Buprenorphine as a unique opioid analgesic – an overview ofexperimental and clinical data

<ns3:p>Buprenorphine has been used in pain medicine for several decades, but in recent years it has been rediscovered dueto its unique receptor and pharmacokinetic profile. The well-known “ceiling effect” of the drug has been mistakenlyunderstood clinically as referring to analgesia, but it is now known to refer primarily to respiratory depression andeuphoria, not an analgesic effect. This seems particularly important in the context of the concerns that many patientsand clinicians have about opioid drugs. Numerous studies have demonstrated the analgesic efficacy of buprenorphinein various types of pain (acute, chronic, neuropathic, musculoskeletal, cancer, and others), not differing from other opioiddrugs, while maintaining a high safety profile. The antihyperalgesic effect of buprenorphine is used in the case of opioid--induced hyperalgesia. Particular populations that may benefit from the use of buprenorphine in pain managementinclude patient with noncancer pain, the elderly, patients with a history of opioid dependence and requiring a drugfrom the third step of the analgesic ladder, patients with immunosuppression and undergoing oncological treatment,and pregnant women requiring the use of opioid analgesia.</ns3:p>