Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Opioid partial agonist (μ-receptor partial agonist, κ-antagonist)

Buprenorphine

Brand names: BuTrans (transdermal), Transtec (transdermal), Subutex (sublingual), Suboxone (with naloxone), Sublocade (depot SC monthly), Temgesic (sublingual)

Buprenorphine is an opioid used as transdermal patches for stable chronic pain and sublingually for opioid dependence (often with naloxone); it is a controlled drug.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Administer buprenorphine sublingual tablet sublingually as a single daily dose. (2.1) Strongly consider prescribing naloxone at the time buprenorphine sublingual tablet is initiated or renewed because patients being treated for opioid use disorder have the potential for relapse, putting them at risk for opioid overdose. (2.2) To avoid precipitating withdrawal, induction with buprenorphine sublingual tablet should be undertaken when objective and clear signs of withdrawal are evident. (2.3) Buprenorphine and naloxone sublingual film or buprenorphine and naloxone sublingual tablet is generally initiated after two days of buprenorphine sublingual tablet titration. (2.4) Administer …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-02-03. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is a partial agonist at opioid (mu) receptors with high receptor affinity, giving a degree of ceiling on respiratory depression but firm receptor binding.

Prescribing in practice

  • Because of its high affinity and partial agonism, it can precipitate withdrawal if given too soon to someone dependent on full opioid agonists — timing matters in dependence treatment.
  • Patches are for opioid-tolerant patients with stable pain; heat increases absorption.
  • Respiratory depression is still possible, especially combined with sedatives; counsel on dependence and safe storage.

Monitoring

Review pain or dependence-treatment response, sedation and bowel habit; with patches review at each change.

Counselling the patient

  • With a patch, avoid heat over it and follow the change schedule; dispose of used patches safely.
  • Do not combine it with alcohol or other sedatives.
  • In dependence treatment, take it exactly as directed regarding timing.

Evidence & guidelines

Used for chronic pain (patches) and as a first-line option in opioid-dependence treatment (NICE TA114), with a relative ceiling on respiratory depression.

Reference: SmPC BuTrans / Suboxone / Sublocade; NICE TA114 / TA354; UK Drug Misuse and Dependence Guidelines 2017 ('Orange Book'); MOTHER trial NEJM 2010; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways