Buprenorphine for Cats

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What is Buprenorphine?

Buprenorphine, sometimes referred to as “bupe”, is a powerful short-term pain relief medication. It is an opioid, which is a fast-acting narcotic, and works within 30 minutes after dosing and lasts about eight hours. Buprenorphine is a very powerful medication and it is available only by prescription through your vet.

Buprenorphine is known as its traditional brand names: Buprenex®, Simbadol®, Belbuca®, Vetergesic®, Buprenodale®, Sublocade®, Suboxone®, Subutex®, Temgesic®

What is an Opioid?

Opioids are drugs that, when reaching opioid receptors, have effects similar to those of morphine. Medically they are primarily used for pain relief. Opioids do not treat the source of pain or distress, they simply block receptors in the brain that send pain messages to the body.

Opioids are commonly used for premedication and perioperative analgesia. Morphine continues to be the standard opioids and is a safe, effective analgesic for most cats.

What is Buprenorphine Used for in Cats?

A cat who has suffered severe trauma or a large physical injury is a potential candidate for buprenorphine treatment. It is often prescribed following a serious injury or surgery. The drug is used to relieve pain and increase feelings of euphoria in cats after major surgeries. It is also at times proscribed for anxiety.

Buprenorphine for Post-Operative Pain in Cats

Buprenex is used for cats that have had recent surgery, to reduce their post-operative pain. In particular because it works slowly and lasts a long time. For example, it is used in adult cats for spaying and neutering surgeries as a pre- and post-operative means of pain control in the first place and relief in the second.

Buprenorphine For Chronic Pain In Cats

Because it is  a long acting drug, Buprenex is used in the management of ongoing severe pain in cats, caused by arthritis for example. But, like all opioids, it has the potential to create dependence.

Short-term use for postoperative cats shouldn’t create dependency issues however, but long-term administration for chronic pain could.

Withdrawal is one of the nastier side effects of opiates, even in cats, and vets will try and limit your cat’s exposure to prevent this from becoming a problem.

How is Buprenorphine Given?

Buprenorphine is administered by mouth in the form of a liquid. It should not be eaten, but rather it should be squirted into the side of the mouth into the cheek pouch or under the tongue so that it can be absorbed through the mouth.

Be sure to measure liquid doses very carefully, as this is a strong drug. It can also be given by injection in the hospital or clinic setting. You may be tasked to give injections of this medication to you cat, under the skin, at home.

This medication will take effect quickly, in about 30-60 minutes, and improvement in clinical signs should follow.

Are there any Side Effects to Buprenorphine?

The most common side effect is sleepiness. Injections into muscle may cause pain at the injection site. In cats, behavior changes, increased heart rate or body temperature, or vomiting is rare but can occur. Serious side effects are rare but can include severely decreased breathing rate. 

This short-acting medication should stop working within 8 hours, although effects can be longer, up to 24 hours or more,  in pets with liver or kidney disease.

Because the medication does not last very long in a cat’s system, buprenorphine is usually given two to three times a day for as many as five days. The reason for this is not due to its addictive qualities, but because it can have negative impact on a cat’s appetite and weight. There is no real standard yet for buprenorphine in cats because cats have such a variety of reactions to it. Side effects are generally mild, but can include appetite loss and slowed respiration.

Some cats can have allergic reactions to it, and it should never be taken in combination with other medications, including certain flea and tick preventatives.

Buprenorphine is thought to have a ceiling effect, this is when a medication has reached its maximal response. In this case, increasing the dose does not enhance the effectiveness.

Are there any Drug Interactions for Buprenorphine?

The following medications should be used with caution when given with buprenorphine:

  • local anesthetics
  • anticonvulsants
  • azole antifungals
  • benzodiazepines
  • cisapride
  • central nervous system depressant agents
  • cyclobenzaprine
  • desmopressin
  • erythromycin
  • fentanyl
  • halothane
  • metoclopramide
  • MAOIs (antidepressants)
  • naloxone
  • pancuronium
  • phenobarbital
  • rifampin
  • serotonergic agents
  • tramadol.

Be sure to tell your veterinarian about any other medications that your cat is taking, including vitamins, supplements, or herbal therapies.

What Monitoring Needs to be Done with Buprenorphine?

Depending on why your cats was prescribed buprenorphine, your veterinarian may monitor your pet to be sure that the medication is working properly. Monitor your pet for any severe adverse side effects mentioned above, especially heart function and breathing.

How Should Buprenorphine be Stored Properly?

Store at room temperature between 68°F and 77°F (20°C and 25°C ) and protected from light exposure. Excessive heat above 40°C (104°F), and freezing will destroy the usefulness of buprenorphine. Follow the storage directions on the label for compounded forms of this medication.

Buprenorphine Prices and Cost

According to drugs.com, Buprenex (a brand version of Buprenorphine) cost is about 90$ USD for an injectable solution (0.3 mg/mL) for a supply of 5 milliliters, depending on the pharmacy you visit.