Considerations for prescribing Butrans

Butrans should be prescribed only by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain


Butrans® (buprenorphine) Transdermal System CIII is indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Limitations of Use

  • Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve Butrans for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
  • Butrans is not indicated as an as-needed (prn) analgesic.

Opioids should be prescribed only if expected benefits outweigh risks—and in combination with non-pharmacologic and non-opioid therapy, as appropriate1

PRIOR to initating theraphy with opioids, and periodically during therapyPRIOR to initating theraphy with opioids, and periodically during therapy

During Butrans therapy, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals

*Not every urine drug test reliably detects synthetic or semisynthetic opioids, such as buprenorphine, especially those designed for in-office use. And many laboratories will report urine drug concentrations below a specified "cut-off" as "negative". Therefore, ensure that the assay’s sensitivity and specificity are appropriate, and consider the urine drug test's limitations when interpreting results.2-4

PDMP = prescription drug monitoring program.