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Drug - Butrans  (buprenorphine) transdermal patches [Purdue]

March 2011

Strengths - 5 mcg/hour, 10 mcg/ hour, 20 mcg/hour

FDA approved indication

Butrans (buprenorphine) is indicated for the management of moderate to severe chronic pain in patients requiring a continuous, around-the-clock opioid analgesic for an extended period of time.

Butrans is a transdermal system (patch) providing systemic delivery of buprenorphine continuously for 7 days.


  • Patient has chronic pain requiring opiate therapy
  • The patient has been tried on sustained release morphine but experienced intolerable adverse events. Ineffectiveness of morphine to control pain is not a criteria for approval

Quantity Limits Apply: Only 4 patches per fill and only one strength allowed per patient. The maximum dose of Butrans per label is 20 mcg/hour per label.  Butrans 15 mcg/ hour (one 5 mcg/hour [patch and one 10 mcg/hour patch) will not be approved.

Exclusion criteria

Payment for Butrans will be denied in the following situations:
  • Butrans is add-on therapy to another long acting opioid. If patient is being transitioned from one opioid to Butrans, then a discontinuation plan of the first opiod must be provided
  • Patient’s current long acting ± short acting opioid dose is >80 mg morphine equivalents per day
  • Patient’s current opiate is fentanyl patch strengths ≥50 mcg/hour

Approximate opioid equivalents to oral morphine

Total mg per day

Morphine 80 mg/day
Codeine 250 mg/day
Hydrocodone 40 mg/day
Hydromorphone 10 mg/day
Meperidine 400 mg/day
Methadone 30 mg/day
Oxycodone (OxyContin) 40 mg/day
Pentazocine 240 mg/day
Tramadol 800 mg/day


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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