Vol 10, No 3 (2016)
Review paper
Published online: 2017-03-13
Buprenorphine - opioid with unique properties
Medycyna Paliatywna w Praktyce 2016;10(3):77-88.
Abstract
Opioid analgesics are the basis for the treatment of moderate and severe pain, regardless of its etiology. Opioids used in clinical practice differ significantly in terms of pharmacological properties.The differences allowto adjust individual medicine, what increases both the effectiveness and the safety of treatment. Buprenorphine is an opioid analgesic with special properties that are still not fully understood. The medicine is widely used to treat both acute and chronic pain, both in non-cancer pain and cancer patients, also as a substitution therapy for drug addicts. A unique, different from other opioids, pharmacological and clinical profile of buprenorphine has been demonstrated in numerous experimental and clinical studies, conducted in various chronic pain syndromes. The most important clinical aspects relate to the safety profile of buprenorphine and include ceiling effect for respiratory depression, low risk of constipation, less effect on the CNS in comparison to other strong opioids, little or no immunosuppressive effect, inhibition of hyperalgesia, no accumulation in renal impairment, and minimal risk of drug-drug interactions. These aspects make buprenorphine valuable therapeutic option in chronic pain treatment. In the paper the authors discuss the most relevant aspects for clinician: pharmacodynamics, pharmacokinetics, safety profile of buprenorphine and its effectiveness in the variety of chronic pain syndromes and in other chronic diseases.
Keywords: buprenorphinechronic painpharmacotherapyopioids
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