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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Buprenorphine is a Schedule III partial opioid agonist that compounding pharmacies prepare as sublingual solutions, transdermal gels and sterile injections by prescription only.
Buprenorphine is a partial agonist at the mu-opioid receptor with weak kappa antagonism. It binds mu receptors tightly and lets go slowly, which gives it a ceiling on some opioid effects and milder withdrawal than full agonists. Manufactured products fall into two groups. For pain: Belbuca buccal film (BioDelivery Sciences/Collegium) and Butrans weekly transdermal patch, approved for severe and persistent pain requiring an opioid when alternatives are inadequate, and buprenorphine injection (Buprenex and generics). For opioid dependence: buprenorphine sublingual tablets (for example Hikma, Sun), buprenorphine-naloxone tablets and films, and the extended-release injections Sublocade (Indivior) and Brixadi (Braeburn); the sublingual label states these tablets are not appropriate as an analgesic. Prescribers may order buprenorphine compounded when they need a preservative-free sublingual solution, a strength below any manufactured product, or a transdermal gel. Compounded preparations are not FDA-approved and require a prescription.
Buprenorphine carries an FDA boxed warning on the pain products: addiction, abuse and misuse that can lead to overdose and death; life-threatening respiratory depression, especially at the start or after a dose increase, and with chewing, swallowing, snorting or injecting a film; accidental exposure, where one dose can kill a child; profound sedation, coma and death with benzodiazepines, alcohol or other CNS depressants; neonatal opioid withdrawal syndrome after prolonged use in pregnancy; and the Opioid Analgesic REMS program. CYP3A4 inhibitors raise buprenorphine levels and inducers lower them. Do not use it with significant respiratory depression, severe asthma in an unmonitored setting, bowel obstruction or a known allergy. It can prolong the QT interval, cause liver injury or adrenal insufficiency, and taking it with a full opioid agonist can trigger withdrawal. Transmucosal forms have caused cavities, tooth fracture and tooth loss; wait an hour after a dose before brushing and see a dentist regularly. Avoid MAOIs within 14 days, and watch for serotonin syndrome with serotonergic drugs. Belbuca's label says breastfeeding is not recommended, while lactation references report low milk levels and call use acceptable, including for opioid use disorder, with monitoring of the infant for sleepiness or poor feeding. Keep naloxone or nalmefene on hand, call 911 for an overdose, and talk to your prescriber or pharmacist about any side effect.
Buprenorphine is a high-affinity partial mu agonist with slow receptor dissociation, weak kappa antagonism and delta agonism. Oral bioavailability is poor because of first-pass metabolism, so other routes are used; it is about 96 percent protein-bound, metabolized by CYP3A4 to norbuprenorphine and by glucuronidation, and excreted about 69 percent in feces and 30 percent in urine; after sublingual dosing the mean elimination half-life is 31 to 35 hours (Hikma label). Levels and half-life rise in moderate to severe hepatic impairment. Labeled indications are given above; Belbuca is not for as-needed use and carries a QTc warning. Prescribers have ordered compounded buprenorphine as an alcohol-, sugar- and preservative-free sublingual solution for neonatal opioid withdrawal syndrome; a 2023 stability study (Ahmadi et al., J Pediatr Pharmacol Ther) found a refrigerated saline dilution of the injectable held concentration for 14 days and called for clinical studies of bioavailability. Dose, route and induction timing are per prescriber. Monitoring: COWS before induction, respiratory status, liver function at baseline and periodically, QTc where relevant, and CYP3A4 co-medications. Buprenorphine is a Schedule III controlled substance. Electronic prescribing of controlled substances is voluntary under federal DEA rules, CMS applies a prescriber-level threshold for Part D, and a number of states mandate it.
Wash and dry your hands. Place the troche between your cheek and gum or under your tongue, as your label directs, and let it dissolve. Do not chew or swallow it whole unless told to. Dissolving can take up to 30 minutes. Follow your label about eating or drinking around the dose.
Troches are nonaqueous, so a USP <795> default beyond-use date of up to 180 days usually applies. Store in the closed container in a cool, dry place at room temperature, away from heat so they do not soften, and out of reach of children. Discard after the beyond-use date on the label.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Place 1 troche between cheek and gum and let slowly dissolve
