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BUPRAMYL 20 MICROGRAMS/HOUR TRANSDERMAL PATCH

Active substance(s): BUPRENORPHINE

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Package leaflet: Information for the patient

• if you have severe liver problems
• if you have ever been addicted to drugs or alcohol
• if you have a high temperature, as this may lead to larger quantities of the active ingredient being
absorbed into the blood than normal.
If you have recently had an operation, please speak to your doctor before using these patches.
Athletes should be aware that this medicine may cause a positive reaction to sports doping control tests.
Children and adolescents
Do not give this medicine to children and adolescents below 18  years.
Other medicines and Bupramyl
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
• Bupramyl must not be used together with a type of medicine known as a monoamine oxidase inhibitor
(examples include tranylcypromine, phenelzine, isocarboxazid, moclobemide and linezolid), or if you have
taken this type of medicine in the last two weeks.
• If you take some medicines such as phenobarbital or phenytoin (medicines commonly used to treat
seizures, fits or convulsions), carbamazepine (a medicine to treat seizures, fits or convulsions and certain
pain conditions), or rifampicin (a medicine to treat tuberculosis) the effects of Bupramyl may be reduced.
• Bupramyl may make some people feel drowsy, sick or faint or make them breathe more slowly or weakly.
These side effects may be made worse if other medicines that produce the same effects are taken at
the same time. These include certain medicines to treat pain, depression, anxiety, psychiatric or mental
disorders, medicines to help you sleep, medicines to treat high blood pressure such as clonidine, other
opioids (which may be found in painkillers or certain cough mixtures e.g. morphine, dextropropoxyphene,
codeine, dextromethorphan, noscapine), antihistamines which make you drowsy, or anaesthetics such as
halothane.
• Bupramyl must be used with caution if you are also taking benzodiazepines (medicines used to treat
anxiety or to help you sleep). This combination may cause serious breathing problems.
Bupramyl with alcohol
Alcohol may make some of the side effects worse and you may feel unwell if you drink alcohol whilst
wearing Bupramyl. Drinking alcohol whilst using Bupramyl may also affect your reaction time.
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your
doctor or pharmacist for advice before using this medicine.
Pregnancy
There is not sufficient experience regarding the use of buprenorphine in pregnant women. Therefore you
should not use Bupramyl if you are pregnant or if you could become pregnant during treatment.
Breast-feeding
Buprenorphine, the active substance contained in the transdermal patch, may inhibit milk formation and
passes into the breast milk. Therefore, you should not use Bupramyl if you are breast-feeding.
Driving and using machines
Bupramyl may affect your reactions to such an extent that you may not react adequately or quickly enough
in the event of unexpected or sudden occurrences. This applies particularly:
• at the beginning of treatment
• if you are taking medicines to treat anxiety or help you sleep
• if your dose is increased
If you are affected (e.g. feel dizzy, drowsy or have blurred vision), you should not drive or operate machinery
whilst using Bupramyl, or for 24 hours after removing the patch.
The medicine can affect your ability to drive as it may make you sleepy or dizzy.
• Do not drive while taking this medicine until you know how it affects you.
• It is an offence to drive if this medicine affects your ability to drive.
• However, you would not be committing an offence if:
* the medicine has been prescribed to treat a medical or dental problem and
* you have taken it according to the instructions given by the prescriber or in the information provided
with the medicine and
* it was not affecting your ability to drive safely.
Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this
medicine.

