with the added benefit of not having the typical side effects of heavy duty narcotics. I work as a psychologist at a prison so I cannot be impaired on the job and my dr. and I discussed this. I am hoping to hear from someone that this drug works. And I would be so glad to ditch the whole pain pill thing as well if I can. I need a change badly in my PM plan. Thanks for any input anyone can give me.


  • i am on week two of my butrans patch rx and i have to admit i was kinda surprised at the results i recieved as well. although the pain control doesnt last the whole seven days for me ( usually about 5 days) at 10mg i have to admit that my nerve pain has been significantly reduced, better control than i have had in a while. I still have to take some break through meds occasionally and still take my muscle relaxers but not anywhere near the amount i had to take in the past. i hope it gives you some relief. the first few days suck while getting used to it but it does go away. please let us know how it works for you. good luck.
  • I'm prescribed buprenorphine as well, as my main analgesic. The patches aren't available here, but the sublingual tablets are longer-acting than most IR meds (6-8 hours, generally). They don't get rid of all of my pain - nothing does - but they help more than the other drugs I've been prescribed over the years (morphine, oxycodone, dihydrocodeine, tramadol, etc.), and the safety profile is very good, so that's a nice bonus. One thing I have found is that I have to be careful to get the dose just right - I can take 0.8mg sometimes and barely get any relief, but one extra 0.2mg tablet often makes all the difference, giving me significant relief.

    Edit: Just remembered - one other thing I have noticed with buprenorphine, as opposed to other opioid analgesics, is that they cause less heaviness and grogginess. I often feel energized after taking it, and a lot of people have reported similar benefits, including an antidepressant effect (minus all the adverse effects of the usual antidepressant drugs).
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  • Thanks to both of you for the replies. Glad to know that it was rough at first so i will not just throw away the patch if I feel bad on it after one day. I am impulsive and that's what I did w/many of my Duragesic patches. As soon as I felt nauseous, in the garbage it went. I am also working w/a rheumatologist and they are trying to rule out a non-rheumatoid inflammatory type of arthritis. My recent MRI showed sacroilitis. Glad to also know that a small dosage adjustment can make a big difference. I am only on 5 mcg and I have a feeling I will need a minimum of 10 mcg. But heck, I've never taken this drug before. Can you take break-through meds on top of it if you are still in pain? Such as the Percocet? I forgot to ask this.
  • Sorry this reply is so late - I've been away for a few days. Yes, you can take breakthrough medication with the buprenorphine patch. I read a lot about the drug when I was first prescribed it, and I checked with my PM doctors too, and they both said it's fine. Trials have been conducted using the buprenorphine patch along with various other opioid drugs, including morphine, oxycodone, hydromorphone and tramadol, and there was an added analgesic effect, but no antagonism. Buprenorphine is sometimes described as an agonist/antagonist because it has agonist effect on the mu opioid receptor and some antagonism at the kappa opioid receptor. My doctor prescribes me breakthrough medicine (morphine and sometimes tramadol) on top of the buprenorphine, and he told me there was no cause for concern within the usual analgesic dose range. I have never had a problem (I take between 1.6 and 2.4mg of buprenorphine a day, on average).

    Buprenorphine is a partial mu receptor agonist, which basically means it has activity at this opioid receptor, but less than, say, morphine (which is a full agonist). At low doses, though (the range used for pain management), buprenorphine acts as a full mu receptor agonist.

    Obviously, like all drugs it works well for some and not so well for others. It helps with my pain - not 100%, but then again nothing does - I'm happy that it just reduces my pain at this point (nothing else has been helping much). I hope it works well for you and gives you relief from your pain.

  • Thanks Huggy for your comments. Day 4 on the Butrans patch and I am loving it. I am getting as good of relief as I had on the Duragesic patch without the terrible side effects. I did not realize until I began this medication just how bad the Percocet & Oxycotin was making me feel. I did a little bit of research on this drug on the internet and was trying to figure out if it is Suboxone? Or is it Suboxone minus the Nalexene? I am on the lowest dose, 5 mcg, and am plenty happy with the pain relief I am getting even at this low level. But I only have a vague understanding of how it works. Thanks for your helpful explanation. Lisa
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  • Hi Lisa, glad I could be of help. I'm happy to hear the Butrans patch is working for you - I've seen a lot of similar comments from people who've tried it after taking other opioids and have been happily surprised by how it works and the lower incidence of side effects. There is a respiratory ceiling dose ith buprenorphine, which means it's practically impossible to die from an overdose, which is another advantage, obviously!

    Buprenorphine is the same opioid that is in Suboxone, but in that formulation it is mixed with naloxone (an antagonist to deter abuse by injecting) and it is typically at much higher doses (from 2mg all the way up to 32mg). In these higher doses it's supposed to be helpful as a substitute for other opioids in people who have addiction problems. It's been used for this purpose for nearly a decade in the US, although it has been used as a pain reliever for at least thirty years in many other countries. It's use for chronic pain is on the rise now, as more and more research has concluded it is a safe and effective alternative to other strong opioids.
  • Yesterday was day 5 - by 6:00 pm, I felt that the patch was wearing off. And i still had 1.5 days to go. Today is day 6 and I ended up changing it at about 3:00 pm. It was not due to be changed until tomorrow at 6:00 am. How have others with this problem managed to resolve it with your dr? My PM dr is pretty nice but also pretty strict. Even if he says I can change it on every 5th day as opposed to the 7th, I'm not sure the insurance will accept this. But first thing's first. I need to get my dr. on board. I hope I don't have to just tough it out for 2 days. I will have no BT meds soon, so filling in this way will not be an option unless the dr. agrees to do it. Or maybe I could stretch out the last two days with the sublingual suboxone. Any thoughts? Thanks again. Lisa
  • I am going to talk to my pm about these patches next week. I am so sick of feeling tired all day from the oxycontin cr, oycodone and zanaflex plus my pain is not being controlled very well on the higher dose any longer. But feeling utterly exhausted all the time is depressing in it self.

    Thanks for the thread

  • Julie, I think you will be very happy w/this patch given what you are on now and have taken. Prior to beginning this medication, I was aware that I had slowly lost my life due to the effects of various pain medications but felt trapped b/c I still need pain relief. I switched over from Percocet 5 mg 4x daily, but had previously been on Oxycotin + Percocet. This is much better. And the Percocet was barely doing anything for me after one year on it. I wish you the best at your appt. Please post and let us know how it went. Lisa
  • Lisa, you should probably talk to your doctor about the patch wearing off before the whole week is over. This seems to be a common problem with many extended-release medications: the period of effective analgesia seems to vary from person to person. OxyContin, for example, is supposed to work for a full twelve hours, but some people find the effects start wearing off after only about eight hours. I expect there are similar variations with the buprenorphine patch.

    It's a pity you don't have Temgesic (the sublingual tablets intended for pain relief) over there. I don't know about Suboxone, to be honest. I hope you can get this sorted out with your doctor. Good luck!
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