transdermal buprenorphine patch

Last reviewed 07/2023

Consult expert advice and local guidance

• buprenorphine is a partial opioid agonist. The transdermal preparation releases the patch strength in micrograms per hour of buprenorphine over several days and the manufacturers recommend changing the Transtec ® patch twice weekly. 24 hours should be allowed for full analgesic effect. After removal, plasma concentrations of buprenorphine will be halved after 30 hours
• approximate relative doses of Transtec® buprenorphine twice weekly patch
  
  

  • Transtec (micrograms per hour)	Approximate *Oral morphine (mg per 24 hours)
    35	84
    52.5	126
    70	168

    
    
    
• a further transdermal buprenorphine patch formulation containing a lower dose of buprenorphine is available (BuTrans®, releasing between 5 and 20 micrograms per hour of buprenorphine over 7 days). It is not yet clear what place these buprenorphine preparations have in palliative care
  • approximate relative doses of BuTrans® buprenorphine once weekly patch

    • BuTrans (micrograms per hour)	Approximate Oral Codeine (mg per 24 hours)	Approximate* oral morphine dose (mg in 24hrs)
      5	120	12
      10	240	24
      20		48

      
      

Transdermal buprenorphine patch preparations: Transtec® Patches releasing 35, 52.5, or 70 micrograms buprenorphine per hour as a twice weekly patch.

* Approximate mid-range oral morphine doses are described here; prescribers should note that manufacturers describe a range of oral morphine doses for each strength of patch

Bu-Trans® patches releasing 5, 10 or 20 micrograms per hour over 7 days.

Reference:

• (1) West Midlands Palliative Care Physicians (2012). Palliative care - guidelines for the use of drugs in symptom control.