Buprenorphine Transdermal Patch Duration
The buprenorphine transdermal patch lasts 7 days and should be changed weekly. 1, 2
Standard Dosing Schedule
The FDA-approved buprenorphine transdermal system (marketed as Butrans® in the US) is designed for once-weekly application, with each patch worn continuously for 7 days before replacement. 1
Steady-state plasma concentrations are reached within 48 hours of the first patch application, providing sustained analgesia throughout the entire 7-day wearing period. 1
The patch provides continuous delivery of buprenorphine at rates of 5,10, or 20 mcg/hour, maintaining relatively consistent plasma drug concentrations throughout the full dosing interval. 2
Evidence Supporting 7-Day Duration
Clinical pharmacokinetic studies demonstrate that three consecutive 7-day applications provide consistent and sustained delivery with no significant difference in minimum plasma concentrations (Cmin) across applications, confirming the appropriateness of the weekly schedule. 1
Analysis of patch adhesion confirmed that the 7-day application period is optimal, with patches maintaining adequate adherence throughout this timeframe. 1
The transdermal formulation exhibits flip-flop pharmacokinetics with a mean terminal half-life of 64.9 hours (range 39.1-85.7 hours), allowing for sustained drug delivery over the full week. 3
Extended Duration Considerations
A Phase III randomized crossover study evaluated extending patch wear from 3 days to 4 days in patients with chronic pain, finding comparable analgesic efficacy (93.9% adequate quality of treatment for both regimens) and similar tolerability. 4
However, this research examined extending individual patch duration in a different context (cancer pain management with higher-dose patches changed more frequently), not the standard weekly low-dose formulation approved in the US. 4
Clinical Application
For chronic pain management, apply one patch weekly to the upper outer arm, upper chest, upper back, or side of chest, rotating application sites with each new patch. 2, 5
The patch is indicated for moderate chronic pain requiring continuous around-the-clock analgesia for an extended period. 1
Patient adherence to the 7-day schedule is typically very high in real-world practice, with most patients using the patch in accordance with treatment recommendations. 5