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600x130mm (LSN-CON-08) (L) V1

BUTEC PAT 15MG PIL UK 6510762 V4.indd 1

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22/07/2016 10:51

600x130mm (LSN-CON-08) (L) V1

Package leaflet: Information for the patient

Butec® 15 microgram/hour transdermal patches
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 effects not listed
in this leaflet. See section 4.
What is in this leaflet:
1. What Butec patches are and what
they are used for
2. What you need to know before you
use Butec patches
3. How to use Butec patches
4. Possible side effects
5. How to store Butec patches
6. Contents of the pack and other

BUTEC PAT 15MG PIL UK 6510762 V4.indd 2

1. what Butec patches are and
what they are used for
Butec patches contain the active
ingredient buprenorphine which
belongs to a group of medicines called
strong analgesics or ‘painkillers’. They
have been prescribed for you by your
doctor to relieve moderate, longlasting pain that requires the use of a
strong painkiller.
Butec patches should not be used to
relieve acute pain.
Butec patches act through the skin.
After application, buprenorphine
passes through the skin into the blood.
Each patch lasts for seven days.
2. What you need to know before
you use Butec patches
Do not use Butec patches:
• 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
• 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
Butec patches must not be used to
treat symptoms associated with drug
Warnings and precautions
Talk to your doctor, pharmacist or nurse
before using Butec patches:
• if you suffer from seizures, fits or
• 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

• 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.
Children and adolescents
Do not give this medicine to children
below 18 years.
Other medicines and Butec patches
Tell your doctor or pharmacist if you
are taking, have recently taken or
might take any other medicines.
• Butec patches 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
• 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 Butec
patches may be reduced.
• Butec patches 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.
• Butec patches 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 which could
be fatal in case of overdose. Tell
your doctor if you are taking this

Using Butec patches with food, drink
and alcohol
Alcohol may make some of the side
effects worse and you may feel unwell
if you drink alcohol whilst wearing
Butec patches. Drinking alcohol whilst
using Butec patches may also affect
your reaction time.
Pregnancy, breast-feeding and fertility
You should not use Butec patches if
you are pregnant or are breast-feeding,
think you may be pregnant or are
planning to have a baby.
Ask your doctor or pharmacist for
advice before taking this medicine.
Driving and using machines
Butec patches 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
• 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 Butec patches, or for
24 hours after removing the patch.

The medicine can affect your ability
to drive as it may make you sleepy or
• Do not drive while taking this
medicine until you know how it
affects you.
• It is an offence to drive while you
have this medicine in your body
over a specified limit unless you
have a defence (called the ‘statutory
• This defence applies when:
o The medicine has been
prescribed to treat a medical
or dental problem; and
o You have taken it according to
the instructions given by the
prescriber and in the information
provided with the medicine.
• Please note that it is still an offence
to drive if you are unfit because of
the medicine (i.e. your ability to
drive is being affected).
Details regarding a new driving
offence concerning driving after drugs
have been taken in the UK may be
found here:
Talk to your doctor or pharmacist if
you are not sure whether it is safe
for you to drive while taking this

3. How to use Butec patches
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 Butec patches
are available. Your doctor will decide
which strength of Butec patch will suit
you best.
When people first start using Butec,
they often experience some nausea and
vomiting (see section 4). This usually
passes after the first week of treatment.
It’s a good idea to book a follow-up
appointment with your doctor a week
or two after you first start using Butec
patches to ensure that you are taking
the correct dose and to manage any
side effects.
During treatment, your doctor may
change the patch you use to a smaller
or larger one if necessary, or tell
you to use a combination of up to
two patches. 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 up to a maximum total dose of
40 micrograms/hour.

Adults and elderly patients
Unless your doctor has told you
differently, attach one Butec 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 the Butec patch. 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 under 18 years of age
Butec patches should not be used in
patients below the age of 18 years.
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 the
Butec patch may be affected and your
doctor will therefore check on you
more closely.

Before applying the Butec 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
below). Ask for assistance if you
cannot apply the patch yourself.

• The Butec patch 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 patch
Step 1: Each patch is sealed in a
pouch. Just before use, open the pouch
by tearing where indicated. Take out
the patch. Do not use the patch if the
pouch seal is broken.
Step 2: The sticky side
of the patch is covered
with a silvery protective
foil. Carefully peel off
half the foil. Try not to
touch the sticky part of the patch.
Step 3: Stick the patch on to the area
of skin you have chosen and remove
the remaining foil.
Step 4: Press the patch against your
skin with the palm of
your hand and count
slowly to 30. Make sure
that the whole patch is in
contact with your skin,
especially at the edges.
Wearing the 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.

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600x130mm (LSN-CON-08) (L) V1

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
Butec patches (see “Take special care”
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 patch” below).
Changing the patch
• Take the old patch off.
• Fold it in half with the sticky side
• Open and take out a new patch. Use
the empty pouch to dispose of the
old patch. Now discard the pouch
• Even used patches contain some
active ingredient that may harm
children or animals, so make sure
your used patches are always kept
out of the reach and sight of them.
• Stick a new 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.

BUTEC PAT 15MG PIL UK 6510762 V4.indd 3

• Remember to change your patch at
the same time of day. It is important
that you make a note of the time of
Duration of treatment
Your doctor will tell you how long
you should be treated with the Butec
patch. Do not stop treatment without
consulting a doctor, because your pain
may return and you may feel unwell
(see also “If you stop using Butec
patches” below).
If you feel that the effect of the Butec
patch is too weak or too strong, talk to
your doctor or pharmacist.
If you use more Butec patches 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 apply the Butec patch
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 Butec patches
If you stop using Butec patches 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 Butec patches 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 Butec
patch 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 product, ask your doctor
or pharmacist.