Bupramyl 5 micrograms/hour,
10 micrograms/hour and
20 micrograms/hour
transdermal patches
buprenorphine

Read all of this leaflet carefully before you start using this
medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor, pharmacist
or nurse.
• This medicine has been prescribed for you only. Do not pass it
on to others. It may harm them, even if their signs of illness are
the same as yours.
• If you get any side effects, talk to your doctor, pharmacist or
nurse. This includes any possible side effects not listed in this
leaflet. See section 4.
• These patches contain a strong pain killer.
• Ensure that old patches are removed before applying a
new one.
• Patches must not be cut.
• Do not expose the patches to a heat source (such as a hot water
bottle).
• Do not soak in a hot bath or take a hot shower whilst wearing
a patch.
• If you develop a fever tell your doctor immediately.
• Follow the dosage instructions carefully and only change your
patch on the same day and at the same time 7 days later.
• If your breathing becomes shallow and weak take the patch off
and seek medical help.
What is in this leaflet
1. What Bupramyl is and what it is used for
2. What you need to know before you use Bupramyl
3. How to use Bupramyl
4. Possible side effects
5. How to store Bupramyl
6. Contents of the pack and other information

1. What Bupramyl is and what it is used for
Bupramyl contains the active ingredient buprenorphine which belongs to a group of medicines called
strong analgesics or ‘painkillers’. It has been prescribed for you by your doctor to relieve moderate,
long-lasting pain that requires the use of a strong painkiller.
Bupramyl should not be used to relieve acute pain.

2. What you need to know before you use Bupramyl
Do not use Bupramyl:
• if you are allergic to buprenorphine or any of the other ingredients of this medicine (listed in section 6)
• if you have breathing problems
• if you are addicted to drugs
• if you are taking a type of medicine known as a monoamine oxidase inhibitor (examples include
tranylcypromine, phenelzine, isocarboxazid, moclobemide and linezolid), or you have taken this type of
medicine in the last two weeks
• if you suffer from myasthenia gravis (a condition in which the muscles become weak)
• if you have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating
upon stopping taking alcohol.
Bupramyl must not be used to treat symptoms associated with drug withdrawal.
Warnings and precautions
Talk to your doctor, pharmacist or nurse before using Bupramyl:
• if you suffer from seizures, fits or convulsions
• if you have a severe headache or feel sick due to a head injury or increased pressure in your skull (for
instance due to brain disease). This is because the patches may make symptoms worse or hide the extent
of a head injury
• if you are feeling light-headed or faint

Description Bupramyl_0.005mg_hr_0.02mg_hr_0.01mg_hr_4
Component Type Leaflet
Affiliate Item Code 1180540
Superceded Affiliate Item Code 944073
TrackWise PR No. 1180540
MA No.
Packing Site/Printer

PL 04569/1634-1636
Tesa Labtec GmbH
(Hamburg - DE)

Supplier Code 16181-90069-01

Pharma Code 6281
SAP No. N/A
Vendor Job No. 520640
Trackwise Proof No. 5
Client Market United Kingdom

Date: 22 Dec 17
No. of colours
Colours
Non-Print
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Equate CMYK
with

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1

3. How to use Bupramyl
Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.
Different strengths of Bupramyl are available. Your doctor will decide which strength of Bupramyl will suit
you best.
During treatment, your doctor may change the patch you use to a smaller or larger one if necessary. Do not
cut or divide the patch or use a higher dose than recommended. You should not apply more than two
patches at the same time.
If you feel that the effect of the Bupramyl is too weak or too strong, talk to your doctor or pharmacist.

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Adults and elderly patients
Unless your doctor has told you differently, attach one Bupramyl patch (as described in detail below) and
change it every seventh day, preferably at the same time of day. Your doctor may wish to adjust the dose
after 3-7 days until the correct level of pain control has been found. If your doctor has advised you to take
other painkillers in addition to the patch, strictly follow the doctor’s instructions, otherwise you will not fully
benefit from treatment with Bupramyl. The patch should be worn for 3 full days before increasing the dose,
this is when the maximum effect of a given dose is established.
Patients with kidney disease/dialysis patients
In patients with kidney disease, no change in dose is necessary.
Patients with liver disease
In patients with liver disease, the effects and period of action of Bupramyl may be affected and your doctor
will therefore check on you more closely.
Patients under 18 years of age
Bupramyl should not be used in patients below the age of 18  years.
Method of administration
Bupramyl is for transdermal use.
Bupramyl acts through the skin. After application, buprenorphine passes through the skin into the blood.
Before applying the transdermal patch
• Choose an area of non-irritated, intact
skin on your upper arm, outer arm, upper
chest, upper back or side of the chest (see
illustrations besides). Ask for assistance if you
cannot apply the patch yourself.

