If you have certain conditions, you may be interested in learning more about buprenorphine. It’s a generic prescription drug that comes as an extended-release patch* and a sublingual tablet (a tablet that dissolves under your tongue). These forms have different uses.
- Opioid use disorder. Buprenorphine tablets are used to treat opioid use disorder (previously known as opioid dependence) in adults. It’s used as part of a treatment program that usually includes counseling and social support.
- Severe pain. Buprenorphine patch is used to treat severe, ongoing pain in adults and some children. It’s only used for pain that needs treatment with an opioid, and it’s only used if other pain relievers haven’t worked.
Buprenorphine also comes in injectable forms, but those are not covered in this article.
Buprenorphine may be used as a short-term or long-term treatment.
This article describes buprenorphine’s side effects (also called adverse effects). For more information about buprenorphine, including details about its uses, see this in-depth article.
* An extended-release patch releases the medication into your body slowly over a period of time.
These are just a few of the more common side effects reported by people who used buprenorphine tablets or patches in studies. These side effects can vary depending on the condition the drug is being used to treat.
More common side effects in people taking buprenorphine tablets for opioid use disorder include:
- headache
- insomnia (trouble sleeping)
- nausea and vomiting*
- sweating
- burning sensation or numbness in the mouth
More common side effects in people using the buprenorphine patch for severe pain include:
- nausea and vomiting*
- dizziness
- sleepiness
- headache
- itching at the patch application site
* To learn more about this side effect, see the “Side effects explained” section below.
Examples of mild side effects that have been reported with buprenorphine include:
- nausea and vomiting*
- constipation*
- dizziness
- sleepiness
- insomnia (trouble sleeping)
- weakness
- sweating
- headache
- dry mouth
- itching
- swollen feet, ankles, or hands
- burning sensation or numbness in the mouth (if taking the tablets)
- itching, rash, or irritation at the patch application site
- mild allergic reaction*
* To learn more about this side effect, see the “Side effects explained” section below.
In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using buprenorphine unless your doctor recommends it.
Serious side effects that have been reported with buprenorphine include:
- very low blood pressure
- adrenal insufficiency (adrenal glands don’t produce enough hormones)
- liver problems, such as hepatitis (liver inflammation)
- severe skin reactions (if using the patch)
- severe allergic reaction*
boxed warnings :- risk of respiratory depression†
- risk of accidental overdose†
- risks when used with central nervous system (CNS) depressant drugs†
- risk of addiction and misuse (see “Buprenorphine and misuse” below)
- risk of neonatal opioid withdrawal syndrome (NOWS) (see “Pregnancy and breastfeeding while using buprenorphine” under “Buprenorphine warnings” below)
If you develop serious side effects while taking buprenorphine, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
* To learn more about this side effect, see the “Side effects explained” section below.
† To learn more, see “Boxed warnings” under the “Side effects explained” section below.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with buprenorphine, visit MedWatch.
Get answers to some frequently asked questions about buprenorphine’s side effects.
Will I have withdrawal symptoms if I stop using buprenorphine?
It’s possible. Stopping buprenorphine treatment suddenly may cause withdrawal symptoms (side effects that can occur if you suddenly stop taking a drug that your body has become dependent on).
It’s possible to become dependent on buprenorphine, whether you take it for pain or for opioid use disorder. You’re more likely to become dependent on buprenorphine if you take it for long periods of time, or if you misuse* it.
Withdrawal symptoms that can occur if you suddenly stop taking buprenorphine include:
- watery eyes
- runny nose
- shaking
- sweating
- muscle aches
- diarrhea
- restlessness
- irritability
- insomnia (trouble sleeping)
- cravings for buprenorphine
Withdrawal symptoms caused by stopping buprenorphine tablets are usually not as severe when compared to stopping other opioids.
To help prevent withdrawal symptoms when stopping buprenorphine, your doctor will likely lower your dosage gradually. But if you’re still concerned about withdrawal symptoms, talk with your doctor.
* The buprenorphine patch has a
Does buprenorphine cause any long-term side effects?
It’s possible, although long-term side effects are not common. Most of buprenorphine’s side effects go away quickly, either as you continue taking it or soon after you stop treatment.
But if buprenorphine causes problems with your adrenal glands or liver, these may be long-term problems that continue after you end your treatment. Taking buprenorphine for long periods of time may raise your risk for these side effects.
Taking buprenorphine long term also raises your risk of dependence on the drug. (Keep in mind that physical dependence is different than drug addiction.)
If you’re concerned about long-term side effects with buprenorphine, talk with your doctor.
Does the risk of side effects with buprenorphine tablets depend on the strength (2 mg or 8 mg)?
