questions about Butrans (bupenephrine) Patch

I was just prescribed these a few weeks ago,  Its been wonderful for the most part (my pain drops by 1 or 2 points on the pain scale).

I do have some questions that health care professionals and the literature dont know/or cant tell

1-It can't be taken off then but back on... ant idea why?

2-bupenephrine IS an opiod antagonist so its able to stop other opiates to bind to receptors its blocking. Practically speaking, how does the antagonist effect work?  If I take my normal oxycodone will if feel X% weaker
OR does it block out the first few mg that enters  your body (something like is If I take 10mg oxycodone, it will all be blocked and I feel nothing, if I take 15mg...I will feel like I took 10mg (15-5), or if I take 20mg it will feel like I took 15mg (20-5).  etc.. 



  • I used the patches for quite a while, unfortunately due to cost I had to stop them, you can't take them off and put them back on because of the adhesive, they will not stick well if you try to re-apply, I am not smart enough to answer your second question but I can tell you this, I was allowed 2 hydrocodone per day with the patch, I could still tell when I took them.


  • I’ve been told by pain management BuTrans patches are indicated for chronic pain and since chronic pain is well, chronic, it would be illogical to remove temporarily a device/patch used as treatment for around-the-clock pain.

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  • I have been on the Burtrans  patch for close to 8 years. Definitely can’t take the patch off and reapply later I tried an even tried one of those large adhesive patches to go over dressing and it didn’t work. I have issues with finding sites to put the patches and the only place that works for me is upper arm so I alternate arms and location on my arm to allow for healing between applications. I also have breakthrough meds for when the pain gets real bad and it does work. I have been off Butrans since June waiting for a revision surgery c6/c7 that was postponed from August to October, not fun.  

  • SergeP1SergeP1 Posts: 20
    edited 10/17/2019 - 11:17 PM

    My own experience over the last 2mo. Different brands have vastly different qualities. Some (Rhodes) can be reapplied once if it been removed briefly and are soft and flexible. Teva, patches are twice the size, kinda feels like a laminated business card is superglue to you, will start shifting and pinching within days, will never stick if removed/moves, and won't stay on a full week.

  • To clarify my question 2, wouldn't the antagonist effect of butrans keep morphine from working?  

    im taking 10mcg/hr butrans patch and 90mg morphine a day. Is this a normal combo?

    Im never completely pain free, like on oxycodone, my range is uncomfortable-very soar. morphine wont help beyond that range. And for the 12hours a day Im in bed. I font need any morphine.

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  • I don't know the answer to your question, I am bach on Butrans 20 mcg, I am also allowed 2 Hydrocodone 10/325 per day for breakthrough, your pain management doctor would be the best person to ask, after getting an answer, please let us know.

    Take care and keep us posted


  • what I got from the doctor
    Butrans blocks the non mu receptors, and has a high affinity to attach to the mu receptors. so it will cancel some of the peak effect of the opiate. And when you take an opiate,  butrans molecules are using up some or you mu receptors, dose matters, but either way some of the opiate will go unable to be used. This is why withdawl symptoms are so common when people start while on their max dose of other opiate med.

  • Thank's for the explanation

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