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How to Apply Your Butrans Patch

Butrans patches are available in different strengths and patch sizes. Make sure you have the right strength patch that has been prescribed for you, and review the steps below before applying your Butrans patch.

The application instructions provided here are intended as a guide, and do not include all of the steps you must follow when using Butrans.

Please review the Instructions for Use you received with your Butrans prescription before starting your treatment with Butrans.

If you have any questions, talk to your healthcare professional or pharmacist.

Step 1

Choose an application site

  • Butrans should be applied to the left or right upper outer arm, upper chest, upper back, or the side of the chest for a total of 8 different application sites in all

    Upper arm
  • It is important to change the skin site where you apply your Butrans patch every week (exactly 7 days), making sure that at least 3 weeks (21 days) pass before you re-use the same site

  • If you are wearing a patch, remember to remove it before applying a new one

  • Do not use soap, alcohol, lotions, oils, or other products to remove any leftover adhesive from a patch, because this may cause more medicine to pass through the skin

  • Do not apply more than 1 patch at the same time unless your healthcare professional tells you to do so

  • If you are using 2 patches as prescribed, remember to apply them at the same site right next to each other. Always apply and remove the 2 patches together at the same time

Step 2

Prepare the skin

Do not shave
  • Butrans should be applied to hairless or nearly hairless skin. If needed, you can clip the hair at the site, but do not shave the area

  • The skin should be free of cuts and irritation (rashes, swelling, redness, or other skin problems)

  • Use only water to clean the site, and allow the skin to dry completely before applying the patch (do NOT use soaps, alcohol, oils, lotions, or abrasive devices)

Step 3

Remove the patch from its pouch

Do not shave
  • Each patch is sealed in its own protective pouch

  • Do not use a patch if the seal on its protective pouch is broken or if the patch is cut, damaged, or changed in any way

  • Cut the pouch open along the dotted line and remove the patch

  • Do not remove the patch from the pouch until you are ready to use it

Step 4

Remove the liner from the patch

Remove the liner from the patch
  • Hold the patch with its protective liner facing you

  • Gently bend the patch along the faint line and peel back the larger portion of the liner, which covers the sticky surface of the patch

  • Do not touch the sticky side of the patch with your fingers

Step 5

Place the patch on your skin

Remove the liner from the patch
  • Using the smaller part of the protective liner as a handle, apply the sticky side of the patch to one of the 8 body locations described in step 1

Step 6

Remove the protective liner

grasp-the-edge
  • While holding the sticky side down, gently fold back the smaller portion of the patch

  • Grasp an edge of the remaining protective liner and slowly peel it off

Step 7

Press the patch firmly into place

go-over-edges
  • Press down on the entire patch for about 15 seconds with the palm of your hand (do not rub)

  • Make sure the patch firmly sticks to the skin and go over the edges with your finger to ensure good contact around the patch

Step 8

Wash up

wash-your-hands
  • Always wash your hands after applying or handling a Butrans patch

See how to dispose of your Butrans patch.

WARNING: ADDICTION, ABUSE, AND MISUSE; LIFE-THREATENING BREATHING PROBLEMS; ACCIDENTAL EXPOSURE; WITHDRAWAL SYNDROME IN NEWBORNS; and RISKS FROM USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS

Addiction, Abuse, and Misuse

Butrans is a long-acting (extended-release) opioid pain medicine that can put you and other users at risk for overdose and death. Even if you use your dose correctly as prescribed, you are at risk for opioid addiction, abuse, and misuse that can lead to death.

Life-Threatening Breathing Problems

When you first start using Butrans, or when your dose is increased, serious or life-threatening breathing problems that can lead to death may occur, and may occur even at recommended doses during the normal course of therapy. Do not chew, swallow, snort, or inject buprenorphine from the patch because this can lead to overdose and death.

Accidental Exposure

Accidental exposure, especially in children, may result in breathing problems, overdose, or death.

Withdrawal Syndrome in Newborns

Prolonged use of Butrans when you are pregnant can cause withdrawal symptoms in your newborn baby that may be life-threatening if not recognized and treated.

Use with Benzodiazepines or Other CNS Depressants

Use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, can result in severe drowsiness, breathing problems, coma and death.

What is Butrans?
  • Butrans is a strong prescription pain medicine that contains an opioid (narcotic). It is used to manage pain severe enough to require daily, around-the-clock, long-term treatment with an opioid, when other pain treatments, such as non-opioid pain medicines (e.g., acetaminophen, ibuprofen, or celecoxib) or immediate-release opioid medicines, do not treat your pain well enough, you experience side effects when taking them, or they are deemed otherwise inadequate.