4. Possible side effects
Like all medicines, Butec patches
can cause side effects, although not
everybody gets them.
Serious side effects that may be
associated with Butec patches are
similar to those seen with other strong
painkillers and include difficulty in
breathing and low blood pressure.
This medicine can cause allergic
reactions, although serious allergic
reactions are rare. Remove the patch
and tell your doctor immediately if you
get any sudden wheeziness, difficulties
in breathing, swelling of the eyelids,
face or lips, rash or itching especially
those covering your whole body.
As with all strong painkillers, there is
a risk that you may become addicted
or reliant on Butec patches.
In patients treated with Butec patches,
the following other side effects have
been reported:
Very common (may affect more than
1 in 10 people)
• Headache, dizziness, drowsiness.
• Constipation, feeling or actually
being sick.
• Itchy skin.
• Rash, redness, itching, inflammation
or swelling of the skin at the
application site.

Common (may affect up to 1 in 10
• 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.
• Tiredness, a feeling of unusual
weakness, muscle weakness,
swelling of hands, ankles or feet.
Uncommon (may affect up to 1 in 100
• Mood swings, restlessness,
agitation, a feeling of extreme
happiness, hallucinations,
• Changes in taste, difficulty in
speaking, reduced sensitivity to pain
or touch, tingling or numbness,
• Loss of memory, migraine, fainting,
problems with concentration or coordination.
• Dry eyes, blurred vision.
• A ringing or buzzing sound in the
ears, a feeling of dizziness or
• High or low blood pressure, chest
pain, fast or irregular heart beat.
• Cough, hiccups, wheezing.
• Wind.

Weight loss.
Dry skin.
Spasms, aches and pains.
Difficulty in beginning the flow of
• Inability to fully empty the bladder.
• An increase in accidental injuries
(e.g. falls).
• Withdrawal symptoms such as
agitation, anxiousness, sweating or
shaking upon stopping using Butec
If you need to have blood tests remind
your doctor that you are using Butec
patches. This is important because
Butec patches may change the way
your liver works and this could affect
the results of some blood tests.
Rare (may affect up to 1 in 1,000
• Angina (chest pain associated with
heart disease).
• Decreased sexual drive, mental
• Difficulties with balance.
• Swelling of the eyelids or face, a
reduction in size of the pupils in the
• Difficulty in breathing, worsening of
asthma, over breathing.
• A feeling of faintness, especially on
standing up.
• Difficulty in swallowing.

• Local allergic reaction with marked
signs of swelling (in such cases
treatment should be stopped).
• Swelling and irritation inside the
• Decreased erection, sexual
• A flu-like illness.
• Flushing of the skin.
• Dehydration.
Very rare (may affect up to 1 in
10,000 people)
• Muscle twitching.
• Ear pain.
• Blisters.
Not known (frequency cannot be
estimated from the available data)
• Seizures, fits or convulsions.
• Inflammation of the bowel wall.
Symptoms may include fever,
vomiting and stomach pain or
• Colicky abdominal pain or
• Feeling detached from oneself.
Reporting of side effects
If you get any side effects, talk to
your doctor, pharmacist or nurse. 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. By reporting
side effects you can help provide
more information on the safety of this
5. How to store Butec patches
Keep this medicine out of the sight and
reach of children.
Do not use Butec patches after the
expiry date which is stated on the carton
and on the pouch. The expiry date refers
to the last day of that month. After the
expiry date, take any unused patches to
a pharmacy.
Do not store Butec patches above 25°C.
Do not use the patch if the pouch seal is
Used patches must be folded over on
themselves with the adhesive layer
inwards, and discarded safely out of
sight and reach of children.
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

6. Contents of the pack and other
What Butec patches contain
The active ingredient is buprenorphine.
Each transdermal patch contains
15 mg of buprenorphine in a patch size
of 18.75 cm2 and releases about 15
micrograms of buprenorphine per hour
(over a period of 7 days).
The other ingredients are:
• Polyacrylate (Durotak 387-2051 &
• Levulinic acid
• Oleyl oleate
• Povidone
• Polyethyleneterephthalate
What Butec patches look like and
contents of the pack
A rectangular, beige coloured patch
with rounded corners marked Butec
15 μg/h
Butec patches are available in cartons
containing 4 pouches, each containing
a single patch.
Marketing Authorisation Holder
Qdem Pharmaceuticals Limited,
Cambridge Science Park,
Milton Road,
Cambridge CB4 0AB,

Bard Pharmaceuticals Limited,
Cambridge Science Park,
Milton Road,
Cambridge CB4 0GW,

Mundipharma DC B.V.,
Leusderend 16,
3832 RC Leusden,
The Netherlands.

This leaflet is also available in large print, Braille or as
an audio CD. To request a copy, please call the RNIB
Medicine Information line (free of charge) on:

0800 198 5000

You will need to give details of the product name and
reference number.
These are as follows:
Product name: Butec patches
Reference number: 40431/0027
This leaflet was last revised in July 2016
® BUTEC, QDEM and the ‘Qdem Pharmaceuticals’ logo are registered trade
© 2015 Qdem Pharmaceuticals Limited.
You can also get support and information about arthritis from Arthritis Care:
Phone free: 0808 800 4050 12pm to 4pm Monday to Friday (or 020 7380 6555
10am to 4pm standard call charges apply).
Or write to: Helplines, Arthritis Care,
18 Stephenson Way, London, NW1 2HD.
Or email

22/07/2016 10:51

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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.