buprenorphine

• Risk factors: History of alcohol or substance abuse

Buprenorphine (Buprenex) is a controlled substance (schedule III) that can cause addiction, abuse, and misuse. This raises the risk for serious side effects, such as dangerously slow breathing, inability to stay awake, and even death. Your provider will make sure you get the lowest dose for the shortest amount of time possible to treat your pain. If you have concerns, speak to your provider.

• Risk factors: Taking medications that can cause slow breathing | Drinking alcohol | Medical conditions that cause breathing problems (e.g., COPD, asthma)| First starting buprenorphine (Buprenex) | Dose change

Buprenorphine (Buprenex) can cause dangerously slow breathing, which can be life-threatening. This can happen at any time, but it's more common when people first start this medication. Your risk is higher if you're taking medications that can slow breathing (e.g., benzodiazepines, opioids, sedatives), drinking alcohol, or have breathing problems (e.g., COPD, asthma). Make sure to tell your provider about all of the medications you're taking before starting buprenorphine (Buprenex). If you or your loved one notice you have trouble breathing or have bluish-colored lips, fingers, or toes, get emergency medical help right away.

• Risk factors: Taking buprenorphine (Buprenex) during pregnancy

If you take buprenorphine (Buprenex) during pregnancy, you can pass the medication to your unborn baby. Though rare with buprenorphine (Buprenex) because it's typically only used for a short period of time, it can cause your unborn baby to become dependent on opioids and cause withdrawal symptoms at birth. Symptoms of withdrawal can include high-pitched crying, poor feeding and sucking behavior, and seizures. This condition can be life-threatening if not recognized and treated in time. Make sure to tell your provider if you've received buprenorphine (Buprenex) or any other opioid medications during pregnancy. Providers who are experts in this area will know how to treat your newborn and will make sure your baby gets the care they need once they're born.

• Risk factors: Taking buprenorphine (Buprenex) for longer than 1 month

Opioids can cause your adrenal hormone levels to drop, especially if you take them for longer than 1 month. This side effect is more rare with buprenorphine (Buprenex) because it's typically used short-term. Let your provider know right away if you experience symptoms of low adrenal hormones, including nausea, vomiting, not feeling hungry, tiredness, dizziness, and weakness. Your provider might need to stop buprenorphine (Buprenex) and treat you with corticosteroids.

• Risk factors: Taking certain CNS depressants

Buprenorphine (Buprenex) can suddenly lower your blood pressure, especially when you stand up from sitting or lying down. The risk is higher if you're also taking certain CNS depressants (sedating medications). Your provider will likely monitor your blood pressure in the hospital. Make sure to get up slowly and hold onto something when getting up so you don't fall. Tell your provider if you experience dizziness, light-headedness, or feeling like you're going to faint.

• Risk factors: Heartbeat or heart rhythm problems | Taking medications that affect your heartbeat or heart rhythm | Electrolytes (body salts) not in balance

Buprenorphine can cause QT prolongation, a potentially life-threatening heart rhythm problem. Your risk is higher if you already have heart problems or are taking other medications that cause QT prolongation, such as amiodarone (Pacerone), beta-blockers, and moxifloxacin (Avelox). Make sure to tell your provider about all the medications you're taking. If you feel symptoms of heart problems, such as pounding chest, trouble breathing, feeling faint or lightheaded, or chest pain while taking buprenorphine (Buprenex), let your provider know right away.

Rarely, buprenorphine (Buprenex) can cause serious allergic reactions. Get medical help right away if you experience tightening of the throat, trouble breathing, swelling in your lips, tongue, or face, or rash.

Buprenorphine (Buprenex) shouldn't be used in people with known or suspected obstruction (blockage) in the stomach or intestines. If you have pancreatitis (inflammation of the pancreas), your provider will monitor you for worsening symptoms (e.g., stomach pain, nausea, vomiting).

Buprenorphine (Buprenex) can cause seizures in people with a history of seizures. Let your provider know if you have a history of seizures before receiving buprenorphine (Buprenex).