  • Butrans is only used to treat pain that continues around-the-clock (pain that is constant).

IMPORTANT SAFETY INFORMATION

Butrans is a long-acting (extended-release) opioid pain medicine that can put you at risk for overdose and death. Even if you use your dose correctly as prescribed, you are at risk for opioid addiction, abuse and misuse that can lead to death.

Do not use Butrans if you:

  • Have severe asthma, trouble breathing, or other lung problems

  • Have a bowel blockage or narrowing of the stomach or intestines

  • Are allergic to buprenorphine

Before applying Butrans, tell your healthcare provider if you have a history of head injury or seizures; problems breathing or urinating; liver, kidney, thyroid, pancreas, or gallbladder problems; heart rhythm abnormalities (Long QT Syndrome); abuse of street or prescription drugs; alcohol addiction; or mental health problems.

WARNINGS
  • Use of Butrans, even when used as recommended, can result in addiction, abuse and misuse, which could lead to overdose and death.

  • Get emergency help right away if you take too much Butrans (overdose).

  • The risk of serious or life-threatening breathing problems that could lead to death can occur even at recommended doses. The risk is greatest when you first start using Butrans or when your dose is increased. Patients who have lung disease or are elderly, frail, or in poor general health, are at increased risk, especially if Butrans is given with other drugs that cause breathing problems. Seek medical attention immediately if you have trouble breathing.

  • Taking Butrans with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death. Do not use these together unless you are directed to do so by your healthcare provider.

  • Never give anyone else your Butrans. They could die from using it. Store Butrans away from children and in a safe place to help prevent abuse or theft. Selling or giving away Butrans is against the law.

  • Accidental exposure, especially in a child, may result in breathing problems, overdose, or death. Be sure to store Butrans safely and to dispose of unused patches when Butrans is no longer needed; use the Patch-Disposal Unit or fold the patch in half and flush it down the toilet (see the detailed Instructions for Use provided with the Butrans patch).

  • Tell your healthcare provider if you are pregnant or planning to become pregnant. Prolonged use of Butrans while you are pregnant can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated.

  • Tell your healthcare provider if you are breastfeeding. Breastfeeding is not recommended during treatment with Butrans. It may harm your baby.

  • Tell your healthcare provider about any prescription or over-the-counter medicines, vitamins, or herbal supplements you are taking. Using Butrans with certain other medicines can cause serious side effects that could lead to death.

  • When using Butrans, do not drink alcohol or use prescription or over-the-counter medicines containing alcohol. Using products containing alcohol during treatment with Butrans may cause you to overdose and die.

  • Butrans could cause adrenal insufficiency, a potentially life-threatening condition which may cause symptoms of nausea, vomiting, anorexia, fatigue, weakness, dizziness and low blood pressure. Seek medical attention if you experience these symptoms.

  • Butrans may cause symptoms of low blood pressure such as dizziness, lightheadedness, or fainting. If you experience these symptoms, you should sit or lie down and be careful when you get up from a sitting or lying position.

  • Butrans may complicate head injuries. Butrans should not be used by those with disturbances in consciousness or coma.

  • Do not stop using Butrans without talking to your healthcare provider.

  • Tell your healthcare provider if you develop a fever. While using Butrans, do NOT expose Butrans or the skin near where Butrans is applied to hot water or prolonged direct sunlight; avoid sunbathing, taking hot baths, hot tubs, saunas, heating pads, electric blankets, heated waterbeds, and heat or tanning lamps. These activities can increase the amount of medicine your Butrans delivers and cause an overdose that can lead to death.

  • Get emergency medical help if you have trouble breathing, shortness of breath, fast heartbeat, chest pain, swelling of your face, tongue or throat, extreme drowsiness, light-headedness when changing positions feeling faint, agitation, high body temperature, trouble walking, stiff muscles, or mental changes such as confusion.

  • Butrans may increase the frequency of seizures in patients who experience seizures and may increase the risk of seizures in other settings associated with seizures. Tell your healthcare provider if you have a history of seizures.

  • When using Butrans, do not drive or operate heavy machinery until you know how Butrans affects you. Butrans can make you sleepy, dizzy, or lightheaded, and may reduce your mental and physical ability to perform these activities safely.

