Common questions about buprenorphine - Brand names: Butec, Buvidal, Espranor, Suboxone, Subutex

Buprenorphine is from a group of medicines called opioids or narcotics.

It works in the central nervous system and the brain to block pain signals to the rest of the body. It also reduces the anxiety and stress caused by pain.

This depends on the type of buprenorphine you take.

A buprenorphine injection into a vein gives the quickest pain relief. It works almost straight away and is usually only given in hospital.

Buprenorphine tablets take about 1 to 2 hours to work.

Buprenorphine patches can take up to a day or 2 to start working but they'll last longer. Patches are usually given after buprenorphine tablets or another opioid such as morphine liquid. This is to make sure that you have pain relief until the patches start to work.

Some people with conditions that need long-term pain relief may need to take buprenorphine for a long time.

If you need to take it for a long time your body can become used to it (known as tolerance). That means you need higher doses to control your pain over time.

Some people can become more sensitive to pain (hyperalgesia). If this happens, your doctor will reduce your dose gradually to help these symptoms.

It's possible to become addicted to buprenorphine. For this reason, your dose will be reviewed to make sure you're only having the amount you need to control your pain.

Your treatment plan may include details of how and when you'll stop buprenorphine.

If you're having treatment for cancer pain or other severe pain, your pain control will be carefully monitored. Speak to your doctor if you're worried about tolerance, hyperalgesia or becoming addicted.

If you're addicted to buprenorphine you may find it difficult to stop using it, or feel you want to use it more often than you need to.

If you stop taking buprenorphine suddenly you may get withdrawal symptoms.

These can include:

• feeling agitated or anxious
• panic attacks
• feeling your heart beat (palpitations)
• difficulty sleeping
• shaking
• sweating
• body aches
• feeling restless

Talk to your doctor if you:

• are worried about addiction
• need help with addiction
• want to stop taking buprenorphine

If you need to take or use buprenorphine for a long time, your body can become used to it.

This is not usually a problem. However, you could get withdrawal symptoms if you stop taking it suddenly.

If you want to stop taking or using buprenorphine, talk to your doctor first. Your dose can be reduced gradually so you do not get withdrawal symptoms.

If you stop having buprenorphine suddenly it can make you:

• feel agitated
• feel anxious
• shaky
• sweat a lot

Buprenorphine acts on different pain signals in the brain to some other opioids, such as codeine, morphine and tramadol.

The pain relief and side effects from buprenorphine will be different for everyone. Your doctor may prescribe buprenorphine if you've had side effects from other opioids.

The way you take buprenorphine is different to some other painkillers. Buprenorphine is not absorbed very well by swallowing tablets. Instead, your body absorbs it through your skin or mouth.

Some people find skin patches more convenient than taking tablets or capsules regularly.

Fold the buprenorphine patch in half so that the sticky sides stick to each other. Then either put the patch back in the packet it came in or, if you're replacing it with a new patch, you could put your used patch in the empty packet from the new patch.

Return any used or unused patches to your pharmacist who will destroy them safely.

Patches can accidentally stick to another person.

Buprenorphine does not affect any type of contraception including the combined pill or emergency contraception.

However, if buprenorphine makes you vomit, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Do not drive a car or ride a bike if buprenorphine makes you sleepy, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions.

This may be more likely when you first start using buprenorphine but could happen at any time, for example when starting another medicine.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Even if your ability to drive is not affected, the police have the right to request a saliva sample to check how much buprenorphine is in your body.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while using buprenorphine. GOV.UK has more information on the law on drugs and driving.

It's best not to drink alcohol when you first start taking or using buprenorphine until you see how it affects you.

Drinking alcohol while using buprenorphine can make you more sleepy and increases the risk of side effects.

Buprenorphine is not generally affected by food or drink so you can eat normally. It's best not to drink alcohol when you first start taking or using buprenorphine until you see how it affects you.

Check the information leaflet that came with your tablets to see whether you need to avoid food at the same time as taking your tablets.

If you take recreational drugs, such as cannabis, cocaine or heroin, while you're taking buprenorphine, you're more likely to get serious side effects. These include breathing difficulties, heart problems such as high blood pressure, seizures or fits and even going into a coma.

Some recreational drugs, such as cannabis, will also increase the risk of side effects from buprenorphine – it may make you feel very sleepy or dizzy.

Taking heroin while you're on buprenorphine is especially dangerous. You're more likely to get all the side effects of buprenorphine.

Tell your doctor if you think you may take recreational drugs while you're on buprenorphine.

You can find out about the side effects of recreational drugs on the Frank website.