Buprenorphine 5, 10 and 20 μg/h transdermal patch: a review of its use in the management of chronic non-malignant pain

Autor: Plosker, G. L., Barkin, R. L., Harald Breivik, Gordon, A., Hernandez, J. J., Hess, P. E.
Rok vydání: 2011
Předmět:
Time Factors
Unclassified drug
Transdermal patch
Transdermal Patch
Ibuprofen
Chronic pain
Review
Norspan
Drug blood level
Central depressant agent
Randomized controlled trial (topic)
Medicine
Hip osteoarthritis
Pharmacology (medical)
Drug dosage form comparison
Tramadol
Transdermal
Pain Measurement
Randomized Controlled Trials as Topic
Drug withdrawal
Embase
Naloxone
Headache
Nausea
Double blind procedure
Gastrointestinal disease
Respiration depression
Crossover procedure
Application site reaction
Buprenorphine
Analgesics
Opioid
Carbamazepine
Ketoconazole
Paracetamol
Clinical trial (topic)
Treatment Outcome
Tolerability
Phenobarbital
Anesthesia
Controlled clinical trial (topic)
Knee osteoarthritis
Halothane
Oxycodone
Human
medicine.drug
Diclofenac
Drug elimination
Vomiting
Drug interaction
Analgesic
Pain
Mu opiate receptor
Application site pruritus
Placebo
Dizziness
Xerostomia
Atazanavir
Adis-drug-evaluations
Low drug dose
Drug dose titration
Tilidine
Drug formulation
Humans
Low back pain
Disease registry
Disease severity
Rifampicin
Somnolence
Drug metabolism
Ritonavir
Dose-Response Relationship
Drug
Codeine
business.industry
Pruritus
Loading drug dose
Nonhuman
Nonsteroid antiinflammatory agent
Cyclooxygenase 2 inhibitor
Drug efficacy
Opioid
Erythema
Phenytoin
Chronic Disease
Publication
Efavirenz
Drug tolerance
business
Dihydrocodeine
Constipation
Zdroj: Scopus-Elsevier
Repositorio EdocUR-U. Rosario
Universidad del Rosario
instacron:Universidad del Rosario
ISSN: 1179-1950
Popis: This article reviews the pharmacology, therapeutic efficacy and tolerability profile of the 7-day lower-dose (5, 10 and 20?gh) buprenorphine transdermal patch (BuTrans®, Norspan®) in the management of chronic non-malignant pain, with a focus on European labelling for the drug. Buprenorphine is a semi-synthetic opioid analgesic that acts primarily as a partial agonist at the mu opioid receptor. The transdermal formulation provides continuous delivery of buprenorphine, resulting in relatively consistent plasma drug concentrations throughout the 7-day dosing interval.The analgesic efficacy of transdermal buprenorphine in patients with osteoarthritis of the hip andor knee has been demonstrated in several randomized controlled trials, which have shown the formulation to be equivalent to sublingual buprenorphine, noninferior to prolonged-release tramadol tablets, noninferior to codeine plus paracetamol (acetaminophen) combination tablets (when transdermal buprenorphine was used together with regularly scheduled oral paracetamol) and generally superior to a matching transdermal placebo patch. Transdermal buprenorphine was significantly more effective than placebo in reducing chronic low back pain of at least moderate severity in two randomized, double-blind, crossover trials. Other clinical trials, including a randomized, double-blind, maintenance-of-analgesia study, have also demonstrated the analgesic efficacy of transdermal buprenorphine in patients with chronic non-malignant pain of various causes.In general, serious adverse events with transdermal buprenorphine are similar to those for other opioid analgesics. Transdermal buprenorphine has a ceiling effect for respiratory depression, and the main risk is when it is combined with other CNS depressants. The most frequently reported adverse events with transdermal buprenorphine are headache, dizziness, somnolence, constipation, dry mouth, nausea, vomiting, pruritus, erythema, application site pruritus and application site reactions. Transdermal buprenorphine was better tolerated than sublingual buprenorphine in a 7-week, randomized, double-blind trial in patients with osteoarthritis pain. Nevertheless, as with other opioids, persistence with transdermal buprenorphine therapy is difficult for many patients because of adverse events or other reasons.Thus, transdermal buprenorphine has generally demonstrated good efficacy and tolerability in clinical trials in chronic non-malignant pain, providing effective background analgesia as part of pain management strategies for patients with osteoarthritis, low back pain and other persistent pain syndromes of at least moderate severity. It also has favourable pharmacodynamic and pharmacokinetic properties, which have beneficial clinical implications, most notably the convenience of once-weekly administration and no need for dosage adjustments in the elderly or those with compromised renal function, making it an opioid of choice in these patients, and a useful therapeutic option overall in the management of chronic non-malignant pain. © 2011 Adis Data Information BV. All rights reserved.
Databáze: OpenAIRE
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