Decontamination

For ingestions of sublingual or transdermal preparations of buprenorphine, offer gastrointestinal decontamination with activated charcoal to alert and cooperative patients who are able to protect their airway and present within 2 hours of the estimated ingestion time. If the patient is intubated, activated charcoal can be given any time after ingestion via a nasogastric or orogastric tube—confirm correct placement of the nasogastric or orogastric tube beforehand.

If buprenorphine toxicity is caused by the application of transdermal patches, remove any remaining patches. The subdermal reservoir of buprenorphine that remains after removing patches does not need intervention.