It might. As with many drugs, higher doses of buprenorphine are more likely to cause side effects than lower doses. So you may be more likely to have side effects with an 8-milligram (mg) dose than a 2-mg dose.
But keep in mind that many factors can affect your risk of side effects with buprenorphine. These include health conditions you may have and other drugs you take.
If you’re concerned about your risk of side effects with the buprenorphine dose you’re prescribed, talk with your doctor.
Learn more about some of the side effects buprenorphine may cause.
Boxed warnings
The buprenorphine patch has several
The buprenorphine tablet can also cause these side effects, but it doesn’t have boxed warnings. That’s because these risks are lower with the tablet formulation compared to patches. Certain risks are also lower with buprenorphine tablets compared with the patches because the tablets treat opioid use disorder and not severe pain.
Risk of respiratory depression
Buprenorphine patches have a boxed warning for the risk of respiratory depression. With respiratory depression, your breathing becomes slow, shallow, and weak. Your breathing may even stop completely, which can be fatal.
You’re more likely to have respiratory depression if you use a higher dose of buprenorphine than your doctor prescribes or if you misuse* this drug. (Misuse means taking the drug in a way that’s not prescribed.)
You may also have a higher risk of respiratory depression if you have lung or breathing problems. Examples include chronic obstructive pulmonary disease (COPD), asthma, and sleep apnea.
Using certain other drugs with buprenorphine can also raise your risk of respiratory depression. To learn more, see “Risks when used with central nervous system (CNS) depressant drugs” below.
* Buprenorphine patches have a boxed warning for the risk of misuse. For more information, see the “Buprenorphine and misuse” section below.
What might help
To help prevent respiratory depression with buprenorphine, you should only use it as prescribed by your doctor. If your breathing becomes slow, shallow, or weak while taking this drug, get emergency medical help right away.
Also, talk with your doctor about keeping a supply of naloxone (Narcan) on hand during your buprenorphine treatment. Narcan is a nasal spray that can be used in an emergency to block the effects of opioids. It can temporarily treat respiratory depression caused by buprenorphine. But you’ll still need to get emergency medical help after using Narcan.
If you have questions about using Narcan, talk with your doctor or pharmacist.
Risk of accidental overdose
Buprenorphine patches have a boxed warning for the risk of accidental overdose. If someone (especially a child) is accidentally exposed to buprenorphine patches or accidentally ingests buprenorphine tablets, this can cause overdose. In some cases, overdose can lead to a coma or can be fatal.
Buprenorphine overdose symptoms can include:
- respiratory depression (to learn more, see section directly above)
- extreme sleepiness
- loss of consciousness
- muscle weakness
- cold, clammy skin
- pinpoint pupils
- dizziness or fainting
What might help
It’s important to keep buprenorphine in a safe place to help prevent someone from being exposed to it by accident. It’s especially important to keep this drug out of the sight and reach of children.
You should talk with your doctor about keeping a supply of naloxone (Narcan) while you’re using buprenorphine. Narcan is a nasal spray that can be used in an emergency to help treat an opioid overdose.
If someone has symptoms of a buprenorphine overdose, call 911 or your local emergency number right away. You should call 911 even if you’ve administered Narcan. The person may need further treatment after Narcan wears off.
Risks when used with central nervous system (CNS) depressant drugs
Buprenorphine patches have a boxed warning for risks when used with other CNS depressant drugs.
CNS depressants are drugs that slow the activity in your brain and spinal cord. Examples include:
- alcohol
- other opioids (buprenorphine is an opioid), such as hydrocodone (Hysingla ER)
- benzodiazepines, such as alprazolam (Xanax)
- sleeping pills, such as zolpidem (Ambien)
- muscle relaxants, such as tizanidine (Zanaflex)
Taking buprenorphine with other CNS depressants can raise your risk of respiratory depression or buprenorphine overdose, and it can even be fatal.
What might help
Before taking buprenorphine, tell your doctor about any other drugs you take. This includes prescription drugs, over-the-counter drugs, and illegal drugs. And while you’re taking buprenorphine, be sure to check with your doctor or pharmacist before taking any new medications.
Using buprenorphine with another CNS depressant raises your risk for buprenorphine overdose. Talk with your doctor about keeping a supply of naloxone (Narcan) on hand while you’re using buprenorphine. Narcan is a nasal spray that can be used in an emergency to help treat an opioid overdose, including a buprenorphine overdose.
Constipation
Constipation can occur while taking buprenorphine. In studies, constipation was commonly reported in studies of the buprenorphine tablet and patch.
Constipation from buprenorphine is usually mild. But if it doesn’t go away or isn’t treated, it could lead to a blockage in your bowel.
