Sublingual Bupraxon Tablets in Cancer Patients: Initial Results from Real-World Clinical Practice

Introduction. Adequate pain management in cancer patients remains a serious challenge. Long-term and uncontrolled use of NSAIDs is associated with a high risk of complications, while the use of opioids is often limited by their adverse effects, particularly constipation, and the potential risk of diversion. Combination drugs such as Bupraxon (buprenorphine + naloxone) represent a promising alternative.
Objective. To present to the medical community the initial clinical experience with the domestic combined drug Bupraxon for sublingual administration in cancer patients with chronic pain syndrome (CPS).
Methods and materials. This paper presents the results of a post-marketing observational study involving 22 cancer patients with CPS, as well as two detailed clinical case reports. The analgesic efficacy, time to onset and duration of action, tolerability, and safety of the drug were assessed in a real-world clinical setting.
Results. Bupraxon was shown to provide effective control of moderate to severe intensity pain. The onset of action was observed within 30–45 minutes, and the duration of analgesia was 4–8 hours. For 12 out of 22 patients, an effective dose was titrated within 2–3 days. The drug was well-tolerated, with no significant gastrointestinal adverse events (specifically, no constipation) and no withdrawal syndrome following short-term use. The combination with naloxone enhances narcological safety by reducing the risk of abuse.
Conclusions. Bupraxon is an effective and safe option for the management of CPS in cancer patients, particularly in those at risk of bowel obstruction. Its non-invasive form, controllable analgesia, and favorable safety profile make it a promising alternative to other opioid analgesics. Further comparative studies are required for a comprehensive assessment of the drug's potential.

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