Hello - I am usually prescribed pure buprenorphine 0.4 tablets - either morningside or accord brand - however this month I was given Temgesic - I assumed they had had issues sourcing the usual brands.
I definitely feel different on the Temgesic - I seem to have more of a ‘hangover’ in the morning and feel very low - I wondered what the difference is re Temgesic which is also buprenorohine but I think is maybe more fast acting with a shorter half life. Has anyone got any information on this?
Thank you
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Drls
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Buprenorphine is extremely difficult to get hold of at the moment. Biscuitface posted her pharmacy couldn't source it. Nor can mine. But they did say Temgesic was in stock at the suppliers. But, as Temgesic isn't branded on BNF as Buprenorphine ( it is) I have to get another prescription from my GP for Temgesic specifically.I have spent ages researching Temgesic versus Buprenorphine. The pharmakinetic properties are the same. With the same half life. So they SHOULD work the same.
However, I notice that different brands of Buprenorphine work differently..
Accord works best for me..
Sandoz or Prefib aren't as good and I end up having to take an extra 0.1mg on those brands.
It could be something in the Temgesic tablets that is causing the 'hangover' feeling.
It is VERY worrying that opioids are in short supply. We will end up with severe RLS and opioid withdrawals.
Thanks Jools - I think my current pharmacist is extremely good because I don’t know how I would have coped without any buprenorphine - it definitely feels different and causes more dry mouth - but I am grateful to have the prescription..
Does anyone know why people can’t source it at the moment? Is it a back log / customs thing because it must still be being produced?
It is a mystery. My little pharmacy uses the same supplier, Alliance Healthcare, as Superdrug. Computer said no to my pharmacy for ANY brands, but YES to the larger Superdrug. Maybe when drugs are in short supply, they give priority to the large pharmacy chains?But there is a worldwide shortgage of ALL drugs, including insulin. It could be because more and more people take meds, overpopulation, shortage of ingredients.
Good morning. Yes, big pharmacies have more buying power and deals, buying and storing as a group so will have more stock to move around their branches than your local independent pharmacy or GP surgery. However if there is a manufacturing issue they will also run out eventually.
I’m scared too as I am on 200mcg Bup/Temgesic and this is the only thing that works for me and is running out faster than 400mcg. although I feel I need 400mcg but my consultant absolutely won’t let me increase - but that’s another story!
Wow. If 200mcg isn't stopping your RLS, 400mcg is still a tiny dose!. The average effective dose as per Mayo Clinic Algorithm is 1-1.5 mg. That's7 times your dose.Perhaps your consultant should read the Mayo Algorithm AND Dr Winkelman's opioid register.
But it is worrying that you are having trouble getting Temgesic.
Superdrug don't hold any stock at all. They explained that they have to place the order on their computer first. It then states whether the drug is available from their distribution company, Alliance Healthcare, and if the computer says yes, they place the order.
However, my small pharmacy, using the same distribution system was told there was NO stock.
Superdrug pharmacist told me it's often the other way around.
But this will be a continuing problem. Worldwide drug shortages.
I know it’s a low dose and I did refer my consultant to the mayo clinic etc but she is absolutely adamant she won’t prescribe more. Already off license, very addictive drug etc blah blah. Must not take codeine etc as I might stop breathing etc. completely out of touch. Took me a year to convince her to try 200mcg sublingual. She has now discharged me from her care as there is nothing more she can offer. Feeling a little bit hopeless.
Where are you? Several consultants are aware of the efficacy of low dose buprenorphine and that it won't cause 'addiction', unlike dopamine agonists!!We can suggest a good neurologist who keeps up to date and is aware of Dr Winkelman's opioid register for RLS.
I am in Suffolk. I have been under the care of Papworth sleep clinic. I would love to hear recommendations for alternative consultants. Thank you for your help and by the way for all your info and advice which I have been reading although not participating on the site for the last 4 years.
There are around 3 doctors who are aware of the benefits of Buprenorphine. The Mayo Clinic Algorithm sets out the average effective dose of Buprenorphine as 1 -1.5mg. Professor Walker at UCL, Queen Sq, Dr Jose Thomas at Gwent Sleep Clinic in Wales, and Dr Robin Fackrell at Bath hospital are all neurologists/sleep doctors who prescribe iron infusions and Buprenorphine. And not at such a minimal dose! Prof. Walker takes weeks to answer emails though. If you're persistent, he, or his secretary, will respond eventually. And sadly, the only way to get to see them within a year is to go privately.
I wish these 'experts' would quote research studies to back up their unfounded assertions that Buprenorphine will cause 'addiction'.
I had hoped to get a medical trial of Buprenorphine in the UK to allow GPs to prescribe it for severe, refractory RLS. Sadly, my last attempt to get King's College Hospital to do the trial failed. They said they don't have the staff, time or resources.
I called around several pharmacies in my area. Superdrug was able to get my favourite brand, Accord, and I've just collected it.If you still feel iffy on Temgesic, try calling around different pharmacies to see if they can source Buprenorphine, then ask the GP to issue another prescription.
Interestingly, I was talking to the female pharmacist about RLS, and she said she experienced it during peri menopause, but taking HRT has completely resolved it.
Thank you, it’s good to know that contacting other pharmacies is an option if I’m struggling to get buprenorphine moving forward -
I also think all my symptoms got much worse during the menopause ( and indeed since) so hormones obviously have a massive impact on RLS - its caused by a complicated web of many things it would seem.
It is very confusing. My small pharmacy was adamant that 'Temgesic' has to be set out specifically on the prescription. There are around 12 brands of generic Buprenorphine but they were out of stock. They said I would need the GP to reissue a prescription to get Temgesic.
I managed to get my favourite brand of Accord yesterday from Superdrug. My independent pharmacy haven't been able to source Accord for 5 months.
The UK primary care system and prescription service is very complicated and confusing. I really do NOT understand it.
I can get Buprenorphine in S. London, but it's 'red listed' in North London, so GPs can't prescribe it and pharmacies often are unable to dispense it.
I have worked as a GPs dispenser and pharmacy dispenser for many years so here is some insider info. When a new drug or formulation ( eg sublingual) is “discovered “ it is only available as the original brand eg Temgesic. When it comes off licence any drug company eg Sandoz can manufacture it usually cheaper so it gets prescribed “genetically “ ie as buprenophene. Tephine etc are “branded genetics” this is so they can be prescribed specifically as yes, all slow release forms can release differently giving the issue you are having.
that’s all very interesting to know - Temgesic definitely dissolves differently and affects the mouth more…. I’m carrying on with it for this month but will speak to the pharmacy before the next prescription is due to see if they are able to source accord or morningside …. They definitely work better for me I think - thank you everyone for your comments
Temgesic mcg dose you could be in and out of mild withdrawal only a 4 hr half life Buprenorphine is less acidic and a 24 hr half life and dose not rot teeth as Temgesic can do.
I’m in Brisbane what state are you in Temgesic is much easier to get than SUBUTEX
Subutex not to be confused with SUBOXONE
SUBUTEX is this best form of Buprenorphine 24 hour half life
The old protocol was to trail someone on Temgesic and you back and say it’s helping a little but it's not quite enough and the fact that you have to keep taking it. And so much that is makes you feel sick I tried it 5 tablets YUK nope did not work just made me feel sick .
Having said that some people are very successful on Temgesic apart from teeth.
After trialing Temgesic I fully understand why it’s dissolving teeth especially when not broken into tiny pieces and letting them fully absorb under the younger so it dose not get near the teeth.
5 years I have been on Buprenorphine and zero issues with my teeth
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