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BUPRENORPHINE HCL (BUPRENORPHINE HCL)
- Postoperative acute pain
- Severe pain
HCl 0.3 mg/mL injection solution
- Inject 1 milliliter (0.3 mg) by intramuscular route every 6 hours as needed
0.3 mg/mL injection solution
- Inject 1 milliliter (0.3 mg) by intramuscular route every 6 hours as needed
Postoperative acute pain
- Inject 1 milliliter (0.3 mg) by intramuscular route every 6 hours as needed
- Inject 1 milliliter (0.3 mg) over at least 2 minute(s) by intravenousroute every 6 hours as needed
Severe pain
- Inject 1 milliliter (0.3 mg) by intramuscular route every 6 hours as needed
- Inject 1 milliliter (0.3 mg) over at least 2 minute(s) by intravenousroute every 6 hours as needed
- Depade
- naltrexone
- naltrexone microspheres
- Revia
- Vivitrol
Contraindicated
- amiodarone
- amiodarone in dextrose,iso-osm
- Betapace
- Betapace Af
- Cordarone
- Corvert
- dextromethorphan-quinidine
- disopyramide
- dofetilide
- ibutilide fumarate
- Nexterone
- Norpace
- Norpace Cr
- Nuedexta
- Pacerone
- procainamide
- quinidine gluconate
- quinidine sulfate
- sodium oxybate
- Sorine
- sotalol
- Sotalol Af
- Tikosyn
- Xyrem
Severe
Moderate
- acetaminophen-codeine
- Alfenta
- alfentanil
- alprazolam
- Alprazolam Intensol
- amitriptyline-chlordiazepoxide
- Ascomp With Codeine
- Astramorph-pf
- Ativan
- belladonna alkaloids-opium
- Belladonna-opium
- bromphen-pseudoephed-codeine
- brompheniramine-PE-codeine
- Butalbital Compound W/codeine
- Butalbital Compound-codeine
- butalbital-acetaminop-caf-cod
- butorphanol tartrate
- Capcof
- Capital With Codeine
- carisoprodol-ASA-codeine
- Cheratussin Ac
- Cheratussin Dac
- chlorcyclizine-codeine
- chlordiazepoxide HCl
- chlordiazepoxide-clidinium
- chlorphen-pseudoephed-codeine
- chlorpheniramine-codeine
- chlorpheniramine-hydrocodone
- chlorpheniramine-PE-codeine
- clobazam
- clonazepam
- clorazepate dipotassium
- clrcycliz-pseudoephed-codeine
- codeine sulfate
- codeine-butalbital-ASA-caff
- codeine-guaifenesin
- codeine-pyrilamine
- cpm-pseudoephed-hydrocodone
- Demerol
- Demerol (pf)
- Depodur (pf)
- dexbrompheniramine-PSE-codeine
- dexchlorphen-phenyleph-codeine
- Diastat
- Diastat Acudial
- diazepam
- Diazepam Intensol
- dihydrocodeine-aspirin-caff
- Dilaudid
- Dilaudid (pf)
- diphenoxylate-atropine
- Doral
- Duramorph (pf)
- Endocet
- Endodan
- estazolam
- Fanatrex
- fentanyl citrate (PF)
- Fioricet With Codeine
- Fiorinal-codeine #3
- flurazepam
- gabapentin
- gabapentin enacarbil
- Gralise
- Gralise 30-day Starter Pack
- Guaiatussin Ac
- Guaifenesin Ac
- Guaifenesin Dac
- Guiatuss Ac
- Horizant
- Hycet
- hydrocodone bitartrate
- Hydrocodone Compound
- hydrocodone-acetaminophen
- hydrocodone-homatropine
- hydrocodone-ibuprofen
- Hydromet
- hydromorphone
- hydromorphone (PF)
- Ibudone
- ibuprofen-oxycodone
- Iophen C-nr
- isoniazid-rifamp-pyrazinamide
- Klonopin
- Librax (with Clidinium)
- Lomotil
- lorazepam
- Lorazepam Intensol
- Lortab Elixir
- Lortuss Ex
- M-clear Wc
- M-end Max D
- M-end Pe
- Mar-cof Bp
- Mar-cof Cg
- meperidine
- meperidine (PF)
- Meperitab
