The transdermal matrix patch formulation of
buprenorphine has been shown to be effective in managing moderate-to-severe
cancer pain and severe
pain unresponsive to
nonopioid analgesics. Clinical trials have revealed that it is possible to switch from weak
opioids or low doses of step III
opioids to transdermal
buprenorphine without any problems. With
buprenorphine patches, the sublingual
buprenorphine intake was dose-dependently reduced and was superior to placebo in this respect. The proportion of responders increased with the
buprenorphine dose, and a higher proportion of patients receiving
buprenorphine patches reported uninterrupted sleep for longer than 6 h compared with those receiving placebo. In a long-term, open, follow-up study in which the mean
duration of treatment was 7.5 months,
analgesia was rated as at least satisfactory by 90% of patients. Almost 60% of patients could manage their
pain with one patch alone or with one additional sublingual
tablet a day during the whole period of treatment, indicating a low incidence of tolerance development. The
buprenorphine transdermal patch was assessed as user friendly by 94.6% of patients. In a postmarketing surveillance study,
pain relief with transdermal
buprenorphine was rated as good or very good by 70% of the responders. Postmarketing surveillance studies have shown that transdermal
buprenorphine is also effective in the management of nociceptive and
neuropathic pain, which some studies have shown to be relatively insensitive to mu-
opioid analgesics, such as
morphine. Transdermal
buprenorphine was well tolerated. Most adverse events were either local reactions to the patch that generally subsided within 24 h or systemic events typical of treatment with
opioid analgesics, such as
nausea,
vomiting and
constipation.