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Chronic severe pain Clinical criteria: Treatment Phase: Initial PBS treatment after 1 June 2020 where patient has been treated with opioids for less than 12 months The condition must require daily, continuous, long term opioid treatment, AND Patient must have cancer pain; OR Patient must have had or would have inadequate pain management with maximum tolerated doses of non-opioid or other opioid analgesics; OR Patient must be unable to use non-opioid or other opioid analgesics due to contraindications or intolerance. Authorities for increased maximum quantities and/or repeats under this restriction must only be considered for chronic severe disabling pain where the total duration of non-PBS and PBS opioid analgesic treatment is less than 12 months. Authority requests extending treatment duration up to 1 month may be requested through the Online PBS Authorities system or by calling Services Australia. Authority requests extending treatment duration beyond 1 month may be requested through the Online PBS Authorities system or in writing and must not provide a treatment duration exceeding 3 months (quantity sufficient for up to 1 month treatment and sufficient repeats).
“Buprenorphine is a high- affinity partial agonist at the human μ (mu) opioid receptor and is a high - affinity antagonist at the δ (delta) and κ (kappa) opioid receptors, as well as being a moderate - affinity partial agonist for nociception opioid receptors.”
“The rate of release of buprenorphine from Buvidal Weekly controls its elimination with a terminal half-life in plasma ranging from 3 to 5 days.”
Working under the parallel aged-care framework? Aged-care equivalent →
Severe disabling pain Clinical criteria: Patient must have had or would have inadequate pain management with maximum tolerated doses of non-opioid or other opioid analgesics; OR Patient must be unable to use non-opioid or other opioid analgesics due to contraindications or intolerance. Treatment criteria: Patient must be undergoing palliative care. Authority requests for treatment duration up to 1 month may be requested through the Online PBS Authorities system or by calling Services Australia. Authority requests extending treatment duration beyond 1 month may be requested through the Online PBS Authorities system or in writing and must not provide a treatment duration exceeding 3 months (quantity sufficient for up to 1 month treatment and sufficient repeats).
Opioid dependence Clinical criteria: Treatment criteria: Must be treated by a health care professional. The treatment must be within a framework of medical, social and psychological treatment. The prescriber must not request the maximum listed quantity or number of repeats if lesser quantity or repeats are sufficient for the patient's needs.
Curated subset. The full adverse-effect list is in the TGA Product Information; click any citation above to open it.
“Buprenorphine is metabolised by N-dealkylation to norbuprenorphine via cytochrome P450 CYP3A4 and both parent molecule and metabolite then undergo glucuronidation.”