Buprenorphine

[Huntingleroy]

IF I dont succeed in finding a Gp who will prescribe my Buprenorphine tablets I may have to try patches instead . Can anyone tell me the usual strength to start on and what people generally stay on ? Im worried about feeling like a zombie all day with them !

[Marlayna67]

hi. Im in the states and take 1/4 of a sublingual strip equaling .5 buprenorphine. More than that gives me a strange insomnia.

[Huntingleroy in reply to Marlayna67]

Thank you very much

[Drls]

hello I went from a 10 mcg patch per week to 1-2 0.4 mcg tablets per night without any noticeable change in side effects - the lower patches are 5 mcg so to be on the safe side you might want to start there with the potential of moving up to the 10 mcg patch if your new go is flexible - good luck

[Huntingleroy in reply to Drls]

Thank you so much

[707twitcher]

patches will take about 48 hours to really take full effect, so you won’t know for a while how well they are working. 10mcg is likely a reasonable starting point. If that controls RLS symptoms by day 3, then you could consider trying a lower dose later if side effects bother you. ( several of us here have cut patches and found that seems to work fine despite manufacturer advice not to do so. That would be a way to go if you want to lower the dose but can’t get a Rx for 5mcg timely.). If it doesn’t control your symptoms and the side effects are bearable, you could add a second patch on day 3 and see how that goes. Just recognize the lag involved with the patch taking full effect. And also plan on needing to replace it after 5 or 6 days instead of the prescribed 7 days - that is most everyone’s experience here. Hopefully your prescribing doctor is flexible enough to allow for these factors otherwise you could get stuck not being able to refill your Rx until after 28 days (it comes in packages of four).

[Huntingleroy in reply to 707twitcher]

Thank you , very informative

[LotteM]

I switched from a 0.2mg sublingual buprenorphine pill to a 5 mcg/h patch some 1.5 years ago. Went smoothly. Like drls suggested, I would say start with the lowest dose and you will find out soon enough whether that suffices. If not, make sure you have the leeway to up the dose in the 2nd week.

I found that if I replace the patch in the morning (first thing, when getting dressed) it works by nighttime. However, to be sure I always keep the old patch one more day and remove the old patch the next morning.

If it doesn’t work as fast for you, adding a paracetamol may help. Madlegs used to say that paracetamol enhances opioids. I tried it several times, but cannot tell for sure whether it worked. Maybe just waiting a bit longer while walking / stretching / any thing else we do to overrule the creepy crawly feeling might gave done the trick too.

[Huntingleroy in reply to LotteM]

Thank you so much

[LotteM in reply to Huntingleroy]

PS. I do think the buprenorphine builds up a little over time. In one study in which they looked at levels of buprenorphine in the blood for three consecutive weeks, the ‘top’ level didn’t increase. But as we are all different, some of us may absorb amd breakdown the buprenorphine faster than average, and other slower. Especially the last group may end up with very slowly increasing blood levels. The first group may suffer from insufficient dosing towards the end of the week.

I think. No backup from research, as most look to averages and not individuals differences.

[birdman74]

I use a 4mg/24hr Neupro patch and I think that I started off with that dose.

[Huntingleroy in reply to birdman74]

Ah thankyou . I thought the patches lasted 7 days , didnt realise you can get daily ones