Transdermal Buprenorphine (Transtec ® ) in Clinical Practice: An Introduction to Three Short Communications

Abstract

159 ISSN 1758-1869 10.2217/PMT.11.90 © 2012 Future Medicine Ltd Pain Manage. (2012) 2(2), 159–161 Data from the International Association on the Study of Pain (IASP) and the European Federation of the IASP Chapters indicate that moderate-to-severe chronic pain affects one in five people, and that one in three are unable, or less able, to maintain an independent lifestyle due to their pain. Approximately 50–60% of people with chronic pain are less able or unable to exercise, enjoy normal sleep, perform household chores, attend social activities, drive a car, walk or have sexual relations [101,102]. Moderateto-severe chronic pain can be associated with cancer or noncancer conditions (e.g., musculoskeletal, neuropathy and nociceptive pain). WHO advocates the following threestep ladder for the relief of cancer pain: step 1: nonopioids; step 2: weak opioids, as necessary; step 3: strong opioids, until adequate pain relief is achieved [103]. Buprenorphine, a centrally acting opioid analgesic, binds with high affinity to μ-opioid receptors (agonist) and to k-opioid receptors (antagonist) [1,2]. Historically, there were concerns relating to a possible analgesic ‘ceiling effect’ with buprenorphine but these concerns have since been disproved; on the other hand, buprenorphine displays a ceiling effect for respiratory depression, which is a positive safety characteristic [2]. Initially available in parenteral and sublingual formulations, a transdermal buprenorphine patch (Transtec, Grunenthal GmbH, Aachen, Germany) was introduced in 2001 [2]. Transtec is available in three dose strengths: 35, 52.5 and 70 μg/h, corresponding to buprenorphine 0.8, 1.2