BUPRENORPHINE PATCH SHOULD NOT BE CUT

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Important: Buprenorphine patches (e.g. BuTrans, Transtec) should NOT be cut.

Cutting the patch can:

• alter drug delivery

• cause unpredictable dosing

• increase risk of overdose or underdose

• damage the controlled-release system

Manufacturers advise patches must be applied intact. (medicines.org.uk)

Practical paediatric palliative care points

If a lower dose is needed:

• use a lower-strength patch if available

• consider alternative opioid formulations

• seek specialist palliative/pharmacy advice

Additional precautions

• Apply to intact, non-irritated skin

• Rotate sites

• Avoid external heat (hot water bottles, heated blankets, fever exposure) as heat can increase absorption

• Fold patch adhesive sides together before disposal

Important exception

Some matrix patches in general medicine can technically be cut, but buprenorphine patches used in paediatric palliative care should be treated as non-cuttable unless explicit pharmacy/manufacturer guidance states otherwise. The safest rule clinically is:

“Do not cut buprenorphine patches.”