Buprenorphine in the management of persistent pain – update review

Buprenorphine is a strong opioid that is used more and more widely in cancer and non-cancer pain treatment. The aim of this paper is the critical review of the experimental and clinical data as to possibly in objective way present specific pharmacokinetic and pharmacodynamic features of the medicine as well as to refer to the evidence of clinical effectiveness and safety. It has been discussed in details concomitant usage of buprenorphine with other opioids, opioid rotation to buprenorphine, safety profile and usage in persistent pain. The attention has been paid on favorable pharmacokinetics of the drug that allows for transdermal application, especially in elderly patients, with hepatic or renal impairment. The released guidelines and statements have been referred to and the current tendencies on buprenorphine therapy in end-stage patients have been detailed. Based on the collected data, it may be set that favorable pharmacokinetic and pharmacodynamic features, together with the comfortable application of patches, often preferred by the ill, make buprenorphine a valuable element of the strategy of pain management in palliative-care patients.