What Factors Affect Buprenorphine Dosage?

Buprenorphine is an opioid drug that has multiple uses in a clinical setting, including treating acute and chronic pain, as well as to treat opiate addiction. There are many factors that can influence buprenorphine dosage in patients, particularly what condition the drug is being used to treat. Other conditions such as liver problems, the use of other central nervous system depressants, and surgical anesthesia can also influence the dosage.

When buprenorphine is used to treat pain, the dosages used are generally much lower than those used to treat opiate addiction. For the treatment of acute, or sudden, pain, the standard buprenorphine dosage is 0.2 milligram (mg) if the drug is administered via sublingual tablet. This initial dosage may be increased if an individual has a tolerance to opioid medications, up to 1 mg.

Treating chronic pain can also utilize 0.2 mg tablets as a starting dose, but may also use a transdermal patch for a steady delivery of medication. Transdermal patches vary in strength, but deliver a buprenorphine dosage of 20 to 70 micrograms (ug) every hour for 48 hours. Higher initial dosages can depend on a person's body weight and opioid tolerance. Buprenorphine, unlike other opiates, does not seem to create the same growth of tolerance, but dosages may increase over time.

The highest dosages are usually used for the treatment of opiate addiction. When used for this purpose, there are sublingual tablets in doses of 2 mg and 8 mg. Starting doses for maintenance or taper therapies are usually around 8-12 mg. Some research has found that higher doses are more effective in ensuring that patients stay in the program, though, meaning that doctors may prescribe 12 to 24 mg per day.

Buprenorphine dosage levels for opiate addiction therapy are often influenced by factors like the dosage of drugs the patient was taking before they began therapy. Generally, the higher the level of opiates used before therapy, the higher the dosage of buprenorphine needed to control symptoms. This means that some patients may quickly work their way up to the maximum recommended dosage of 32 mg per day.

During taper therapies for opiate addiction, several factors can influence when dosages are lowered. A lower dose may be given after several weeks of therapy to minimize side effects and help wean the patient off of the drug. Should the patient begin to experience withdrawal symptoms or start to show noncompliance to therapy, the buprenorphine dosage may be stabilized.