- midazolam
- morphine
- morphine (PF)
- morphine liposomal (PF)
- nalbuphine
- Neurontin
- Niravam
- Norco
- Onfi
- Opana
- opium tincture
- oxazepam
- Oxecta
- oxycodone
- oxycodone-acetaminophen
- oxycodone-aspirin
- oxymorphone
- paregoric
- pentazocine lactate
- pentazocine-naloxone
- Percocet
- Percodan
- Phenylhistine
- Phenylhistine Dh
- Poly-tussin
- Poly-tussin Ac
- Poly-tussin D
- Primlev
- Pro-clear Ac
- Pro-clear Caps
- Pro-red Ac (w/ Dexchlorphenir)
- Promethazine Vc-codeine
- promethazine-codeine
- promethazine-phenyleph-codeine
- pseudoephedrine-codeine-GG
- pseudoephedrine-hydrocodone
- quazepam
- Relcof C
- remifentanil
- Reprexain
- Restoril
- Rezira
- Rifadin
- Rifamate
- rifampin
- rifampin-isoniazid
- Rifater
- Roxicet
- Rydex
- Statuss Green (codeine)
- Sublimaze (pf)
- Sufenta
- sufentanil citrate
- Synalgos-dc
- Talwin
- temazepam
- Tranxene T-tab
- triazolam
- Trymine Cg
- Tusnel C
- Tussicaps
- Tussigon
- Tussionex Pennkinetic Er
- Tylenol-codeine #3
- Tylenol-codeine #4
- Ultiva
- Valium
- Vicodin
- Vicodin Es
- Vicodin Hp
- Vicoprofen
- Virtussin Ac
- Vituz
- Xanax
- Xanax Xr
- Xartemis Xr
- Xodol 10/300
- Xodol 5/300
- Xodol 7.5/300
- Z-tuss Ac
- Z-tuss E
- Zamicet
- Zodryl Ac 25
- Zodryl Ac 30
- Zodryl Ac 35
- Zodryl Ac 40
- Zodryl Ac 50
- Zodryl Ac 60
- Zodryl Ac 80
- Zodryl Dac 25
- Zodryl Dac 30
- Zodryl Dac 35
- Zodryl Dac 40
- Zodryl Dac 50
- Zodryl Dac 60
- Zodryl Dac 80
- Zodryl Dec 25
- Zodryl Dec 30
- Zodryl Dec 35
- Zodryl Dec 40
- Zodryl Dec 50
- Zodryl Dec 60
- Zodryl Dec 80
- Zohydro Er
- Zutripro
- Acute asthma attack
- Congenital long QT syndrome
- Paralytic ileus
Contraindicated
- Alcohol intoxication
- Drug abuse
- History of opioid overdose
- Intracranial hypertension
- Respiratory depression
- Severe hepatic disease
Severe
Moderate
- Adrenal cortical insufficiency
- Alcohol withdrawal delirium
- Benign prostatic hyperplasia
- Biliary tract disorder
- Chronic obstructive pulmonary disease
- Cor pulmonale
- Debilitation
- Untreated hypothyroidism
- Urethral stricture
BUPRENORPHINE HCL (BUPRENORPHINE HCL)
- Postoperative acute pain
- Severe pain
- Abnormal hepatic function tests
- Constipation
- Headache disorder
- Injection site sequelae
- Nausea
- Vomiting
More Frequent
Severe
Less Severe
- Increased alanine transaminase
- Increased aspartate transaminase
- Respiratory depression
- Dizziness
- Drowsy
- Fatigue
- Hyperhidrosis
- Pruritus of skin
- Sedation
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute confusion
- Adrenal cortical insufficiency
- Allergic dermatitis
- Anaphylaxis
- Androgen deficiency
- Bradycardia
- Depression
- Disorder of adrenal gland
- Hallucinations
- Orthostatic hypotension
- Paresthesia
- Skin rash
- Tachycardia
- Urinary retention
- Urticaria
- Wenckebach's block
Less Severe
- Blurred vision
- Erectile dysfunction
- False sense of well-being
- General weakness
- Infertility
- Libido changes
- Malaise
- Tremor
- Visual changes
Contraindicated
None
Severe Precaution
Buprenorphine (INJ)
No safety/efficacy. Potential increased sensitivity to effects and adverse effects.
