Buperenorphine dose?

My cat, Kitty, was rx compounded buprenorphine .5 mg/ml solution for chronic pancreatitis. She was rx .5ml twice a day. She weighs 9.5 pounds. Does this dose seem correct? I question it, because prior to the compounded version she was on the injectable, but I was giving it orally at .2 mls. I am concerned about the increase in the dose.

Thanks in advance!

Kim

 

Kim,

Read this link.
http://www.petplace.com/drug-library/bu ... page1.aspx

At the bottom of the page is dosing information. It looks like you are getting the lower end of the dosing suggestion. Does Kitty react okay to the dose?

Best,
Pam & Layla

 

Truly, I have been scared to give it and have only been given about .3. But, she seemed better when she was getting the .2 of the injectable orally. I want to be safe, but I also want to give her what she can tolerate.

So, the .5 ml should be okay---it looks like a lot in that syringe!!!

Thanks Pam!

 

This dose sounds high to me, if the concentration of the compounded Bupe is .5 mg/ml. The injectable that you were using before was probably in a concentration of .3 mg/ml. The previous dose of .2 ml (at .3 mg/ml) was .06 mg. The new dose of .5 ml (at .5 mg/ml) is .25 mg, a significant increase.

Bupe is dosed by weight and by duration. A typical 12 hour dose would be .03 mg/kg. The weight of 9.5 pounds = 4.3 kg. The desired dose would be about 4.3 X .03 = .13 mg. At your concentration of .5 mg/ml, that would be .26 ml.

 

Layla's last rx was .1 based on the .3 ampule. I transferred to an insulin syringe and gave it sub-q. That was last fall - she weighed 8.5 or 9 lbs.

Linda's formula made my head spin ( a little ) so, agree, and never give more than your vet suggested or what you feel comfortable giving kitty.

Good luck!

 

This link suggests a max dose of .01 mg per pound, which would be .095 mg in your case. At .5 mg per ml, that would be .19 ml.

I would confirm the concentration of the compounded Bupe, and confirm the dosage with the vet.

 

Linda, on Layla's bupe it gives the dose and says from the .3 ampule, so, maybe Kim's rx has that information too - but if not, agree to confirm the dose.

Best,
Pam & Layla

 

Linda, I sure am glad there are people like you in the world--no way I could have converted that!

I gave .3 earlier this week and I thought it made her a little wide eyed...the last few days I dropped back to .1 and it didn't seem to have much effect. Tonight I gave .2, but truly I have no idea. I actually called my vet when the bupre. arrived and asked was the dose correct and she assured me it was. But, the .3 seemed a little strong to me.

So, If I stay with the .2 I should be okay?

Thanks!

Kim

 

I am going to get the paperwork that came with the rx and see if there is any additional information. I will post shortly.

 

The only information on the label or paperwork states....Buprenorphine 0.5 mg/ml solution. (compounded from Roadrunner Pharmacy)
directed to give.5 mls bid

Does this change anything? She weighs 9.5 pounds.

Is 2.6 still the dose I should be giving?

 

This does get confusing, because we are talking about dosage not only in mg per kg (or mg per pound), but also in ml actually given. The key is the concentration (number of mg per ml). Your compounded Bupe is unusual in containing .5 mg/ml. Bupe is normally supplied in a concentration of .3 mg per ml.

If I understand your post correctly, not only has the vet increased the concentration from .3 mg per ml to .5 mg per ml, he has also increased the dosage from .2ml of the lower concentration to .5 ml of the higger concentration. Am I reading this correctly? If so, I would really want to check this with the vet.

A higher dose of Bupe will provide a longer duration of pain relief, not a stronger level of pain relief. A higher dose will, however, also cause more side effects (increased sedation). Giving .2 ml seems like a good compromise until you can discuss this further with the vet.

When you say you are giving this orally, you are giving it in the cheek pouch, correct? It is meant to be absorbed through the mucous membrane of the cheek, not swallowed down the throat.

 

You mean .26, not 2.6 ml. The prescribed dose (.5 ml) sounds high to me. I don't want to prescribe a dosage for your cat, but I would be conservative until you have a chance to discuss this with the vet.

 

Yes .26

I live in a small town without a lot of vets, so I don't have a lot of choices--but, I have no confindence in her. I am shooting it into the mouth---she never said the cheek pocket. I will be sure to give it there from now on.

The vet actually told me that the compounded was less concentrated than the injectable. I will check again tomorrow. Either way, do you think I am okay with .2 or would you reduce further?

Thanks!

 

I think that .2 ml is fine for now, until you get a chance to clarify things. If your cat seems too groggy, you can reduce the amount slightly.

Ask the vet how many mg/kg he wants to give for a 12 hour dose.
Ask him how many mg that works out to in your cat.
Ask him, based on a concentration of .5 mg/ml, how many ml that translates to.
Ask him if it is to be administered trans mucosally.

 

Thanks again!

I gave .2 tonight --- she seems okay. This might sound crazy, but is there a "peak" time of bupre or is consistent for the 12 hours?

Thanks for your help.

Kim

 

It's not crazy. The dose of Burprenorphine determines the duration of pain relief. For instance, at a concentration of .3 mg/ml (your old concentration), a dose of .03 mg/kg will give 12 hours relief, .02 mg/kg gives 8 hours, and .01 mg/kg gives 6 hours. This varies slightly among different sources, but the idea is that a higher dose gives longer duration of pain relief (and also may make the cat feel more zonked). I think the 12 hour dose starts to wear out a bit toward the very end.

I find a high dose too sedating for my CP cat, so I am giving a 6 hour dose every 12 hours. He weighs the same as your cat. My Bupe has the lower concentration of .3 mg/ml. I give my cat .14 ml.

 

While we are talking CP-- is your CP cat also diabetic? If so, what do you feed him? It is very challenging to find low carb, low fat food!

 

I feed him three pate varieties of FF. He doesn't seem sensitive to higher fat foods. He eats a bit of dry to keep his weight up. He is not diabetic, but he has intestinal lymphoma and IBD which flare up a lot. He takes chemotherapy, other meds (metronidazole, tylosin, pepcid, ursodiol, and ondansetron). Also B12 injections. Cerenia and bupe as needed. He takes strong injectable steroids.

 

My Vet says that many times the compounded Buprenex does not absorb well.
He will not use it.

 

Also use caution with the compounded formula possibly containing sugar. They probably gave you a flavored syrup, and it may be sweetened. It doesn't make sense, as Bupe is tasteless.

 

There is Buperenorphine available in 0.5 mg/ml. My vet has some of that since it i hard to get because of the shortage. My vet's stuff come in a large vial not line the 1 ml vials/carpulet for the Buprenex.