Generally, anisocoria is caused by impaired dilation (a sympathetic response) or impaired constriction (a parasympathetic response) of pupils. An injury or lesion in either pathway may result in changes in pupil size.
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Generic Butrans. There are currently no generic Butrans (buprenorphine patch) products available in the United States. Although the first patent for Butrans expired in November 2010, it is likely that other patents prevent manufacturers from making a generic version. The next patent is set to expire in December 2015, which would be the earliest date a generic product could become available.