- 1 Day – 2 Years
- No safety/efficacy. Potential increased sensitivity to effects and adverse effects.
Management or Monitoring Precaution
None
Buprenorphine
- Severity Level:
2
- Additional Notes: Neonatal withdrawal/resp.depress. w/chronic or high dose
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Buprenorphine
Low levels in breastmilk; poor oral bioavail in infants; monitor for cns dep
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Drug shown to have adverse effect | Low levels in breastmilk; poor oral bioavail in infants; monitor for cns dep |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Buprenorphine (injection)
General-Consider adding naloxone Rx. Pulmonary-Life threatening respiratory depression risk with high doses, cachexia, or debilitation due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Monitor closely at initiation and dose titration. Neuro/Psych-Risk for confusion, delirium and falls. Avoid treatment with 3 or more CNS active agents. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | Y | Y | Y | Y | N |
BEERS: Y HEDIS: N STOPP: Y
No Known Risk
None
- None
| Postoperative acute pain | |
| G89.12 | Acute post-thoracotomy pain |
| G89.18 | Other acute postprocedural pain |
| Severe pain | |
| G89 | Pain, not elsewhere classified |
| G89.1 | Acute pain, not elsewhere classified |
| G89.11 | Acute pain due to trauma |
| G89.12 | Acute post-thoracotomy pain |
| G89.18 | Other acute postprocedural pain |
| G89.2 | Chronic pain, not elsewhere classified |
| G89.21 | Chronic pain due to trauma |
| G89.22 | Chronic post-thoracotomy pain |
| G89.28 | Other chronic postprocedural pain |
| G89.29 | Other chronic pain |
| G89.3 | Neoplasm related pain (acute) (chronic) |
| M25.5 | Pain in joint |
| M25.50 | Pain in unspecified joint |
| M25.51 | Pain in shoulder |
| M25.511 | Pain in right shoulder |
| M25.512 | Pain in left shoulder |
| M25.519 | Pain in unspecified shoulder |
| M25.52 | Pain in elbow |
| M25.521 | Pain in right elbow |
| M25.522 | Pain in left elbow |
| M25.529 | Pain in unspecified elbow |
| M25.53 | Pain in wrist |
| M25.531 | Pain in right wrist |
| M25.532 | Pain in left wrist |
| M25.539 | Pain in unspecified wrist |
| M25.54 | Pain in joints of hand |
| M25.541 | Pain in joints of right hand |
| M25.542 | Pain in joints of left hand |
| M25.549 | Pain in joints of unspecified hand |
| M25.55 | Pain in hip |
| M25.551 | Pain in right hip |
| M25.552 | Pain in left hip |
| M25.559 | Pain in unspecified hip |
| M25.56 | Pain in knee |
| M25.561 | Pain in right knee |
| M25.562 | Pain in left knee |
| M25.569 | Pain in unspecified knee |
| M25.57 | Pain in ankle and joints of foot |
| M25.571 | Pain in right ankle and joints of right foot |
| M25.572 | Pain in left ankle and joints of left foot |
| M25.579 | Pain in unspecified ankle and joints of unspecified foot |
| M26.62 | Arthralgia of temporomandibular joint |
| M54.5 | Low back pain |
| M54.6 | Pain in thoracic spine |
