buprenorphine - sublingual to transdermal conversion

[707twitcher]

I have seen a few instances where people are switching from sublinguals to patches, and they are getting too high of a dose for the patch.

Here’s a table that shows dose equivalents for several opiods. Everything is converted to ME (morphine equivalent) for sake of comparison. You have to read footnote 4 to see that a 5mcg patch = 9ME, which is equivalent to .3mg (300 micrograms) of a sublingual. If you are switching from sublingual to patch, take your mcg dose (typically in multiples is 200 unless you are cutting strips into different fractions), and divide by 60. So a 400 mcg pill is equivalent to a 6.7mcg/hour patch. Patch only comes in 5, 7.5, 10, 15, 20. So 7.5 is what you would want. Even prescribing doctors aren’t aware of this - they might say you need 400 mcg in a 24 hour period, so that = a 15 mcg patch (or more😱).

I have verified this with my own experience. For me, a 7.5mcg patch works the same as 400 mcg of sublingual.

communitycarenc.org/sites/d...

[LotteM]

Thanks Twitcher, very useful. Absorption is different from the pills and the patch.

Just to add my 2 cents worth, I switched from an effective 0.2mg sublingual pill to a 5 mcg/h patch. Both worked well. Only the pill gave me mini-withdrawal in the day, with all body restlessness and an overall unwell feeling as symptoms. None of that on the patch.