Norspan

Generic Name: Buprenorphine
Product Name: Norspan

• Indication of Norspan
• Action of Norspan
• Dose advice of Norspan
• Schedule of Norspan
• Common side effects of Norspan
• Uncommon side effects of Norspan

Indication of Norspan:

Norspan is used in the management of moderate to severe pain which is not relieved by other analgesics.

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Action of Norspan:

Buprenorphine stimulates the mu-opioid receptor which exerts primary analgesic effects. It also blocks the activity of kappa-opioid receptor. The opioid agonist activities of buprenorphine are dose related. This means that above a certain dose there is no further analgesic effect. Each Norspan Transdermal Patch delivers buprenorphine over a period of seven days. Steady state is achieved by day 3 following the first application.

After removal of the Norspan Transdermal Patch, approximately 50% buprenorphine concentration remains after 12 to 24 hours. Following Norspan Transdermal Patch application, buprenorphine diffuses from the patch through the skin. Buprenorphine has only approximately 15% bioavailability as compared to intravenous administration and is highly protein bound. Buprenorphine metabolism in the skin following Norspan Transdermal Patch application is negligible. Buprenorphine is eliminated via hepatic metabolism, with subsequent biliary excretion and renal excretion of soluble metabolites. Buprenorphine is also eliminated in the faeces within seven days.

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Dose advice of Norspan:

Recommended dosage

Norspan is used transdermally over a period of 7 days. Initial starting dose for Norspan is 5 micrograms per hour in adults who have no previous experience with opioids. Higher strength patch may be used to achieve desired effects of pain relief if you have used Norspan Transdermal patch or other opioid analgesics before.

Precautions

Use of Norspan patches is not recommended if you are under 18 years of age due to lack of clinical safety and efficacy data.

Use of Norspan Transdermal Patch should be avoided in breastfeeding women and during Pregnancy (Category C) unless the benefits outweigh its associated risks.

You should not drive or operate machineries while using Norspan Transdermal Patch until you know how it affects you.

Method of application

1. Norspan Transdermal Patch should be applied to dry, non hairy and non irritated skin of the upper outer arm, upper chest, upper back or the side of the chest.
2. The application site should only be cleaned with water if necessary. Soaps, alcohol, oils, lotions or abrasive devices should not be used.
3. Norspan Transdermal Patch should be applied immediately after removal from the sealed pouch packaging. The transdermal patch should be pressed firmly for approximately 30 seconds after application. This is to ensure that the contact is complete, especially around the edges. Bathing, showering or swimming should not affect the adhesives. New patch should be used if the patch falls off.
4. Application site should be rotated. Re-application of patch at the same site may result in skin irritation and increase in the absorption rate. Norspan Transdermal Patch should not be applied to the same site for more than 3 to 4 weeks.
5. No more than 2 patches should be applied at the same time, regardless of strength.
6. New patch should be applied if the patch falls off. While wearing the Norspan Transdermal Patch, you should avoid exposure to external heat sources such as heating pads, electric blankets, heat lamps, saunas, hot tubs and heated water beds. To dispose the used patches, the adhesive sides should be brought together and disposed safely.
    

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Schedule of Norspan:

Schedule 8

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Common side effects of Norspan:

Norspan Transdermal Patch produces typical opioid side effects which include:

• Dry mouth, nausea and vomiting
• Constipation,
• Headache
• Pruritus
• Rash at site of injection
• Dizziness and confusion.

These adverse effects are very common (>10%). In general, buprenorphine is well tolerated.

Other common (1% - 10%) adverse effects are:

• Anorexia
• Dyspepsia
• Vasodilation
• Peripheral oedema
• Respiratory depression and taste perversion.

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Uncommon side effects of Norspan:

The following side effects associated with Norspan Transdermal Patch are rather infrequent. Their occurrence are rare, i.e. less than 1%. However, if you experience any of the following side effects, you should seek medical advice immediately.

• Gastrointestinal disorders including diverticulitis, dysphagia, ileus and biliary colic
• Hallucinations
• Syncope
• Psychotic disorder
• Cardiovascular side effects such as tachycardia, flushing, hypertension, angina pectoris and palpitations
• Urinary retention and sexual dysfunction
• Tinnitus, blurred vision and vertigo

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Reference:

1. Australian Medicines Handbook, Adelaide, Pharmaceutical Society of Australia, 2007.
2. MIMS Online [online]. 2003 [cited 2007 August 30]. Available from: URL: http://mims.hcn.net.au

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Article Dates:

Modified: 3/9/2010

Created: 9/11/2007