It is recommended that buprenorphine patches are prescribed by BRAND - see UKMI Branded Prescribing Recommendations document. The locally preferred brand for buprenorphine 7-day patches is Butec® Butec® is available across all of the dose ranges, already represents the most commonly prescribed brand nationally (>50%), and is considerably less costly than the originator brand BuTrans. Patients currently receiving generically written prescriptions should be reviewed with a view to change the prescribing to a cost-effective brand.

A stepped approach to pain management is recommended. Paracetamol is considered a 1st line option for the treatment of pain.

Sub-lingual / buccal - consider for use patients who are unable to tolerate standard codeine/ dihydrocodeine tablets or capsules or if morphine is contra-indicated.

Patches - (low dose) for use in the limited number of patients who are unable to tolerate oral medications or if morphine is contra-indicated. Higher dose buprenorphine patches are not included in the pathway within this guideline and have a limited place in therapy for persistent non-malignant pain.

 Please refer to the guidelines.

Consider a patient agreement is completed by the patient (see below) prior to a trial of Buprenorphine.