Side Effects
  • The most common side effects reported by patients treated with Butrans in the clinical trials were nausea, headache, application site itch, dizziness, constipation, sleepiness, vomiting, application site redness, dry mouth, and application site rash. Call your healthcare provider if you have any of these symptoms and they are severe.

  • These are not all the possible side effects of Butrans. Call your doctor for medical advice about side effects.

Please read the Brief Summary and Full Prescribing Information, including Boxed Warning, Medication Guide, and Instructions for Use.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Indications and Usage
What is Butrans?
  • Butrans is a strong prescription pain medicine that contains an opioid (narcotic). It is used to manage pain severe enough to require daily, around-the-clock, long-term treatment with an opioid, when other pain treatments, such as non-opioid pain medicines (e.g., acetaminophen, ibuprofen, or celecoxib) or immediate-release opioid medicines, do not treat your pain well enough, you experience side effects when taking them, or they are deemed otherwise inadequate.

  • Butrans is only used to treat pain that continues around-the-clock (pain that is constant).

Important Safety Information

WARNING: ADDICTION, ABUSE, AND MISUSE; LIFE-THREATENING BREATHING PROBLEMS; ACCIDENTAL EXPOSURE; WITHDRAWAL SYNDROME IN NEWBORNS; and RISKS FROM USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS

Addiction, Abuse, and Misuse

Butrans is a long-acting (extended-release) opioid pain medicine that can put you and other users at risk for overdose and death. Even if you use your dose correctly as prescribed, you are at risk for opioid addiction, abuse, and misuse that can lead to death.

Life-Threatening Breathing Problems

When you first start using Butrans, or when your dose is increased, serious or life-threatening breathing problems that can lead to death may occur, and may occur even at recommended doses during the normal course of therapy. Do not chew, swallow, snort, or inject buprenorphine from the patch because this can lead to overdose and death.

Accidental Exposure

Accidental exposure, especially in children, may result in breathing problems, overdose, or death.

Withdrawal Syndrome in Newborns

Prolonged use of Butrans when you are pregnant can cause withdrawal symptoms in your newborn baby that may be life-threatening if not recognized and treated.

Use with Benzodiazepines or Other CNS Depressants

Use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, can result in severe drowsiness, breathing problems, coma and death.

IMPORTANT SAFETY INFORMATION

Butrans is a long-acting (extended-release) opioid pain medicine that can put you at risk for overdose and death. Even if you use your dose correctly as prescribed, you are at risk for opioid addiction, abuse and misuse that can lead to death.

Do not use Butrans if you:

  • Have severe asthma, trouble breathing, or other lung problems

  • Have a bowel blockage or narrowing of the stomach or intestines

  • Are allergic to buprenorphine

Before applying Butrans, tell your healthcare provider if you have a history of head injury or seizures; problems breathing or urinating; liver, kidney, thyroid, pancreas, or gallbladder problems; heart rhythm abnormalities (Long QT Syndrome); abuse of street or prescription drugs; alcohol addiction; or mental health problems.

WARNINGS
  • Use of Butrans, even when used as recommended, can result in addiction, abuse and misuse, which could lead to overdose and death.

  • Get emergency help right away if you take too much Butrans (overdose).

  • The risk of serious or life-threatening breathing problems that could lead to death can occur even at recommended doses. The risk is greatest when you first start using Butrans or when your dose is increased. Patients who have lung disease or are elderly, frail, or in poor general health, are at increased risk, especially if Butrans is given with other drugs that cause breathing problems. Seek medical attention immediately if you have trouble breathing.

  • Taking Butrans with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death. Do not use these together unless you are directed to do so by your healthcare provider.

  • Never give anyone else your Butrans. They could die from using it. Store Butrans away from children and in a safe place to help prevent abuse or theft. Selling or giving away Butrans is against the law.

  • Accidental exposure, especially in a child, may result in breathing problems, overdose, or death. Be sure to store Butrans safely and to dispose of unused patches when Butrans is no longer needed; use the Patch-Disposal Unit or fold the patch in half and flush it down the toilet (see the detailed Instructions for Use provided with the Butrans patch).

  • Tell your healthcare provider if you are pregnant or planning to become pregnant. Prolonged use of Butrans while you are pregnant can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated.

  • Tell your healthcare provider if you are breastfeeding. Breastfeeding is not recommended during treatment with Butrans. It may harm your baby.

