Buprenorphine Patch: Transdermal Butrans Patch

Medically Reviewed by Johnelle Smith, M.D. on July 14, 2021

Butrans is a patch containing buprenorphine that’s used to treat chronic pain and the symptoms of opioid withdrawal. The patch is placed on the skin to provide 24-hour relief and should be replaced once every seven days.

Using Butrans For Opioid Addiction Treatment

Butrans transdermal (medication applied through the skin) patches contain buprenorphine and are used to treat a variety of conditions.

Butrans treats:

  • opioid withdrawal symptoms
  • severe pain
  • chronic back pain

This is a long-acting (extended-release) pain-relief medication that’s designed to treat around-the-clock pain, such as the symptoms of opioid withdrawal.

Learn more about using buprenorphine to overcome opioid addiction

How Does Butrans Work?

Butrans is applied as a patch that remains on the skin for up to a week, providing constant relief from opioid withdrawal.

Buprenorphine is a partial agonist that works to treat opioid withdrawal symptoms by activating opioid receptors and blocking other opioids at the receptors in the brain.

Buprenorphine binds to the opioid receptors, preventing other opioids (like heroin, methadone, or oxycodone) from entering those receptor sites.

This process eliminates withdrawal symptoms and cravings for withdrawal because the opioid of abuse is being replaced with buprenorphine.

Types Of Butrans

Butrans patches are available in brand-name and generic form.

The brand name is Butrans, and the generic name is buprenorphine transdermal system.

Both versions of this medication are available in Butrans clinics and by prescription for at-home administration.

Read more about the generic version of Butrans

Side Effects Of A Butrans Patch

Buprenorphine patches can cause a number of side effects. Some of these are mild, while others are more serious side effects and will require medical attention.

Common side effects of Butrans patches include:

  • nausea
  • vomiting
  • headache
  • drowsiness
  • dizziness
  • constipation
  • somnolence
  • dry mouth
  • stomach pain
  • raised body temperature
  • hypotension (low blood pressure)
  • rash at the application site
  • red skin at the application site
  • itching at the application site

Seek help from a healthcare professional immediately if you or a loved one experiences weak or shallow breathing, chest pain, increased heart rate, or feel lightheaded.

Read more about the side effects of Butrans patches

Applying Your Butrans Patch

To properly apply a Butrans patch, select a location on the skin. You can apply Butrans on the left or right upper outer arm, upper chest, upper back, or the side of the chest.

Take the liner off the patch and apply it to your skin. Then, with the sticky side down, remove the protective liner and press down on the patch to secure it.

Read more about how to properly apply a Butrans patch

Moving Your Butrans Patch

Once the Butrans patch is in place, you should not move it. If it’s moved, the Butrans patch may not be sticky anymore and the medication will be ineffective.

Read more about moving your Butrans patch

Timeline For Using Butrans

Butrans should be replaced with a new patch once every seven days. Once the first patch is placed on the skin, the effects will take one to three days to set in.

For most people, it will take about two days for Butrans to kick in. For others, this timeline might be longer.

While buprenorphine that comes in a tablet form may work faster, patches will last longer.

Are There Risks To Taking Butrans?

When using any form of opioid drug, there are risks involved.

Substance Abuse

Butrans is a Schedule III controlled substance, meaning it can be abused and is subject to misuse and addiction.

It is possible to get high off Butrans if it’s misused, so there is a potential for substance abuse.

Mixing Butrans With Alcohol Or CNS Depressants

Some drug interactions can be extremely dangerous when using Butrans.

The U.S. Food & Drug Administration (FDA) warns that Butrans should never be combined with alcohol, benzodiazepines, or other central nervous system (CNS) depressants.

Fatal side effects can occur if Butrans is mixed with alcohol, CNS depressant drugs, or prescription drugs that slow breathing.

Mixing these substances can result in:

  • sedation
  • ​coma
  • respiratory depression
  • death

Life-Threatening Respiratory Depression

Even if used as prescribed, there is a risk of life-threatening respiratory depression when using transdermal Butrans patches.

The greatest risk of fatal breathing problems is after the first time using it or following a dose increase.

Neonatal Opioid Withdrawal Syndrome

Using Butrans while pregnant can lead to neonatal opioid withdrawal syndrome. This happens when the fetus is exposed to opioids.

After the baby is born, he or she can experience symptoms of withdrawal because they’re no longer being supplied with opioids.

It is safe to use Butrans while breastfeeding, as this has shown no indication of harm to the child.

QT Prolongation

QT Prolongation is an irregularity of the electrical activity of the heart, which can lead to cardiac arrest.