What might help
If you have constipation with buprenorphine, you can try:
- eating high fiber foods, such as fruit, vegetables, and wholegrains
- drinking plenty of water
- getting regular exercise
If these measures don’t relieve your constipation, talk with your doctor or pharmacist. They may recommend taking a laxative. Examples of these medications include:
- stool softeners, such as docusate sodium
- stimulant laxatives, such as senna
- bulk-forming laxatives, such as methylcellulose
Liver problems
It’s possible to develop liver problems with buprenorphine. But in studies of the buprenorphine tablet and patch, this side effect wasn’t common.
Liver problems that have been reported with buprenorphine include elevated liver enzymes, hepatitis (liver inflammation), and liver failure.
Symptoms of liver problems may include:
- nausea and vomiting
- belly pain
- pale stools
- bruising easily
- jaundice (yellowing of the skin or whites of the eyes)
What might help
Your doctor will likely order blood tests to check your liver while you’re taking buprenorphine.
If you have symptoms of liver problems while you’re taking this drug, talk with your doctor.
Nausea and vomiting
Some people may experience nausea and vomiting while taking buprenorphine. In studies, nausea and vomiting were commonly reported with the buprenorphine tablet and buprenorphine patch.
Note that nausea and vomiting may also be symptoms of more serious side effects buprenorphine may cause, including liver problems (see above). However, there are also many other possible contributing factors to nausea and vomiting that aren’t related to buprenorphine.
What might help
If you have nausea and vomiting with buprenorphine, it may help to:
- get plenty of fresh air
- frequently sip cold drinks
- instead of large main meals, eat small amounts more often
- drink ginger or peppermint tea
If your symptoms are severe or bothersome, talk with your doctor. They may recommend treatment to ease your symptoms.
Allergic reaction
Like most drugs, buprenorphine can cause an allergic reaction in some people.
Symptoms can be mild to serious and can include:
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:
- an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
- a product you apply to your skin, such as hydrocortisone cream
If your doctor confirms you’ve had a mild allergic reaction to buprenorphine, they’ll decide whether you should continue using it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to buprenorphine, they may have you switch to a different treatment.
Keeping track of side effectsDuring your buprenorphine treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were taking when you had the side effect
- how soon you had the side effect after starting that dose
- what your symptoms were
- how it affected your daily activities
- what other medications you were taking
- any other information you feel is important
Keeping notes and sharing them with your doctor will help them learn more about how buprenorphine affects you. They can then use this information to adjust your treatment plan if needed.
There are several warnings to consider when deciding if buprenorphine is right for you. These include boxed warnings.
Boxed warnings
The buprenorphine patch has several
Risk of addiction and misuse. Buprenorphine patches have a risk of misuse and addiction. (With misuse, a drug is used in a way that’s not prescribed. With addiction, you feel unable to stop using a drug, even if it’s causing harm.) To learn more, see the “Buprenorphine and misuse” section below.
Risk of respiratory depression. Buprenorphine can cause respiratory depression (slow, shallow breathing) that can be life threatening. To learn more, see the “Side effects explained” section above.
Risk of accidental overdose. Being accidentally exposed to a buprenorphine patch or tablets can lead to overdose and can even be fatal, especially in children. To learn more, see the “Side effects explained” section above.
Risk of neonatal opioid withdrawal syndrome (NOWS). If used during pregnancy, buprenorphine can cause side effects in a newborn. To learn more, see the “Pregnancy and breastfeeding while using buprenorphine” section below.
Risks when used with central nervous system (CNS) depressant drugs. CNS depressants slow activity in your brain and spinal cord. Buprenorphine is a CNS depressant. Using it with other CNS depressants raises the risk of serious side effects. To learn more, see the “Side effects explained” section above.
The buprenorphine tablet can also cause these side effects, but it doesn’t have boxed warnings. That’s because these risks are lower when the drug is used for opioid use disorder, which is the condition the buprenorphine tablet treats.
Other warnings
Buprenorphine may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether buprenorphine is the right treatment option for you.
Talk with your doctor about your health history before starting buprenorphine. Factors to consider include those described below.
Allergic reaction. If you’ve had an allergic reaction to buprenorphine or any of its ingredients, your doctor will likely not prescribe it. Ask them what other medications are better options for you.
Heart conditions. If you have certain heart conditions, taking buprenorphine may raise your risk of abnormal heart rhythm. If you have a heart condition, such as heart failure or a slow or irregular heartbeat, ask your doctor if buprenorphine is safe for you.
Lung or breathing problems. The buprenorphine patch has a boxed warning for respiratory depression (slow, shallow breathing), although the tablets can also cause this side effect. You may have a higher risk of this side effect if you have lung or breathing problems. Examples include chronic obstructive pulmonary disease (COPD), asthma, and sleep apnea. If you have lung or breathing problems, talk with your doctor about whether buprenorphine is right for you.
