(2S)-2-[(-)-(5R,6R,7R,14S)-9α-cyclopropylmethyl-4,5-epoxy-6,14-ethano-3-hydroxy-6-methoxymorphinan-7-yl]-3,3-dimethylbutan-2-ol

Absorption
C max is approximately 5.47 ng/mL (16 mg SL dose). AUC is approximately 32.63 h•ng/mL (16 mg SL dose).

Distribution
Approximately 96% protein bound.

Metabolism
Undergoes CYP3A4-mediated N-dealkylation to norbuprenorphine (active) and glucuronidation.

Elimination
30% is excreted in the urine and 69% in the feces. The t ½ is 37 h.

Onset
15 min (IM).

Peak
1 h (IM).

Duration
At least 6 h (IM).

Barbiturate anesthetics
May have additive effects with buprenorphine, increasing the respiratory and CNS effects.

Benzodiazepines (eg, diazepam)
Coma and death have been associated with misuse of buprenorphine and benzodiazepines.

CNS depressants (eg, alcohol, phenothiazines, sedative-hypnotics)
Increased CNS depression may occur.

CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin)
May reduce buprenorphine plasma levels, decreasing the efficacy.

CYP3A4 inhibitors (eg, erythromycin, ketoconazole, ritonavir)
May elevate buprenorphine plasma levels, increasing the risk of side effects.