Buprenorphine patches for severe pain

Name of medicine

Buprenorphine patch

Brand names: BuTrans, Bunov, Bupeaze, Bupramyl, Butec, Carlosafine, Hapoctasin, Panitaz, Rebrikel, Reletrans, Reveltec, Sevodyne, Transtec

Why is it important for my child to take buprenorphine patch?

Buprenorphine belongs to a group of medicines called opioids that are used to treat severe pain. This may be after an injury or operation (surgery) or during an illness. Buprenorphine patches will help keep your child’s pain under control. The buprenorphine is released slowly from the patch and passes through the skin into the body, providing continuous pain relief.

What is buprenorphine patch available as?

Buprenorphine patches come in different sizes containing different amounts of buprenorphine that is released over either 7 days or 3–4 days.

·   Patches that last 7 days release 5, 10, 15 or 20 micrograms per hour

·   Patches that last 3–4 days release 35, 52.5 or 70 micrograms per hour

When should I give buprenorphine patch

Depending on the type of patch your child has been given, you will need to change the patch either once or twice a week. It is helpful to do this on the same day or days each week, and at about the same time of day, to help you remember. Keep a note of when you apply a new patch.

How much should I give?

Your doctor will work out the amount of medicine (the dose) that is right for your child. The dose will be shown on the medicine label.

Your doctor may start your child on a low-dose patch and then increase the dose slowly if more is needed.

How should I give buprenorphine patch?

Choose an area of skin that is dry, not hairy, red or sore, and that has not been exposed to radiotherapy. The upper arm or body are good places; the back may be better for young children so they cannot peel off the patch.

• Avoid using soap and any creams, oils or ointments on the skin before applying a patch.
• Peel off the old patch. Fold it in half, sticky sides together, before throwing it away.
• Each patch is in a sealed pouch. When you are ready to apply the patch, cut or tear open the pouch along the dotted line. Be careful not to damage the patch inside.
• The sticky side of the patch is protected by foil. Try not to touch the sticky side of the patch.
• You should stick the new patch to a different area of skin from the previous one.
• Peel off half the foil and stick the patch to the skin, then remove the rest of the foil and press the patch in place for at least 30 seconds – the warmth from your hand helps the patch to stick.
• Do not rub the patch. Do not apply anything tight over it. If the patch lifts at the edges, you can use medical tape to stick it down.
• Wash your hands after handling the patches.
• Do not allow patches to come into contact with direct heat such as head pads or hot-water bottles, as the medicine will be released too quickly.
• Do not cut or tear patches. Do not use damaged patches.

When should the medicine start working?

 It may take up to a day for the first patch to work and up to 3 days for maximum effect. Your doctor will give your child other medicine for pain relief if needed during this time.

 If you are not sure the patch is working, contact your doctor but leave the patch in place in the meantime. Do not apply extra patches, as you may cause harm.

What if my child is sick (vomits)?

If  your child is sick you do not need to give them another dose, as the medicine will still work.

What if I forget to give it?

If you forget to replace a patch, do it as soon as you remember. Make a note of the new day and apply the next patch after either 7 days or 3–4 days, depending on which type of patch you have.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side effects you must do something about

Other side-effects you need to know about

• Your child is likely to feel sick or be sick (vomit) for the first few days of taking buprenorphine patch. Your doctor may prescribe another medicine to help with this.

• Your child may get constipated (have difficulty doing a poo). Your doctor may suggest that your child also takes laxatives to help them poo. You can help by giving your child plenty to drink.

• Your child may feel weak or have low energy, feel sleepy, have headaches or feel dizzy. They should still respond to voices and instructions, however.

• The patches may make the skin red and itchy. Some children get a whole-body rash. Contact your doctor if you are worried.

Your child may sometimes get side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to the UK safety scheme at mhra.gov.uk/yellowcard.

More information on side-effects can be found in a leaflet on our website.

Can other medicines be given at the same time as buprenorphine patch?

Buprenorphine should not be taken with some common medicines that you get on prescription. It is important to tell your doctor and pharmacist that your child is using buprenorphine patches.

You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

•  If your child gets a fever (high temperature), the buprenorphine may be released too quickly from the patch. Ask your doctor for a different form of pain relief while your child has a fever.
•  Do not stop using buprenorphine patches suddenly (unless you think your child may have had too much), as your child may get withdrawal symptoms. If you or your child want to stop using the patches, discuss this with your doctor but continue to use the patches in the meantime.
• You may have heard that some people get addicted to opioid medicines. The risk is low if you use the patches as you have been told to. Talk to your doctor if you are concerned. You can read more about this on the MHRA website.
•  The patches are waterproof, so your child can have a shower or bath but they should not stay in a hot bath for too long.
•  Fold used patches in half, sticky sides together, and put in a bin where young children cannot get them.

General advice about medicines

• Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

• Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container and packaging it came in.

Who to contact for more information?

Your doctor or pharmacist will be able to give you more information about buprenorphine patch and other drugs or methods for pain relief.

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by March 2027.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.