Buprenorphine sublingual tablets

What is this medicine?

BUPRENORPHINE (byoo pre NOR feen) is used to treat certain types of drug dependence.

How should I use this medicine?

The medicine is placed under the tongue and allowed to dissolve. Several minutes will be needed to allow the tablet to fully dissolve. If your dose requires you to take more than 2 tablets at once, either place all the tablets at once under the tongue, or if you cannot fit more than 2 tablets comfortably, place 2 tablets at a time under the tongue. Either way, you should hold the tablets under the tongue until they completely dissolve. Do not swallow or chew the tablet. Do not inject the medicine. Take your medicine at regular intervals. Do not take your medicine more often than directed.

A special MedGuide will be given to you by your healthcare provider each time this medicine is inserted into your arm. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 16 years of age for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

  • breathing problems

  • confusion

  • signs and symptoms of a dangerous change in heartbeat or heart rhythm like chest pain; dizziness; fast or irregular heartbeat; palpitations; feeling faint or lightheaded, falls; breathing problems

  • signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired; yellow of the eyes or skin

  • signs and symptoms of low blood pressure like dizziness; feeling faint or lightheaded, falls; unusually weak or tired

  • trouble passing urine or change in the amount of urine

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • constipation

  • dry mouth

  • nausea, vomiting

  • tiredness

What may interact with this medicine?

Do not take this medication with any of the following medicines:

  • cisapride

  • certain medicines for fungal infections like ketoconazole and itraconazole

  • dofetilide

  • dronedarone

  • pimozide

  • ritonavir

  • thioridazine

  • ziprasidone

This medicine may interact with the following medications:

  • alcohol

  • antihistamines for allergy, cough and cold

  • antiviral medicines for HIV or AIDS

  • atropine

  • certain antibiotics like clarithromycin, erythromycin, linezold, rifampin

  • certain medicines for anxiety or sleep

  • certain medicines for bladder problems like oxybutynin, tolterodine

  • certain medicines for depression like amitriptyline, fluoxetine, sertraline

  • certain medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan

  • certain medicines for nausea or vomiting like dolasetron, ondansetron, palonosetron

  • certain medicines for Parkinson's disease like benztropine, trihexyphenidyl

  • certain medicines for seizures like phenobarbital, primidone

  • certain medicines for stomach problems like cimetidine, dicyclomine, hyoscyamine

  • certain medicines for travel sickness like scopolamine

  • diuretics

  • general anesthetics like halothane, isoflurane, methoxyflurane, propofol

  • ipratropium

  • local anesthetics like lidocaine, pramoxine, tetracaine

  • MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

  • medicines that relax muscles for surgery

  • methylene blue

  • other medicines that prolong the QT interval (cause an abnormal heart rhythm)

  • other narcotic medicines for pain or cough

  • phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children. This medicine can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and against the law.

Store at room temperature between 15 and 30 degrees C (56 and 86 degrees F).

This medicine may cause accidental overdose and death if it is taken by other adults, children, or pets. Flush any unused medicine down the toilet to reduce the chance of harm. Do not use the medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • brain tumor

  • drink more than 3 alcohol-containing drinks per day

  • head injury

  • heart disease

  • kidney disease

  • liver disease

  • lung disease such as asthma or COPD

  • an unusual or allergic reaction to buprenorphine, naloxone, morphine, codeine, other medicines, lactose, mannitol, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

What should I watch for while using this medicine?

Tell your doctor or healthcare professional if your symptoms do not start to get better or if they get worse.

Do not stop taking except on your doctor's advice. You may develop a severe reaction. Your doctor will tell you how much medicine to take.

If you are also taking a narcotic medicine for pain or cough or another medicine that also causes drowsiness, you may have more side effects. Give your health care provider a list of all medicines you use. Your doctor will tell you how much medicine to take. Do not take more medicine than directed. Call emergency for help if you have problems breathing or unusual sleepiness.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medicine and dosage regimens.

This medicine may cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.