Upper Arm

or

Front

or

Back

or

• Bupramyl should be applied to a relatively hairless or nearly hairless skin site. If no suitable hair free sites
are available the hairs should be cut off with a pair of scissors. Do not shave them off.
• Avoid skin which is red, irritated or has any other blemishes, for instance large scars.
• The area of skin you choose must be dry and clean. If necessary, wash it with cold or lukewarm water.
Do not use soap, alcohol, oil, lotions or other detergents. After a hot bath or shower, wait until your skin is
completely dry and cool. Do not apply lotion, cream or ointment to the chosen area. This might prevent
your patch from sticking properly.
Applying the transdermal patch
• Step 1: Each transdermal patch is sealed in a sachet. Just before use,
cut the sachet along the sealed edge with scissors. Take out the
transdermal patch. Do not use the patch if the sachet seal is broken.

• Step 2: The sticky side of the transdermal patch is covered with a
transparent protective foil. Carefully peel off one part of the foil. Try
not to touch the sticky part of the transdermal patch.

• Step 3: Stick the transdermal patch on to the area of skin you have
chosen and remove the remaining foil.

• Step 4: Press the transdermal patch against your skin with the
palm of your hand / and count slowly to 30. Make sure that the
whole transdermal patch is in contact with your skin, especially at
the edges.
Wearing the transdermal patch
You should wear the patch for seven days. Provided that you have applied the patch correctly, there is little
risk of it coming off. If the edges of the patch begin to peel off, they may be taped down with a suitable skin
tape. You may shower, bathe or swim whilst wearing it.
Do not expose the patch to extreme heat (e.g. heating pads, electric blanket, heat lamps, sauna, hot tubs,
heated water beds, hot water bottle, etc) as this may lead to larger quantities of the active ingredient being
absorbed into the blood than normal. External heat may also prevent the patch from sticking properly. If
you have a high temperature this may alter the effects of Bupramyl (see ‘Warnings and Precautions’ section
above).
In the unlikely event that your patch falls off before it needs changing, do not use the same patch again.
Stick a new one on straight away (see ‘Changing the transdermal patch’ below).
Changing the transdermal patch
• Take the old transdermal patch off.
• Fold it in half with the sticky side inwards.
• Open and take out a new patch. Use the empty sachet to dispose of the old patch. Now discard the sachet
safely.
• Stick a new transdermal patch on a different appropriate skin site (as described above). You should not
apply a new patch to the same site for 3-4  weeks.
• Remember to change your patch at the same time of day. It is important that you make a note of the time
of day.
Duration of treatment
Your doctor will tell you how long you should be treated with Bupramyl. Do not stop treatment without
consulting a doctor, because your pain may return and you may feel unwell (see also ‘If you stop using
Bupramyl’ below).
If you use more Bupramyl than you should
As soon as you discover that you have used more patches than you should, remove all patches and call your
doctor or hospital straight away. People who have taken an overdose may feel very sleepy and sick. They
may also have breathing difficulties or lose consciousness and may need emergency treatment in hospital.
When seeking medical attention make sure that you take this leaflet and any remaining patches with you to
show to the doctor.
If you forget to use Bupramyl
Stick a new patch on as soon as you remember. Also make a note of the date, as your usual day of changing
may now be different. If you are very late changing your patch, your pain may return. In this case, please
contact your doctor.
Do not apply additional patches to make up for the forgotten application.
If you stop using Bupramyl
If you stop using Bupramyl too soon or you interrupt your treatment your pain may return. If you wish to
stop treatment please consult your doctor. They will tell you what can be done and whether you can be
treated with other medicines.
Some people may have side effects when they have used strong painkillers for a long time and stop using
them. The risk of having effects after stopping Bupramyl is very low. However, if you feel agitated, anxious,
nervous or shaky, if you are overactive, have difficulty sleeping or digestive problems, tell your doctor.
The pain relieving effect of Bupramyl is maintained for some time after removal of the patch. You should not
start another opioid analgesic (strong painkiller) within 24 hours after removal of the patch.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
There is a risk that you may become addicted or reliant on Bupramyl.
Serious side effects that may be associated with buprenorphine are similar to those seen with other strong
painkillers and include difficulty in breathing and low blood pressure.

