Analgesia for Moderate Chronic Non-Cancer Pain : Low Dose Transdermal Buprenorphine A Novel Option in Mexico
Joseph V. Pergolizzi1,2,3*, Robert B. Raffa4, Miguel Angel Ruiz Ibán5, Gianpietro Zampogna6, Robert Taylor6
Affiliation
- 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- 2Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA
- 3Association of Chronic Pain Patients, Houston, TX
- 4Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA
- 5Shoulder and Elbow Unit. Hospital Universitario Ramóny Cajal, Madrid, Spain
- 6NEMA Research, Bonita Springs, FL
Corresponding Author
Joseph V. Pergolizzi, MD, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, E-mail: drpergo@gmail.com
Citation
Pergolizzi, J., et al. Analgesia for Moderate Chronic Non-Cancer Pain: Low Dose Transdermal Buprenorphine a Novel Option in Mexico. (2016) J Anesth Surg 3(1): 96- 101.
Copy rights
© 2016 Pergolizzi, J. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License
Keywords
Abstract
Chronic non-cancer pain is prevalent in Mexico and its pharmacologic treatment requires clinicians to balance the risks and benefits of various analgesic agents. NSAIDs and paracetamol (acetaminophen) can be effective for mild to moderate pain, but safety considerations place limitations on their use. Opioids are safe and effective, but have opioid-associated side effects plus the potential for abuse. Against this background, it is important to appraise other options with regard to favorable efficacy and safety – such aslow-dose transdermal buprenorphine. Buprenorphine, both in transdermal and oral formulations, has been available in Mexico for a number of years yet just recently a Low-Dose Transdermal Patch formulation has been available for the management chronic non-cancer pain of moderate intensity in adults. Buprenorphine is an opioid agent with a unique pharmacological profile, such that it has a ceiling effect for respiratory depression, but no ceiling effect for analgesia. It can be used without dose adjustment in the elderly and in patients with impaired kidney function (unique among opioids). Its small lipophilic molecule makes it well suited to transdermal formulations, which offer steadystate round-the-clock analgesia after three days with clinical convenience and easier patient compliance. Buprenorphine is an effective analgesic in chronic non-cancer pain patients, and its good tolerability and lower abuse potential may make lowdose transdermal buprenorphine appropriate for a broad range of patients.
