Buprenorphine sublingual
| Buprenorphine sublingual | |
| What is it? | Strong opioid analgesic |
| Mechanism of action | Opioid having agonist and antagonist properties |
| Starting dose | 200 μg every 6–8 hours prn (equivalent to 15 mg morphine 6–8 hourly) |
| Time to onset of effect | 10–20 min17 |
| Formulation | Sublingual tablet—CD schedule three drug |
| Indication | Moderate to severe pain |
| Common adverse effects | Vomiting; opioid adverse effects; constipation; dizziness; drowsiness; dry mouth16 |
| Contraindications | Acute respiratory depression, comatose, head injury, raised intracranial pressure16 |
| Caution | Those at risk of aspiration Severe hepatic impairment |
| Licence | Temgesic and tephine are licensed products for pain |
| Benefits | May cause less constipation May cause less hyperalgesia |
| Risks | Systemic 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