Buprenorphine nausea

An excellent brief article on buprenorphine treatment has been provided by Taikato et al. (2005), which notes the common possible side-effects (headaches, nausea and vomiting, sweating, constipation, etc.) and drug interactions. The limited central depressant effect of buprenorphine may be compounded by alcohol and antidepressants, while the metabolism of buprenorphine can be enhanced by anticonvulsants, with therefore possibly reduced efficacy. There have been some case reports of liver toxicity from buprenorphine that is reversible if the medication is stopped (Herve et al. 2004), and often clinical guidelines will recommend that liver function tests are included in buprenorphine treatment, as they definitely should be with naltrexone. 

Side-effects Buprenorphine induces p-opioid-type side effects including respiratory depression, drowsiness, nausea and vomiting. In the clinical literature, however, there are only few cases of significant respiratory depression. Reversal of respiratory depression may need higher doses of naloxone (Gal, 1989). Buprenorphine has a limited abuse potential and withdrawal reactions, due to slow receptor dissociation, are mild and delayed. 

Although buprenorphine [byou preh NOR feen] is classified as a partial agonist acting at the p receptor, it behaves like morphine in naive patients. However, it can also antagonize morphine. Buprenorphine is administered parenterally and has a long duration of action because of its tight binding to the receptor. It is metabolized by the liver and excreted in the bile and urine. Adverse effects include respiratory depression, decrease (or, rarely, increase) in blood pressure, nausea and dizziness. 

In a double-blind, randomized study of three groups of 18 patients having abdominal surgery who received single doses of either intramuscular pethidine 75 mg, with sublingual buprenorphine 400 pg, or buprenorphine 300 pg alone, sedation and nausea were the most common adverse effects in all three groups. Patients who received... 

Sedation and nausea are relatively frequent. When buprenorphine is used for patient-controlled analgesia, minor dysphoria or euphoria has been reported (SEDA-16, 88). 

Observational studies The role of buprenorphine in the treatment of non-psy-chotic major depression has been explored in six treatment-resistant patients with severe non-psychotic depression [183 ]. They received buprenorphine 0.8-2 mg/day and their depressive symptoms improved within 1 week. In the initial days, they had adverse effects such as nausea, constipation, sedation, dizziness, and sweating. 

In 30 adults, transdermal buprenorphine 35 micrograms/hour produced adequate pain relief, but there was a high incidence of adverse events patients developed constipation n = 3), hypotension (3), urinary retention (2), or paradoxical hyperalgia (1) nine discontinued treatment mostly because of nausea and daytime sleepiness [194 ]. 

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