| M79.6 | Pain in limb, hand, foot, fingers and toes |
| M79.60 | Pain in limb, unspecified |
| M79.601 | Pain in right arm |
| M79.602 | Pain in left arm |
| M79.603 | Pain in arm, unspecified |
| M79.604 | Pain in right leg |
| M79.605 | Pain in left leg |
| M79.606 | Pain in leg, unspecified |
| M79.609 | Pain in unspecified limb |
| M79.62 | Pain in upper arm |
| M79.621 | Pain in right upper arm |
| M79.622 | Pain in left upper arm |
| M79.629 | Pain in unspecified upper arm |
| M79.63 | Pain in forearm |
| M79.631 | Pain in right forearm |
| M79.632 | Pain in left forearm |
| M79.639 | Pain in unspecified forearm |
| M79.64 | Pain in hand and fingers |
| M79.641 | Pain in right hand |
| M79.642 | Pain in left hand |
| M79.643 | Pain in unspecified hand |
| M79.644 | Pain in right finger(s) |
| M79.645 | Pain in left finger(s) |
| M79.646 | Pain in unspecified finger(s) |
| M79.65 | Pain in thigh |
| M79.651 | Pain in right thigh |
| M79.652 | Pain in left thigh |
| M79.659 | Pain in unspecified thigh |
| M79.66 | Pain in lower leg |
| M79.661 | Pain in right lower leg |
| M79.662 | Pain in left lower leg |
| M79.669 | Pain in unspecified lower leg |
| M79.67 | Pain in foot and toes |
| M79.671 | Pain in right foot |
| M79.672 | Pain in left foot |
| M79.673 | Pain in unspecified foot |
| M79.674 | Pain in right toe(s) |
| M79.675 | Pain in left toe(s) |
| M79.676 | Pain in unspecified toe(s) |
| R07.82 | Intercostal pain |
| R10.0 | Acute abdomen |
| R10.1 | Pain localized to upper abdomen |
| R10.10 | Upper abdominal pain, unspecified |
| R10.11 | Right upper quadrant pain |
| R10.12 | Left upper quadrant pain |
| R10.2 | Pelvic and perineal pain |
| R10.3 | Pain localized to other parts of lower abdomen |
| R10.30 | Lower abdominal pain, unspecified |
| R10.31 | Right lower quadrant pain |
| R10.32 | Left lower quadrant pain |
| R10.33 | Periumbilical pain |
| R10.8 | Other abdominal pain |
| R10.84 | Generalized abdominal pain |
| R10.9 | Unspecified abdominal pain |
| R52 | Pain, unspecified |
| R68.84 | Jaw pain |
| 0-9 | A-Z |
|---|---|
| G89 | Pain, not elsewhere classified |
| G89.1 | Acute pain, not elsewhere classified |
| G89.11 | Acute pain due to trauma |
| G89.12 | Acute post-thoracotomy pain |
| G89.12 | Acute post-thoracotomy pain |
| G89.18 | Other acute postprocedural pain |
| G89.18 | Other acute postprocedural pain |
| G89.2 | Chronic pain, not elsewhere classified |
| G89.21 | Chronic pain due to trauma |
| G89.22 | Chronic post-thoracotomy pain |
| G89.28 | Other chronic postprocedural pain |
| G89.29 | Other chronic pain |
| G89.3 | Neoplasm related pain (acute) (chronic) |
| M25.5 | Pain in joint |
| M25.50 | Pain in unspecified joint |
| M25.51 | Pain in shoulder |
| M25.511 | Pain in right shoulder |
| M25.512 | Pain in left shoulder |
| M25.519 | Pain in unspecified shoulder |
| M25.52 | Pain in elbow |
| M25.521 | Pain in right elbow |
| M25.522 | Pain in left elbow |
| M25.529 | Pain in unspecified elbow |
