Buprenorphine

(Date: May 2023. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

Quick read

Buprenorphine might occasionally be prescribed in pregnancy to treat severe pain if other drugs have not worked.

Buprenorphine might also be used as part of a supervised programme to help people who are trying to come off recreational opioid drugs.

What is it?

Buprenorphine (Bunov®, Bupeaze®, Bupramyl®, Butec®, BuTrans®, Buvidal®, Carlosafine®, Espranor®, Hapoctasin®, Natzon®, Panitaz®, Prefibin®, Rebrikel®, Reletrans®, Relevtec®, Sevodyne®, Subutex®, Sixmo®, Transtec®, Temgesic®, Tephine®) is used to treat severe, long-term pain. It might also be given as part of an anaesthetic during surgery. It is also used in some supervised drug withdrawal programmes to help people stop recreational use of other opioid drugs.

What are the benefits of taking buprenorphine in pregnancy?

Buprenorphine is a strong painkiller and might control severe pain where other painkillers have not.

Using buprenorphine in a supervised drug withdrawal programme is likely to be safer than using recreational drugs that might be mixed with different substances and are also of unknown strength.

Are there any risks of taking buprenorphine during pregnancy?

The available information does not suggest buprenorphine affects the baby’s development, although more research is required to fully rule out problems.

Buprenorphine used around the time of delivery can affect the baby after birth. The baby may be ‘jittery’, have feeding problems, and initially need some help with breathing. These problems usually settle within the first few days.

Pregnant women who take buprenorphine should contact their GP or specialist as soon as possible. Their doctor will review whether buprenorphine is still needed and ensure that the dose is correct. Pregnant women should not stop taking buprenorphine or change the dose without speaking to their doctor.

Are there any alternatives to taking buprenorphine?

Possibly. Other medicines can be used to treat pain and to help with opioid dependence in pregnancy. However, if a doctor has offered buprenorphine, this will be based on several factors, including which medications have already been tried, the likelihood of a medical condition not being as well-controlled with another drug, and possible side effects if the medicine is changed. Women who have any questions about a medicine that they are offered in pregnancy should speak to their doctor or midwife.

What if I prefer not to take medicines during pregnancy?

Severe pain can greatly affect quality of life. It can cause difficulty sleeping and mental health problems. Use of recreational drugs can be dangerous to both the woman and her baby. Doctors may suggest use of buprenorphine in pregnancy if they think that the benefits outweigh any possible risks to the baby.

Will my baby need extra monitoring?

Women in the UK will be offered a very detailed scan at around 20 weeks of pregnancy as part of routine antenatal care. Taking buprenorphine in pregnancy is not expected to cause problems that would require any extra monitoring of a baby prior to birth.

Babies who were exposed to buprenorphine in the womb before delivery will be more closely monitored for a while after birth to ensure that they are breathing and feeding as normal.

Are there any risks to my baby if the father has taken buprenorphine?

We would not expect any increased risk to your baby if the father takes buprenorphine.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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