Table 3

Buprenorphine sublingual

Buprenorphine sublingual
What is it?Strong opioid analgesic
Mechanism of actionOpioid having agonist and antagonist properties
Starting dose200 μg every 6–8 hours prn (equivalent to 15 mg morphine 6–8 hourly)
Time to onset of effect10–20 min17
FormulationSublingual tablet—CD schedule three drug
IndicationModerate to severe pain
Common adverse effectsVomiting; opioid adverse effects; constipation; dizziness; drowsiness; dry mouth16
ContraindicationsAcute respiratory depression, comatose, head injury, raised intracranial pressure16
CautionThose at risk of aspiration
Severe hepatic impairment
LicenceTemgesic and tephine are licensed products for pain
BenefitsMay cause less constipation
May cause less hyperalgesia
RisksSystemic absorption
Use complicated: advise patients that tablets should be dissolved under the tongue, not to swallow for 2 min and not to consume food or drink for at least 5 min after administration
Non-registered carers will not be able to administer
Cost£8.50 for 28×200 μg tablets
  • CD - Controlled Drug