  • Tell your healthcare provider about any prescription or over-the-counter medicines, vitamins, or herbal supplements you are taking. Using Butrans with certain other medicines can cause serious side effects that could lead to death.

  • When using Butrans, do not drink alcohol or use prescription or over-the-counter medicines containing alcohol. Using products containing alcohol during treatment with Butrans may cause you to overdose and die.

  • Butrans could cause adrenal insufficiency, a potentially life-threatening condition which may cause symptoms of nausea, vomiting, anorexia, fatigue, weakness, dizziness and low blood pressure. Seek medical attention if you experience these symptoms.

  • Butrans may cause symptoms of low blood pressure such as dizziness, lightheadedness, or fainting. If you experience these symptoms, you should sit or lie down and be careful when you get up from a sitting or lying position.

  • Butrans may complicate head injuries. Butrans should not be used by those with disturbances in consciousness or coma.

  • Do not stop using Butrans without talking to your healthcare provider.

  • Tell your healthcare provider if you develop a fever. While using Butrans, do NOT expose Butrans or the skin near where Butrans is applied to hot water or prolonged direct sunlight; avoid sunbathing, taking hot baths, hot tubs, saunas, heating pads, electric blankets, heated waterbeds, and heat or tanning lamps. These activities can increase the amount of medicine your Butrans delivers and cause an overdose that can lead to death.

  • Get emergency medical help if you have trouble breathing, shortness of breath, fast heartbeat, chest pain, swelling of your face, tongue or throat, extreme drowsiness, light-headedness when changing positions feeling faint, agitation, high body temperature, trouble walking, stiff muscles, or mental changes such as confusion.

  • Butrans may increase the frequency of seizures in patients who experience seizures and may increase the risk of seizures in other settings associated with seizures. Tell your healthcare provider if you have a history of seizures.

  • When using Butrans, do not drive or operate heavy machinery until you know how Butrans affects you. Butrans can make you sleepy, dizzy, or lightheaded, and may reduce your mental and physical ability to perform these activities safely.

Side Effects
  • The most common side effects reported by patients treated with Butrans in the clinical trials were nausea, headache, application site itch, dizziness, constipation, sleepiness, vomiting, application site redness, dry mouth, and application site rash. Call your healthcare provider if you have any of these symptoms and they are severe.

  • These are not all the possible side effects of Butrans. Call your doctor for medical advice about side effects.

Please read the Brief Summary and Full Prescribing Information, including Boxed Warning, Medication Guide, and Instructions for Use.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

WARNING: ADDICTION, ABUSE, AND MISUSE; LIFE-THREATENING BREATHING PROBLEMS; ACCIDENTAL EXPOSURE; WITHDRAWAL SYNDROME IN NEWBORNS; and RISKS FROM USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS

Addiction, Abuse, and Misuse

Butrans is a long-acting (extended-release) opioid pain medicine that can put you and other users at risk for overdose and death. Even if you use your dose correctly as prescribed, you are at risk for opioid addiction, abuse, and misuse that can lead to death.

Life-Threatening Breathing Problems

When you first start using Butrans, or when your dose is increased, serious or life-threatening breathing problems that can lead to death may occur, and may occur even at recommended doses during the normal course of therapy. Do not chew, swallow, snort, or inject buprenorphine from the patch because this can lead to overdose and death.

Accidental Exposure

Accidental exposure, especially in children, may result in breathing problems, overdose, or death.

Withdrawal Syndrome in Newborns

Prolonged use of Butrans when you are pregnant can cause withdrawal symptoms in your newborn baby that may be life-threatening if not recognized and treated.

Use with Benzodiazepines or Other CNS Depressants

Use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, can result in severe drowsiness, breathing problems, coma and death.

What is Butrans?
  • Butrans is a strong prescription pain medicine that contains an opioid (narcotic). It is used to manage pain severe enough to require daily, around-the-clock, long-term treatment with an opioid, when other pain treatments, such as non-opioid pain medicines (e.g., acetaminophen, ibuprofen, or celecoxib) or immediate-release opioid medicines, do not treat your pain well enough, you experience side effects when taking them, or they are deemed otherwise inadequate.

  • Butrans is only used to treat pain that continues around-the-clock (pain that is constant).

IMPORTANT SAFETY INFORMATION

Butrans is a long-acting (extended-release) opioid pain medicine that can put you at risk for overdose and death. Even if you use your dose correctly as prescribed, you are at risk for opioid addiction, abuse and misuse that can lead to death.

