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High dose of buprenorphine in terminally ill patient with liver failure: Efficacy and tolerability

Alessandra Ciccozzi, MD, Chiara Angeletti, MD, Giada Baldascino, MD, Emiliano Petrucci, MD, Cristina Bonetti, MD, Stefania De Santis, MD, Antonella Paladini, MD, Giustino Varrassi, PhD, Franco Marinangeli, MD


Pain in terminally ill patients with cancer can be often hard to manage, due to the unpredictable kinetics of drugs caused by progressive kidney and liver dysfunction. Plasma concentrations of active metabolites–also a cause of dangerous side effects–could be difficult to estimate. This case report holds the idea that buprenorphine, a partial agonist of µ-receptors, even at high dosage, may be effective and safe to use in terminally ill patients with significant liver and kidney impairment.


terminal-illness, pain management, buprenorphine, palliative care

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