Buccal buprenorphine can be a safe and effective therapy for chronic pain if used properly.
Brand name: Belbuca
Parameters:
(1) current MME per day
|
Current MME per day
|
Recommended Daily Dose
|
|
0 to 29
|
75 to 150 µg
|
|
30 to 89
|
150 to 300 µg
|
|
90 to 160
|
300 to 600 µg
|
The daily dose is divided for dosing bid or tid.
Pearls:
(1) When starting therapy, the previous full agonist opioid can be given on the first day for 1 or 2 doses but it should then be stopped.
(2) Breakthrough pain can be treated with NSAIDs or an oral opioid.
(3) Titration should wait 4 days after starting or changing.
(4) Strips can be cut.
(5) Many insurance companies do not cover the cost.
(6) Do not stop before, during or after surgery/procedure.
(7) It does not require an XDEA number or additional training to prescribe.