Adrenal gland problems, such as Addison’s disease. Buprenorphine can cause adrenal insufficiency. If you already have adrenal gland problems, buprenorphine could worsen your condition. Talk with your doctor about whether buprenorphine is right for you.
Liver problems. If you have liver problems, buprenorphine could worsen your condition. Levels of the drug could also build up in your body, which could raise your risk of side effects. If you have liver problems, ask your doctor if buprenorphine is safe for you. If you do use buprenorphine, your doctor may prescribe a lower dose.
Digestive problems. Buprenorphine can cause constipation. If you already have certain digestive problems, using buprenorphine could worsen them. If you have a blockage in your digestive system, your doctor will likely not prescribe buprenorphine. If you have a digestive problem, talk with your doctor about whether this drug is right for you.
Head injury or brain tumor. Buprenorphine can increase the pressure inside your skull if you’ve have a head injury or brain tumor before. Buprenorphine may also have effects that make it harder for your doctor to monitor your condition. If you have a head injury or brain tumor or have had one in the past, talk with your doctor about whether buprenorphine is right for you.
Older age or being very frail or weak. If you’re age 65 years or older, or you’re very frail or weak, you may have a higher risk of side effects with buprenorphine. If these factors apply to you, talk with your doctor about whether buprenorphine is safe for you.
If you do use buprenorphine, your doctor may prescribe a lower dose. And they may want to monitor you more closely during your treatment.
Driving and buprenorphine
It may not be safe to drive or operate machinery while using buprenorphine. The medication can cause certain side effects that could reduce your ability to drive or operate machinery safely. These side effects include sleepiness, dizziness, and slowed reaction times.
You should not drive until you know how buprenorphine affects you and you’re sure you can drive safely.
Alcohol and buprenorphine
If you drink alcohol, you should not drink it during your buprenorphine treatment. Drinking alcohol with this drug can raise your risk of serious side effects. These include:
- respiratory depression* (slow, shallow, weak breathing)
- extreme sleepiness
- loss of consciousness
- liver problems
Drinking alcohol with buprenorphine can also raise your risk of overdose, coma, and death.
If you’re concerned about avoiding alcohol with buprenorphine, talk with your doctor.
* The buprenorphine patch has a
Pregnancy and breastfeeding while using buprenorphine
See below for details about buprenorphine’s use while pregnant or breastfeeding.
Pregnancy
It’s not known if buprenorphine is safe to use during pregnancy. The buprenorphine patch has a
Using buprenorphine for a long time during pregnancy can cause NOWS. This means that the newborn may have opioid withdrawal symptoms after birth. These symptoms include:
- high-pitched crying
- crying for long periods
- trouble sleeping
- shaking
- diarrhea
- vomiting
- irritability
- trouble gaining weight
NOWS can be life threatening, and babies with this condition need treatment in the hospital.
If you’re pregnant or planning to become pregnant, talk with your doctor about the risks and benefits of buprenorphine.
Breastfeeding
Buprenorphine can pass into breast milk in small amounts. Breastfeeding isn’t usually recommended if you’re using the buprenorphine patch. But it might be safe if you’re taking buprenorphine tablets. If you’re breastfeeding or planning to, talk with your doctor about whether it’s safe to use buprenorphine.
If you do breastfeed while using buprenorphine, you should monitor your child closely for side effects. If your child is unusually sleepy, having trouble feeding, or doesn’t gain weight as expected, talk with your doctor. But if they have slow, shallow breathing or can’t be woken, call 911 right away.
The buprenorphine patch has a
The buprenorphine tablet also has a risk of misuse and addiction, but it doesn’t have a boxed warning. That’s because these risks are lower when the drug is used for opioid use disorder, which is the condition the buprenorphine tablet treats.
With misuse, a drug is used in a way that’s not prescribed. Misuse of buprenorphine can cause serious side effects, overdose, or even be fatal.
Misuse of buprenorphine can lead to addiction. (With addiction, you feel unable to stop using a drug, even if it’s causing harm.) But it’s important to note that addiction can occur even when buprenorphine is used as prescribed.
Your doctor will assess your risk for misuse and addiction with buprenorphine before prescribing this drug.
If you have any questions about side effects that buprenorphine can cause, talk with your doctor. You can also ask them about Butrans and Belbuca, which are the brand-name versions of the buprenorphine patch and tablet.
A generic drug and its brand-name version are expected to have the same side effects because they contain the same active ingredient. (An active ingredient is what makes a drug work.)
Examples of questions you may want to ask your doctor include:
- Do I have a high risk of becoming dependent on buprenorphine?
- Is it safe to take buprenorphine with my other medications?
- Is my risk of side effects higher when I first start treatment?
To learn more about buprenorphine, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.