Buprenorphine Shortage: Alternatives for Analgesia

Buprenorphine is on backorder due to manufacturing delays. The Abbott product (Carpu-jects) are on indefinite backorder while the other two products (vials and ampules) are now on backorder due to increased demand from human and veterinary medicine.

Veterinary suppliers expect buprenorphine vials and ampules to become available in mid-March; however, you should plan for much longer delays. Veterinarians will likely be the last to see the product due to high demand in human medicine.

Heidi L. Shafford, DVM, PhD, DACVA of Veterinary Anesthesia Specialists LLC, Portland, has provided the following information to assist you in providing adequate analgesia for your patients without buprenorphine. Please do not hesitate to contact Dr. Shafford if you have specific questions. Her phone is (503) 805-5515.

Alternatives to Buprenorphine

General principles

  • Reserve current stock of buprenorphine strictly for Oral Transmucosal administration in cats experiencing moderate-to-severe post-operative pain
  • Replace buprenorphine with another opioid – full mu-opioid agonists (morphine, hydromorphone, fentanyl, tramadol) if moderate-to-severe pain expected; butorphanol if mild pain anticipated
  • Utilize local anesthetic blocks whenever and wherever possible
  • Use NSAID medications when possible
  • Consider dispensing gabapentin and/or meloxicam for long-term pain management in cats if oral transmucosal buprenorphine not available
  • Do not replace buprenorphine with Sustained Release Buprenorphine or Buprenorphine Gels – there is inadequate data on the uptake and distribution