Description Bupramyl_0.005mg_hr_0.02mg_hr_0.01mg_hr_4
Component Type Leaflet
Affiliate Item Code 1180540
Superceded Affiliate Item Code 944073
TrackWise PR No. 1180540
MA No.
Packing Site/Printer

PL 04569/1634-1636
Tesa Labtec GmbH
(Hamburg - DE)

Supplier Code 16181-90069-01

Pharma Code 6281
SAP No. N/A
Vendor Job No. 520640
Trackwise Proof No. 5
Client Market United Kingdom

Date: 22 Dec 17
No. of colours
Colours
Non-Print
Colours

Keyline/Drawing No N/A

Equate CMYK
with

Barcode Info. N/A

Main Font

3D Render ID N/A

Dimensions

1

Remove the transdermal patch and contact a doctor immediately if you experience any of the
following side effects:
Uncommon (may affect up to 1 in 100 people):
• sudden wheeziness, difficulties in swallowing or breathing, swelling of the face or lips, rash or itching
especially those covering your whole body. These can be symptoms of a serious allergic reaction
(hypersensitivity, anaphylaxis).
• inability of heart to pump blood or lack of blood flow (circulatory collapse)
• unable to pass urine (urinary retention).
Rare (may affect up to 1 in 1,000 people):
• chest pain associated with heart disease (angina)
• severe breathing difficulties (respiratory depression, respiratory failure)
• persistent constipation with swollen stomach and vomiting (ileus).
Other possible side effects:
Very common (may affect more than 1 in 10 people):
• headache, dizziness, drowsiness or sleepiness
• constipation, feeling sick (nausea), vomiting
• itchy skin, redness of the skin
• rash, redness, itching, inflammation or swelling of the skin at the application site.
Common (may affect up to 1 in 10 people):
• loss of appetite
• confusion, depression, anxiety, difficulty in sleeping, nervousness, shaking (tremors)
• shortness of breath
• abdominal pain or discomfort, diarrhoea, indigestion, dry mouth
• sweating, rash, skin eruptions (exanthema)
• tiredness, a feeling of unusual weakness, muscle weakness, swelling of hands, ankles or feet (oedema).
Uncommon (may affect up to 1 in 100 people):
• sleep disorder, restlessness, agitation, a feeling of extreme happiness, mood swings, hallucinations,
nightmares, decreased sexual drive, aggression
• changes in taste, difficulty in speaking, reduced sensitivity to pain or touch, tingling or numbness in the
hands or feet (pins and needles)
• loss of memory, migraine, fainting, problems with concentration or co-ordination
• dry eyes, blurred vision
• ringing or buzzing sound in the ears (tinnitus), a feeling of dizziness or spinning (vertigo)
• high or low blood pressure, chest pain, fast or irregular heart beat
• cough, hiccups, wheezing
• wind
• weight loss
• dry skin
• muscle spasms, muscle aches and pains (myalgia)
• difficulty passing urine or loss of control passing urine
• feeling tired (fatigue)
• fever, chills
• local allergic reaction with marked signs of swelling (in such cases treatment should be stopped)
• flushing of the skin
• increase in accidental injuries (e.g. falls)
• withdrawal symptoms such as agitation, anxiousness, sweating or shaking upon stopping using this
medicine
• change in liver function tests (shown by blood tests).
Rare (may affect up to 1 in 1,000 people):
• mental health problem
• difficulties with balance
• eyesight problems (visual disturbance), swelling of the eyelids or face, a reduction in size of the pupils in
the eye
• worsening of asthma, abnormally fast and deep breathing
• feeling of faintness, especially on standing up
• difficulty in swallowing
• itchy, runny nose (rhinitis)
• decreased erection, sexual dysfunction
• flu-like symptoms
• feeling thirsty and dark-coloured urine (dehydration).
Very rare (may affect up to 1 in 10,000 people):
• drug dependence
• muscle twitching
• ear pain
• skin pimples or blisters.
Not known (frequency cannot be estimated from the available data):
• seizures, fits or convulsions

