Belbuca Dosage

Generic name: buprenorphine (oral/buccal)
Drug class: Narcotic analgesics

Medically reviewed by  A Ras MD.

Adult Dosing

Dosage forms:  BUC STRIP:

75 mcg, 150 mcg, 300 mcg, 450 mcg, 600 mcg, 750 mcg, 900 mcg

Special Note

[prescribing info]

Info: consider prescribing naloxone if risk of opioid overdose or accidental ingestion

Pain, severe chronic

[opioid-naive or opioid-nontolerant pts]

Dose: individualize dose buccally q12h; Start: 75 mcg buccally q12-24h for at least 4 days, then incr. to 150 mcg buccally q12h, then may incr. by no more than 150 mcg buccally q12h no more frequently than q4 days; Max: 900 mcg/12h; Info: use lowest effective dose, shortest effective tx duration; decr. start and titration dose 50% in pts w/ oral mucositis; titrate slowly in pts 65 yo and older; do not cut/chew/swallow strip; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use

[opioid-experienced pts, oral morphine equivalent <30 mg/day]

Dose: individualize dose buccally q12h; Start: 75 mcg buccally q12-24h, then may incr. by no more than 150 mcg buccally q12h no more frequently than q4 days; Max: 900 mcg/12h; Info: taper current opioids to 30 mg/day oral morphine equivalent or less prior to starting buprenorphine; use lowest effective dose, shortest effective tx duration; decr. start and titration dose 50% in pts w/ oral mucositis; titrate slowly in pts 65 yo and older; do not cut/chew/swallow strip; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use

[opioid-experienced pts, oral morphine equivalent 30-89 mg/day]

Dose: individualize dose buccally q12h; Start: 150 mcg buccally q12h, then may incr. by no more than 150 mcg buccally q12h no more frequently than q4 days; Max: 900 mcg/12h; Info: taper current opioids to 30 mg/day oral morphine equivalent or less prior to starting buprenorphine; use lowest effective dose, shortest effective tx duration; decr. start and titration dose 50% in pts w/ oral mucositis; titrate slowly in pts 65 yo and older; do not cut/chew/swallow strip; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use

[opioid-experienced pts, oral morphine equivalent 90-160 mg/day]

Dose: individualize dose buccally q12h; Start: 300 mcg buccally q12h, then may incr. by no more than 150 mcg buccally q12h no more frequently than q4 days; Max: 900 mcg/12h; Info: taper current opioids to 30 mg/day oral morphine equivalent or less prior to starting buprenorphine; use lowest effective dose, shortest effective tx duration; decr. start and titration dose 50% in pts w/ oral mucositis; titrate slowly in pts 65 yo and older; do not cut/chew/swallow strip; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use

Renal dosing

renal impairment: no adjustment

HD: no adjustment; no supplement; PD: not defined

Hepatic dosing

[adjust dose amount]

Child-Pugh Class C: decr. start and titration dose 50%