VOA News - وب سايت فارسی صدای آمريکا VOA Persian homepageBritish firm Reckitt & Colman (now Reckitt Benckiser) first marketed buprenorphine under the trade names Temgesic (sublingual/parenteral preparations, no active additives) and Buprenex (parenteral, no active additives). Two more recent formulations from Reckitt Benckiser have been approved for opioid addiction treatment in the U.S.: Subutex (flavorless sublingual, no active additives; in 2 mg and 8 mg dosages) and Suboxone (orange-tang flavored sublingual, one part naloxone for every four parts buprenorphine; hexagon shaped tablet in 2 mg and 8 mg dosages). Suboxone contains small doses of opiates aswell as the opioid antagonist naloxone to deter illicit intravenous preparation of the tablet. This is intended to attenuate the effects of buprenorphine on opioid-naive users should this formulation be injected - however no human studies have been done demonstrating the efficacy of this approach with buprenorphine and a growing number of street reports indicate that the naloxone is ineffective.
A solution for injection (usually by the intramuscular route) is marketed for the UK veterinary market by Alstoe Animal Health as Vetergesic, licenced for analgesia and sedation in dogs.
Since 2001 buprenorphine is also available transdermally in 35, 52.5 and 70 mcg/hour transdermal patch, that delivers the dose over 96 hours. This application form is marketed as Transtec in most European countries by Gruenenthal [2] (Napp Pharmaceuticals.in the UK [3] Norpharma in Denmark) for the treatment of moderate to severe cancer pain and severe non-cancer pain not responding to non-opioids. Moreover, a new 5, 10 and 20 mcg/hour patch is marketed as Butrans or Norspan, a once weekly patch for severe chronic pain not responding to non-opioids, marketed by Napp Pharmaceuticals Ltd., and Mundipharma and Gruenenthal respectively.
Dosing: Bupropion usually is given in two or three daily doses. When used for smoking cessation, bupropion usually is started as 150 mg once daily for three days, and then the dose is increased if the patient tolerates the starting dose. Smoking is discontinued two weeks after starting bupropion therapy. Wellbutrin SR is given as two daily doses. Wellbutrin XL is given as one dose daily.
Drug Interactions: Although no systematic studies have been done to assess the potential of bupropion to interact with other drugs, bupropion should be used cautiously in patients receiving drugs that reduce the threshold for seizures. Such drugs include prochlorperazine (Compazine), chlorpromazine (Thorazine), and other antipsychotic medications of the phenothiazine class. Additionally, persons who are withdrawing from benzodiazepines (e.g. diazepam, Valium; alprazolam, Xanax) are at increased risk for seizures.