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• inflammation of the bowel wall (diverticulitis) with symptoms
that may include fever, vomiting and stomach pain or
discomfort
• recurring pain in the upper abdomen (biliary colic)
• feeling detached from oneself
• withdrawal symptoms in babies born to mothers who have been
given buprenorphine in pregnancy may include high-pitched
crying, irritability and restlessness, shaking (tremor), feeding
difficulties, sweating and not putting on weight.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaflet. You can
also report side effects directly via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard. By reporting side effects, you can
help provide more information on the safety of this medicine.

5. How to store Bupramyl
• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the carton and sachet after EXP.
The expiry date refers to the last day of that month.
[5 micrograms/hour] & [10 micrograms/hour]
• Do not store above 25°C.
[20 micrograms/hour]
• This medicine does not require any special storage conditions.
• Do not use the patch if the sachet seal is broken.
• Used patches must be folded over on themselves with the adhesive layer inwards, and discarded safely.
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw
away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information
What Bupramyl patches contain
The active substance is buprenorphine.
• 5 micrograms/hour: Each transdermal patch contains 5 mg of buprenorphine in a patch size of
6.25 cm2 and releases 5 micrograms of buprenorphine per hour (over a period of 7 days).
• 10 micrograms/hour: Each transdermal patch contains 10 mg of buprenorphine in a patch size of
12.5 cm2 and releases 10 micrograms of buprenorphine per hour (over a period of 7 days).
• 20 micrograms/hour: Each transdermal patch contains 20 mg of buprenorphine in a patch size of
25 cm2 and releases 20 micrograms of buprenorphine per hour (over a period of 7 days).
The other ingredients are:
Adhesive matrix (containing buprenorphine): povidone K90, levulinic acid, oleyl oleate, Poly[acrylic acid-cobutylacrylate-co-(2-ethylhexyl)acrylate-co-vinylacetate] (5:15:75:5)
Adhesive matrix (without buprenorphine): Poly[(2-ethylhexyl)acrylate-co-glycidylmethacrylate-co(2-hydroxyethyl)acrylate-co-vinylacetate] (68:0,15:5:27),
Separating foil between adhesive matrices with and without buprenorphine: Polyethylene
terephthalate film,
Backing foil: polyester,
Release liner: Polyethylene terephthalate film, siliconised
Blue printing ink
What Bupramyl look like and contents of the pack
Transdermal patch
Three sizes are available.
• 5 micrograms/hour: Rectangular beige coloured patch with rounded edges and imprinted with
‘Buprenorphin’ and ‘5 μg/h’ in blue colour.
• 10 micrograms/hour: Rectangular beige coloured patch with rounded edges and imprinted with
‘Buprenorphin’ and ‘10 μg/h’ in blue colour.
• 20 micrograms/hour: Rectangular beige coloured patch with rounded edges and imprinted with
‘Buprenorphin’ and ‘20 μg/h’ in blue colour.
One transdermal patch is sealed in one child-resistant sachet. The patches are available in cartons containing
2, 4, 8 or 12 transdermal patches.
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Mylan, Potters Bar, Hertfordshire, EN6 1TL, United Kingdom
Manufacturer
Gerard Laboratories, Unit 35/36 Baldoyle Industrial Estate, Grange Road, Dublin 13, Ireland
1180540
This leaflet was last revised in 01/2018
16181-90069-01

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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