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buprenorphine (injection)
Pronunciation: byoo pre NOR feen
Brand: Buprenex


What is the most important information I should know about buprenorphine?
emt• Like other narcotic medicines, buprenorphine can slow your breathing. Death may occur if breathing becomes too weak. Using buprenorphine improperly will increase your risk of serious side effects or death. Follow all dosing instructions carefully. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
donot• Do not use buprenorphine with other narcotic pain medications or sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.
noalcohol• Do not drink alcohol. Buprenorphine can increase the effects of alcohol, which could be dangerous.
habit• Buprenorphine may be habit-forming and should be used only by the person it was prescribed for.


What is buprenorphine injection?
• Buprenorphine is a narcotic pain medicine similar to morphine.
• Buprenorphine is used to treat moderate to severe pain.
• Buprenorphine may also be used for purposes not listed in this medication guide.


What should I discuss with my healthcare provider before using buprenorphine?
donot• You should not use this medication if you are allergic to buprenorphine.
• To make sure you can safely use buprenorphine, tell your doctor if you have any of these other conditions:
     · asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorders;
     · liver or kidney disease;
     · a thyroid disorder;
     · enlarged prostate, urination problems;
     · gallbladder disease;
     · curvature of the spine;
     · Addison's disease (adrenal gland disorder);
     · a history of mental illness, personality disorder, or psychotic episode;
     · a history of drug or alcohol addiction; or
     · a history of seizures, head injury, or brain tumor.
habit• Buprenorphine may be habit forming and should be used only by the person it was prescribed for. Never share buprenorphine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
nopreg• FDA pregnancy category C. It is not known whether buprenorphine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using buprenorphine.
nobrfeed• Buprenorphine can pass into breast milk and may harm a nursing baby. Do not breast-feed while you are using buprenorphine.


How should I use buprenorphine?
emt• Never use buprenorphine in larger amounts, or for longer than recommended by your doctor. Using buprenorphine improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from buprenorphine. Follow all dosing instructions carefully. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
• Buprenorphine is injected into a muscle or into a vein through an IV. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, syringes, IV tubing, and other items used to inject the medicine.
• Buprenorphine is usually given at evenly spaced intervals, up to 6 hours apart. Tell your doctor if buprenorphine does not relieve your pain within 1 hour after an injection.
• Prepare your dose in a syringe or IV only when you are ready to give yourself an injection. Do not use the medication if it has changed colors or has particles in it. Call your doctor for a new prescription. Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.
donot• This medicine can cause irritation if it gets on your skin. If this occurs, remove any clothing the medicine has spilled onto, and rinse your skin with water.
emt• If you need surgery, tell the surgeon ahead of time that you are using buprenorphine. You may need to stop using the medicine for a short time.
donot• Do not stop using buprenorphine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using buprenorphine.
emt• Wear a medical alert tag or carry an ID card stating that you use buprenorphine. Any medical care provider who treats you should know that you are using buprenorphine. Make sure your family members know you are using buprenorphine in case they need to speak for you during an emergency.
rt• Store at room temperature away from moisture, heat, and light. Keep track of the amount of medicine used from each new ampule. Buprenorphine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.


What happens if I miss a dose?
• Since buprenorphine is used on an as needed basis, you are not likely to miss a dose. Never use buprenorphine in larger amounts, or more often than recommended by your doctor.


What happens if I overdose?
emt• Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of buprenorphine can be fatal. Overdose symptoms may include extreme drowsiness or weakness, cold or clammy skin, slow heart rate, weak pulse, fainting, or slow breathing (breathing may stop).


What should I avoid while using buprenorphine?
noalcohol• Do not drink alcohol. Buprenorphine can increase the effects of alcohol, which could be dangerous.
dizzy• This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.


What are the possible side effects of buprenorphine injection?
emt• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Like other narcotic medicines, buprenorphine can slow your breathing. Death may occur if breathing becomes too weak.
donot• Call your doctor at once if you have a serious side effect such as:
     · weak or shallow breathing, feeling light-headed, fainting;
     · blue lips or fingernails;
     · confusion, feelings of extreme happiness;
     · fast or slow heart rate; or
     · urinating less than usual or not at all.
• Less serious side effects may include:
     · dizziness, spinning sensation, weakness, tired feeling;
     · nausea, vomiting, constipation;
     · increased sweating, numbness or tingly feeling;
     · headache, depressed mood; or
     · blurred vision, double vision.
• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


What other drugs will affect buprenorphine injection?
donot• Do not use buprenorphine with other narcotic pain medications or sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.
• Tell your doctor about all other medicines you use, especially:
     · dexamethasone (Cortastat, Dexasone, Solurex, DexPak);
     · imatinib (Gleevec);
     · isoniazid (for treating tuberculosis);
     · nefazodone;
     · St. John's wort;
     · an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), rifapentine (Priftin), or telithromycin (Ketex);
     · antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), or miconazole (Oravig);
     · a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);
     · a blood thinner such as warfarin (Coumadin, Jantoven);
     · heart or blood pressure medication such as nicardipine (Cardene) or quinidine (Quin-G);
     · HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), etravirine (Intelence), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), saquinavir (Invirase), or ritonavir (Norvir, Kaletra);
     · an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate);
     · medicines to treat narcolepsy, such as armodafinil (Nuvigil) or modafinil (Progivil);
     · a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), thioridazine (Mellaril), or trifluoperazine (Stelazine);
     · a sedative such as diazepam (Valium), midazolam (Versed), alprazolam (Xanax) lorazepam (Ativan), clorazepate (Tranxene), triazolam (Halcion), flurazepam (Dalmane), or temazepam (Restoril); or
     · seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline).
• This list is not complete and other drugs may interact with buprenorphine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.


Where can I get more information?
• Your doctor or pharmacist can provide more information about buprenorphine injection.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2011 Cerner Multum, Inc. Version: 2.01. Revision Date: 8/10/2011.

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