| M25.53 | Pain in wrist |
| M25.531 | Pain in right wrist |
| M25.532 | Pain in left wrist |
| M25.539 | Pain in unspecified wrist |
| M25.54 | Pain in joints of hand |
| M25.541 | Pain in joints of right hand |
| M25.542 | Pain in joints of left hand |
| M25.549 | Pain in joints of unspecified hand |
| M25.55 | Pain in hip |
| M25.551 | Pain in right hip |
| M25.552 | Pain in left hip |
| M25.559 | Pain in unspecified hip |
| M25.56 | Pain in knee |
| M25.561 | Pain in right knee |
| M25.562 | Pain in left knee |
| M25.569 | Pain in unspecified knee |
| M25.57 | Pain in ankle and joints of foot |
| M25.571 | Pain in right ankle and joints of right foot |
| M25.572 | Pain in left ankle and joints of left foot |
| M25.579 | Pain in unspecified ankle and joints of unspecified foot |
| M26.62 | Arthralgia of temporomandibular joint |
| M54.5 | Low back pain |
| M54.6 | Pain in thoracic spine |
| M79.6 | Pain in limb, hand, foot, fingers and toes |
| M79.60 | Pain in limb, unspecified |
| M79.601 | Pain in right arm |
| M79.602 | Pain in left arm |
| M79.603 | Pain in arm, unspecified |
| M79.604 | Pain in right leg |
| M79.605 | Pain in left leg |
| M79.606 | Pain in leg, unspecified |
| M79.609 | Pain in unspecified limb |
| M79.62 | Pain in upper arm |
| M79.621 | Pain in right upper arm |
| M79.622 | Pain in left upper arm |
| M79.629 | Pain in unspecified upper arm |
| M79.63 | Pain in forearm |
| M79.631 | Pain in right forearm |
| M79.632 | Pain in left forearm |
| M79.639 | Pain in unspecified forearm |
| M79.64 | Pain in hand and fingers |
| M79.641 | Pain in right hand |
| M79.642 | Pain in left hand |
| M79.643 | Pain in unspecified hand |
| M79.644 | Pain in right finger(s) |
| M79.645 | Pain in left finger(s) |
| M79.646 | Pain in unspecified finger(s) |
| M79.65 | Pain in thigh |
| M79.651 | Pain in right thigh |
| M79.652 | Pain in left thigh |
| M79.659 | Pain in unspecified thigh |
| M79.66 | Pain in lower leg |
| M79.661 | Pain in right lower leg |
| M79.662 | Pain in left lower leg |
| M79.669 | Pain in unspecified lower leg |
| M79.67 | Pain in foot and toes |
| M79.671 | Pain in right foot |
| M79.672 | Pain in left foot |
| M79.673 | Pain in unspecified foot |
| M79.674 | Pain in right toe(s) |
| M79.675 | Pain in left toe(s) |
| M79.676 | Pain in unspecified toe(s) |
| R07.82 | Intercostal pain |
| R10.0 | Acute abdomen |
| R10.1 | Pain localized to upper abdomen |
| R10.10 | Upper abdominal pain, unspecified |
| R10.11 | Right upper quadrant pain |
| R10.12 | Left upper quadrant pain |
| R10.2 | Pelvic and perineal pain |
| R10.3 | Pain localized to other parts of lower abdomen |
| R10.30 | Lower abdominal pain, unspecified |
| R10.31 | Right lower quadrant pain |
| R10.32 | Left lower quadrant pain |
| R10.33 | Periumbilical pain |
| R10.8 | Other abdominal pain |
| R10.84 | Generalized abdominal pain |
| R10.9 | Unspecified abdominal pain |
| R52 | Pain, unspecified |
| R68.84 | Jaw pain |
Formulary Reference Tool