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Buprenorphine is a sublingual type of medication, sold under the brand names Subutex, Temgesic, or the like. This is used to treat patients addiction or dependence with narcotics. It has effect on the persons withdrawal symptoms by retarding the urgency of seeking opioid substances. Being a type of narcotic itself, it is being widely used by professionals and medical practitioners as part of the therapeutic regimen of narcotic dependents.

The main effect of the drug during administration is a long lasting analgesic effect, which is a benefit for most patients because of a longer consistent therapy management. Other benefits of the use of this drug are its low drug interaction effect, low profile administration through the sublingual or transdermal routes, least amount of renal accumulation, and its lack of any type of immune system suppressant. This lessens the side effects to be expected.

Those who have intense to moderately rated chronic pain should be administered with buprenorphine, especially those who are set to have a form of operation. It is a common peri-operative drug utilized usually among cancer patients.

Those who are also suffering from depression attacks or psychosis may be treated successfully with buprenorphine. However, those in the psychiatric division have not included psychological distress in the official list of tested and approved indications for the said drug. The conflict of successful therapeutic claims of the drug over such ailments versus the actual approval in the medical field elicits debates and lands the medication in a gray area in this regard.

The most common dosage for this medication is available in both 2 and 8 milligram variants, wherein adults whose age is 13 years and above may be administered with 1 milliliter of the drug containing .3mg of buprenorphine. It is usually administered through intramuscular route, and is given in a slow push, lasting of up to 2 minutes. Intervals as prescribed by the physician may go as fast as every 6 hours.

As for children, the usual dosage would be 2 to 6 micrograms per kilo of body weight, and is given every 4 hours. Some would practice giving the drug of 6-hour intervals for better body compliance.

In a study of clinical testing of about 1,133 patients sedated with this drug, about two thirds of the specimen population showed side effect signs overall, with different effects. Even with the high level of side effects, the intensity of the said effects was minimal or somehow negligible. As an added note, those patients who were successfully sedated were able to be roused back to an alert state quite easily.

Most common effects occurring with the test sample population was Nausea and Vertigo, which occurred 5 to 10% of the whole population. Other symptoms include sweating or diaphoresis, hypotension, vomiting, headache, and hypoventilation.

There are more adverse side effects that happen in rare occasions such as loss of appetite, agitation, diarrhea, urticaria, and neuromuscular impairment as evidenced by occasional convulsions and muscle twitching.

Drug interaction is documented with CYP3A4 isozymes in the body, which may lower the clearance of the drug in the bloodstream.

As for CYP3A4 inducers such as rifampin, phenytoin, and phenytoin may actually help clearance of the body.

Special precautions to pregnant mothers as this may affect normal fetal growth.

Buprenorphine has the following structural formula:

Chemical structure of buprenorphine

• Molecular formula of buprenorphine is C29H41NO4

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