buprenorphine

Q: What is buprenorphine (Buprenex) used for?

Buprenorphine (Buprenex) is used for severe pain when non-opioid pain medications aren't suitable. It's typically used only in people who are in the hospital. Buprenorphine (Buprenex) isn't one of the buprenorphine products that are approved for [opioid use disorder](https://www.goodrx.com/conditions/substance-use-disorder/opioid-addiction).

Q: How does buprenorphine (Buprenex) work?

Buprenorphine (Buprenex) is a partial opioid agonist. It [works](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2581407/) by attaching to the same receptors in the brain as opioids, but less strongly. This means that it can help relieve pain, but shouldn't cause the same ["high"](https://www.goodrx.com/buprenorphine/what-is) as [opioid medications](https://www.goodrx.com/classes/opioids).

Q: Why is buprenorphine (Buprenex) a controlled medication?

Buprenorphine (Buprenex) is a [controlled (Schedule III) medication](https://www.goodrx.com/drugs/medication-basics/what-are-controlled-substances). This is because buprenorphine can cause physical dependence and abuse. Your provider will make sure you get the lowest dose possible to treat your pain. If you have any questions or concerns, talk with your provider.

Q: How is buprenorphine (Buprenex) given and what's the dose?

Buprenorphine (Buprenex) is given by a healthcare provider in the hospital as a deep muscle injection or an injection into veins. In adults and children 12 years and older, the typical dose is one injection every 6 hours, as needed. In some cases your provider might repeat the dose 30-60 minutes after your first dose depending on your response. For children 2 to 12 years old, the dose is dependent on body weight and is injected every 4 to 6 hours. Your provider will adjust your dose or how often you get it based on how well it treats your pain and if you're having side effects.

Q: What are possible side effects of buprenorphine (Buprenex)?

The most common side effect of buprenorphine (Buprenex) is sleepiness, nausea, and dizziness. Other side effects include sweating, headache, low blood pressure, and vomiting. Your provider will monitor you for side effects and will adjust the dose if necessary.

Generic Buprenex

Used for Pain

Buprenorphine (Buprenex) is an injectable medication that's typically given to people in the hospital for pain. It's usually reserved for people who can't use alternative treatment options, or when other pain medications aren't working.

Reviewed by:

Robert Chad Hakim, PharmD, BCCCP

Kristianne Hannemann, PharmD

Last reviewed on September 20, 2022

Buprenorphine (Buprenex) is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.

What is Buprenorphine (Buprenex)?

What is Buprenorphine (Buprenex) used for?

Severe pain for which non-opioid pain medications aren't recommended

Are you looking for information on buprenorphine / naloxone (Suboxone), Sublocade (buprenorphine) injection, or buprenorphine (Butrans) patch instead?

Drug facts

Common Brands	Buprenex
Drug Class	Opioid partial agonist
Controlled Substance Classification	Schedule III
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Buprenex

Drug Class

Opioid partial agonist

Controlled Substance Classification

Schedule III

Generic Status

No lower-cost generic available

Availability

Prescription only

Risks and warnings for Buprenorphine (Buprenex)

Buprenorphine (Buprenex) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Addiction, abuse, and misuse

Risk factors: History of alcohol or substance abuse

Warning Icon 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.

Dangerously slow breathing (respiratory depression)

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

Warning Icon 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.

Harm to newborns

Risk factors: Taking buprenorphine (Buprenex) during pregnancy

Warning Icon 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.

Low adrenal hormone levels

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.

Severely low blood pressure

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.

Life-threatening heart rhythm problems (QT prolongation)

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.

Serious allergic reaction

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.

Stomach and intestine problems

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).

Risk of seizures

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).

Common questions about Buprenex

Buprenex is used for severe pain when non-opioid pain medications aren't suitable. It's typically used only in people who are in the hospital. Buprenex isn't one of the buprenorphine products that are approved for opioid use disorder.

Buprenex is a partial opioid agonist. It works by attaching to the same receptors in the brain as opioids, but less strongly. This means that it can help relieve pain, but shouldn't cause the same "high" as opioid medications.

Buprenex is a controlled (Schedule III) medication. This is because buprenorphine can cause physical dependence and abuse. Your provider will make sure you get the lowest dose possible to treat your pain. If you have any questions or concerns, talk with your provider.

Buprenex is given by a healthcare provider in the hospital as a deep muscle injection or an injection into veins. In adults and children 12 years and older, the typical dose is one injection every 6 hours, as needed. In some cases your provider might repeat the dose 30-60 minutes after your first dose depending on your response. For children 2 to 12 years old, the dose is dependent on body weight and is injected every 4 to 6 hours. Your provider will adjust your dose or how often you get it based on how well it treats your pain and if you're having side effects.

The most common side effect of Buprenex is sleepiness, nausea, and dizziness. Other side effects include sweating, headache, low blood pressure, and vomiting. Your provider will monitor you for side effects and will adjust the dose if necessary.

Buprenorphine (Buprenex) dosage

Typical dosage for Buprenorphine (Buprenex)

Interactions between Buprenorphine (Buprenex) and other drugs

Buprenorphine (Buprenex) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Buprenorphine (Buprenex). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil
Cisapride
Dronedarone
Fluconazole
Ketoconazole
Mesoridazine
Nalmefene
Naltrexone
Pimozide
Piperaquine
Posaconazole
Safinamide
Saquinavir
Sparfloxacin
Terfenadine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.