Finding the right buprenorphine

[Simkin]

Hi Joolsg, you kindly sent me the photo of your Accord tablets to show my GP. He could not seem to access Accord but he did find the brand Temgesic.He wanted me, as you know, to start buprenorphine on 0.2mg strength.

Anyway Temgesic do their measurements in micrograms. So I am taking one sublingual 200mcg (equivalent to 0.2mg strength) a night.

I am finding this (dissolves under the tongue like your Accord tablets) easy to use, so thanks, yet again, for your help.

Honestly, I think you & Sue ought to join forces & set up an advice forum on RLS that the medical profession can access!!!

[Joolsg]

I'm glad your GP found the 0.2mg (200mcg) temgesic pills. I have all info about Temgesic and, in the UK, it has exactly the same formula as my Buprenorphine pills.I hope it helps.

[Simkin in reply to Joolsg]

Certainly has helped so far.

[smilingjane in reply to Joolsg]

Hi both

Following on from the Temgesic/Buprenorphine post, My chemist say they cannot obtain Accord Buorenorphine and now I am issued Temgesic.

The problem I am finding is that one 200mch tablet, (for me) only works for eight/nine or so hours meaning I take three doses in 24 hours.

The accord lasted around 14/16 hours which reduced my dosage to twice, (still 600 mcgs) -

I know in the scheme of things my RLS is covered and thats fantastic but why does Temgesic last a shorter time? Do you know? I would rather take two as opposed to three daily doses because of teeth damage.

[Simkin in reply to smilingjane]

I just take one temgesic at 10pm before I go to bed & it so far keeps my legs quiet overnight.But I also take gabapentin during the evening.

I wake up a lot in the night but I think that is habit.

[smilingjane in reply to Simkin]

Thanks for your response Simkin.Out of interest, did you have RLS through the day before you started your meds? Unfortunately mine was 24/7.

Do you think the Gabapentin reduces the Temgesic you need to cover your RLS?

[Simkin in reply to smilingjane]

I only ever have RLS at night.

[Joolsg in reply to smilingjane]

numarknet.com/advice-guidan... posted this to KathandKell.

I found that Subutex is only licensed for getting people off heroin and opiates in other countries, so the prescriber will not get paid if he prescribes 'off licence'.

Temgesic is the only brand of buprenorphine made in 200mcg pills, and is licensed for pain relief.

But they're the same drug. Just different brand names.

[smilingjane in reply to Joolsg]

That's intetesting. So pro W. was prescribing Buprenorphine off licence with 400 mcgs. And not getting paid when he could have prescribed Temgesic and been paid. Also my GP was prescribing Buprenorphine. The only reason I am issued Temgesic now is because my chemist cannot get Buprenorphine.Thats what I have been told by the pharmacist.

[Joolsg in reply to smilingjane]

No. There are around 12 or 13 brands of buprenorphine in the UK. Subutex is the one, in Australia, that is licensed for addiction patients only.

Here in the UK, there are lots of different brands making 400mcg buprenorphine.

All brands of buprenorphine, including Subutex and Temgesic contain buprenorphine and have the same half life.

It may be that higher doses, above 400mcg, somehow last longer in the body because of the higher dose.

[Joolsg in reply to smilingjane]

I have spent hours researching this SmilingJane.If you look up the pharmakinetic properties of Buprenorphine and Temgesic, they are identical. Both have the same elimination time and half life.

It remains a mystery.

All I can say is that Sandoz and Morningside brands do not last as long for me.

I firmly believe The 'teeth' issue is caused by dry mouth and not the acidity of the pills. There are reports of people on the Buprenorphine Patch having teeth problems.

I chew gum a lot and use dry mouth sprays. It mainly happens during the night. I wake up with a very dry mouth, not helped by Covid in '22 which triggered a really dry mouth and lack of saliva.

[Simkin in reply to Joolsg]

Interesting Joolsg because I wake up through the night with an incredibly dry mouth.I have a mug of Rooisbosch tea twice during the night which helps.

[Joolsg in reply to Simkin]

It's a very common side effect. Have sugar free gum or Salivex tablets nearby. They do help a little.

[Simkin in reply to Joolsg]

Oh thanks.

[smilingjane in reply to Joolsg]

Thank you so much for all your time. It really is appreciated :)Well would you believe it, the same pharmakinetic properties ... It is a mystery.

Thank you for the dry mouth advice. Interesting that the Buprenorphine patches may cause a dry mouth too. will take note.

Haven't heard of a dry mouth spray.

I sip water through the night. A spray would be easier.

Sorry to hear your situation has been exasperated by Covid

I have an appointment with Pro' W in September, not sure why. I think it must be about the sleep study I am down for.

I will let you know how the LDN idea is received