Do not use Butrans if you:

  • Have severe asthma, trouble breathing, or other lung problems

  • Have a bowel blockage or narrowing of the stomach or intestines

  • Are allergic to buprenorphine

Before applying Butrans, tell your healthcare provider if you have a history of head injury or seizures; problems breathing or urinating; liver, kidney, thyroid, pancreas, or gallbladder problems; heart rhythm abnormalities (Long QT Syndrome); abuse of street or prescription drugs; alcohol addiction; or mental health problems.

WARNINGS
  • Use of Butrans, even when used as recommended, can result in addiction, abuse and misuse, which could lead to overdose and death.

  • Get emergency help right away if you take too much Butrans (overdose).

  • The risk of serious or life-threatening breathing problems that could lead to death can occur even at recommended doses. The risk is greatest when you first start using Butrans or when your dose is increased. Patients who have lung disease or are elderly, frail, or in poor general health, are at increased risk, especially if Butrans is given with other drugs that cause breathing problems. Seek medical attention immediately if you have trouble breathing.

  • Taking Butrans with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death. Do not use these together unless you are directed to do so by your healthcare provider.

  • Never give anyone else your Butrans. They could die from using it. Store Butrans away from children and in a safe place to help prevent abuse or theft. Selling or giving away Butrans is against the law.

  • Accidental exposure, especially in a child, may result in breathing problems, overdose, or death. Be sure to store Butrans safely and to dispose of unused patches when Butrans is no longer needed; use the Patch-Disposal Unit or fold the patch in half and flush it down the toilet (see the detailed Instructions for Use provided with the Butrans patch).

  • Tell your healthcare provider if you are pregnant or planning to become pregnant. Prolonged use of Butrans while you are pregnant can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated.

  • Tell your healthcare provider if you are breastfeeding. Breastfeeding is not recommended during treatment with Butrans. It may harm your baby.

  • Tell your healthcare provider about any prescription or over-the-counter medicines, vitamins, or herbal supplements you are taking. Using Butrans with certain other medicines can cause serious side effects that could lead to death.

  • When using Butrans, do not drink alcohol or use prescription or over-the-counter medicines containing alcohol. Using products containing alcohol during treatment with Butrans may cause you to overdose and die.

  • Butrans could cause adrenal insufficiency, a potentially life-threatening condition which may cause symptoms of nausea, vomiting, anorexia, fatigue, weakness, dizziness and low blood pressure. Seek medical attention if you experience these symptoms.

  • Butrans may cause symptoms of low blood pressure such as dizziness, lightheadedness, or fainting. If you experience these symptoms, you should sit or lie down and be careful when you get up from a sitting or lying position.

  • Butrans may complicate head injuries. Butrans should not be used by those with disturbances in consciousness or coma.

  • Do not stop using Butrans without talking to your healthcare provider.

  • Tell your healthcare provider if you develop a fever. While using Butrans, do NOT expose Butrans or the skin near where Butrans is applied to hot water or prolonged direct sunlight; avoid sunbathing, taking hot baths, hot tubs, saunas, heating pads, electric blankets, heated waterbeds, and heat or tanning lamps. These activities can increase the amount of medicine your Butrans delivers and cause an overdose that can lead to death.

  • Get emergency medical help if you have trouble breathing, shortness of breath, fast heartbeat, chest pain, swelling of your face, tongue or throat, extreme drowsiness, light-headedness when changing positions feeling faint, agitation, high body temperature, trouble walking, stiff muscles, or mental changes such as confusion.

  • Butrans may increase the frequency of seizures in patients who experience seizures and may increase the risk of seizures in other settings associated with seizures. Tell your healthcare provider if you have a history of seizures.

  • When using Butrans, do not drive or operate heavy machinery until you know how Butrans affects you. Butrans can make you sleepy, dizzy, or lightheaded, and may reduce your mental and physical ability to perform these activities safely.

Side Effects
  • The most common side effects reported by patients treated with Butrans in the clinical trials were nausea, headache, application site itch, dizziness, constipation, sleepiness, vomiting, application site redness, dry mouth, and application site rash. Call your healthcare provider if you have any of these symptoms and they are severe.

  • These are not all the possible side effects of Butrans. Call your doctor for medical advice about side effects.

Please read the Brief Summary and Full Prescribing Information, including Boxed Warning, Medication Guide, and Instructions for Use.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please read the Brief Summary and Full Prescribing Information, including Boxed Warning, Medication Guide, and Instructions for Use.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.