New Drug Update 2010-2011 Faculty Disclaimer - CME Conferences
New Drug Update 2010-2011 Faculty Disclaimer - CME Conferences
New Drug Update 2010-2011 Faculty Disclaimer - CME Conferences
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2 nd Annual Essentials in Primary Care<br />
Fall Conference<br />
Friday, November 11, <strong>2011</strong><br />
Buprenorphine Transdermal System - Butrans<br />
DOSING:<br />
• In opioid-naive patients, the initial dosage should always<br />
be 5 mcg/h. The dosage should not be increased until the<br />
patient has been continuously exposed to the previous<br />
dosage for 72 hours.<br />
• Buprenorphine may precipitate withdrawal in patients<br />
who are already on opioids.<br />
– Prior to converting from another opioid to buprenorphine, the<br />
patient’s current around-the-clock opioid should be tapered to no<br />
more than morphine 30 mg or equivalent per day before beginning<br />
buprenorphine.<br />
– Following initiation of buprenorphine therapy, the dose may be<br />
titrated upward after at least 72 hours at the current dose. Individual<br />
dosage titration should be based on the patient’s requirement for<br />
supplemental short-acting analgesics.<br />
– The maximum transdermal buprenorphine dosage is one 20 mcg/h<br />
system because of potential dose-related QTc prolongation.<br />
Buprenorphine Transdermal System - Butrans<br />
Risk Evaluation and<br />
Mitigations Strategy<br />
(REMS) assessment plan<br />
stated in the FDA’s<br />
approval<br />
Including a surveillance<br />
and monitoring system to<br />
detect abuse, misuse,<br />
overdose, and addiction<br />
and any modifications in<br />
provider education and<br />
drug distribution if these<br />
problems exist<br />
The cost for 4 patches<br />
AWP is;<br />
5 mcg -$151.20<br />
10 mcg - $226.80<br />
20 mcg - $401.52<br />
Wayne Weart<br />
<strong>New</strong> <strong>Drug</strong> <strong>Update</strong> Part I