In a clinical trial, a Butrans dose of 40 micrograms (mcg)/hour resulted in QT prolongation.

Adrenal Insufficiency

Long-term use of Butrans can lead to adrenal insufficiency, a disorder that develops when the body doesn’t produce enough of the hormone cortisol.

Greater Risk For Those With Head Injuries

Those with head injuries, increased intracranial pressure (a rise in pressure around the brain), brain tumors, or impaired consciousness may experience greater risks when using Butrans.

These conditions can cause a higher chance of sedation and respiratory depression.

Allergic Reaction

Some people react poorly to Butrans, which can have life-threatening results.

A severe allergic reaction can lead to:

  • bronchospasm: tightening of the muscles around the airways
  • angioneurotic edema: intense swelling at the skin site where Butrans is applied
  • anaphylactic shock: a life-threatening allergic reaction

Does Butrans Lead To Withdrawal?

Butrans can lead to withdrawal. Suddenly ceasing Butrans use can lead to withdrawal symptoms and pain will return.

To avoid withdrawal, a person should gradually taper the dosage.

Read more about Butrans withdrawal symptoms

Recreational Abuse Of Butrans

Chewing, swallowing, snorting, or injecting buprenorphine extracted from the transdermal system is very dangerous and can lead to a potentially fatal overdose.

Read more about the recreational abuse of Butrans

Avoid Heat Sources When Using Butrans

Patients using buprenorphine patches should be advised to avoid exposing the Butrans application site and surrounding area to heat sources.

This includes:

  • hot tubs
  • hot water
  • hot baths
  • heating pads
  • heated water beds
  • electric blankets
  • ​tanning beds
  • saunas

Cost Of Butrans

This can be an expensive opioid medication if it’s purchased without the help of insurance. However, most private and government-funded health care providers do cover Butrans.

Butrans patches can cost anywhere between $250 and $1,000 for four patches, depending on the formulation.

Read more about the cost of Butrans patches

Doses Of Butrans

Butrans is available in the following doses:

  • 5 mcg/hr
  • 7.5 mcg/hr
  • 10 mcg/hr
  • 15 mcg/hr
  • 20 mcg/hr

Butrans 20 is a very high dose and should only be used in opioid-experienced patients.

Butrans FAQs

Find answers to some of the most commonly asked questions about Butrans to decide whether this medication is right for you or your loved one.

❓ Can You Get High From Eating/Chewing A Butrans Patch?

✔️ It is possible to experience euphoria if a Butrans patch is eaten or chewed.

Read more about the effects of eating/chewing a Butrans patch

❓ Are Butrans Patches Waterproof?

✔️ Butrans patches are waterproof. It is safe to shower, bathe, and swim while using Butrans patches.

Read more about using Butrans patches in the water

❓ Are Butrans Patches Covered By Medicare/Medicaid Or Private Insurance?

✔️ Most healthcare providers cover Butrans, including Medicare and Medicaid.

Read more about Butrans insurance coverage

❓ Who Can Prescribe Butrans?

✔️ Butrans can be prescribed by some doctors. The prescribing physician must be trained specifically on the use of potent opioids for managing chronic pain.

❓ Is The Butrans Patch An Opioid?

✔️ Butrans is an opioid medication, though it does not produce the same level of effects as illicit opioid drugs.

❓ What If I Forget To Replace My Butrans Patch?

✔️ If you miss a dose of Butrans by forgetting to replace your patch, remove the old patch and replace it with a new patch as soon as you remember.

Do not apply two patches unless directed to do so by your doctor.

Refer to your medication guide or talk to your doctor for more information on Butrans dosing.

❓ Does Butrans Cause Weight Loss?

✔️ One of the possible side effects of Butrans is weight loss. This does not happen for every person who uses Butrans, but it is possible.

❓ How Do I Dispose Of My Butrans Patch?

✔️ To dispose of your Butrans patch, flush it down the toilet or use your patch-disposal unit, a package designed to safely dispose of a Butrans patch to put in the trash.

❓ What If My Butrans Patch Won’t Stay On?

✔️ To better secure your patch, you can tape down the edges with first aid tape. Only apply first aid tape to the outer edges of the patch.

You should also make sure that the area of skin is clean and dry. Avoid using any lotions right before applying the patch, or it won’t stay on.

Find Butrans Treatment For Opioid Abuse

There is a range of treatment options available to those seeking help for an opioid use disorder.

If you would like to learn more about the options for Butrans treatment at home or in an addiction treatment facility, call our helpline and get started today.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D. on July 14, 2021

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