Initially 5 mg for 7 days. Apply patch to a non-irritated, intact skin on upper outer arm, upper chest, upper back or side of the chest. Continue every 3-7 days until adequate analgesia is achieved. Dose should not be increased at <3 day intervals.
Patients w/ severely impaired resp function or are concurrently receiving MAOIs & those who have received w/in the previous 2 wk. Head injury, intracranial lesions or increased intracranial pressure, shock, reduced level of consciousness of uncertain origin, severe hepatic impairment. May lower seizure threshold in patients w/ history of seizure disorder. Severe febrile illness. Patients w/ known or suspected problems w/ drug or alcohol abuse or serious mental illness. Analgesia in the immediate post-op period or in other situations characterized by rapidly varying analgesic requirement. May precipitate an abstinence syndrome depending on the level of physical dependence, timing & dose of buprenorphine in patients who are physically dependent on full μ-opioid agonists. May impair the ability to drive or operate machinery. Pregnancy & lactation. Childn <18 yr.
MAOIs or who have received MAOIs w/in the previous 2 wk. Concomitant use w/ CNS depressants including sedatives or hypnotics, general anesth, other opioid analgesics, phenothiazine, centrally acting antiemetics, benzodiazepines & alcohol may cause resp depression, hypotension & profound sedation or potentially result in coma. May decrease rate of hepatic elimination w/ general anesth (eg, halothane). Elevated plasma conc w/ CYP3A4 inhibitors. Increased clearance w/ enzyme inducers (eg, phenobarb, carbamazepine, phenytoin & rifampin).
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