Taper Down From 50mcg Fentanyl Patch To 25mcg Withdrawal Help (Page 4)

So, I'm in a big big dilemma. For my own security and well being, I MUST come off my Fentanyl transdermal patch. I've Been using 50mcg/72 hours for about 6 mths straight. I have 3 of the 50mcg patches left and 4 of the 25mcg to help me taper off. I will no longer be using them anymore, just Norcos or oxymorphone IR. I'm absolutely terrified of withdrawals. My doc who put me on them has No idea what it's like to come off like this. Can someone please tell me if and how bad the withdrawals from going down that much will affect me? I can not take any benzos (Ativan, xanax, etc). I have come off the oxymorph about 75% in the last 2 mths. I'm literally freaking out. Again, I'm terrified but HAVE to do this for at least another 7 months. Any help would be appreciated. Or experience/reassurance. Thanks again. BTW- I'll add, all of my RX are legal and prescribed by the same doc and NOT misused.

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I have been cutting down fentanyl patches for about a year now with Doc's consent. I cat about 2 mm off the a100 and 75 patches every 2 patch changes and it helps greatly with the fears. I understand your dilema especially if you cannot use benzo's. Will your doc allow you to increase the oxy? Have you tried using Lyrica to calm you and help with sleep? The fear of what the withdrawal is worse than the withdrawal I believe. I hope you make it.

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Been on 50mcg patches due to nerve damage after three L5-S1 surguries. Once I realized that it helped my pain but was destroying my memory and cognitive function, I begged my VA doc to help get me off of it. Been over a year and I am finally able to stretch out the patch changes to 4 or 5 days with help of gabapentin 900mg 3 times per day and .2mg clonidine the night before patch change. Withdrawals suck ass for me. Hypersthesia sets in where my skin tingles due to the deadened nerve endings coming back to life. I have to walk for hours around the house until the new patch kicks in. At the end of my rope I was offered acupuncture treatment over 16 sessions. I dont believe in this therapy but its doing something because the tingling is gone and I am finally weaning on my own. You have to be in sync with your doctor. If you feel they are pushing you too fast go elsewhere and be honest. A good doc will help you correctly. Bad docs are so scared of a legal suit that they want no part of narcotics for long term use. If you want to get off there are right ways to do it and meds that work better for you than what I use. Lots of antianxiety and ADD meds are used off label to wean narco use. God bless everyone of you strong-willed enough to take your life back. Only addicts know what this withdrawal feels like. Wanna talk? {edited for privacy}.

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I'm curious: you say that the Fentanyl patches are not made in increments suitable for tapering, but hasn't anyone tried cutting the matrix patches in quarters or even eighths? I have been cutting one into quarters to ADD to my pain relief, and it works like a charm. So, I know it works. It would not work with the resevoir patches, however. If I should ever wean down, I would definitely be tapering off the same way: by cutting up the matrix patches in smaller increments.

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I was going to try that but didnt want to ruin a patch. Very good to know that it does work on the matrix type. Thx.

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Were you on the fentanyl patch while you were pregnant? I've been looking to find anyone who became pregnant while on the patch. Did you or your child have any adverse effects?Any information would be greatly appreciated. -Lee

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You are going to be a GREAT mom as you are already caring so much for your little one by posting your question. I hope that this will help ease your worry.

Specific Anesthetic Agents (source: openanesthesia.org)

All inhalational agents and most intravenous agents used by anesthesiologists will cross the placenta – inhalational agents cause very little fetal depression if used at < 1 MAC and delivery occurs within 10 mins of induction. Thiopental, propofol, benzodiazepines, and ketamine all cross the placenta, although only benzodiazepines are noted to produce significant fetal effects. Opiates all cross the placenta to some extent (amount is variable) – from a respiratory standpoint, newborns are most sensitive to maternal morphine. Fentanyl appears to be safe if given at < 1 ucg/kg. Convert your weight to kg and that number should represent how much Fentanyl is safe for your baby according to this formula. For example, if you weigh 150lbs, that would equal 68kg and you would be fine to take 68 microcentigrams (mcg/hr) of Fentanyl which, at that level, would be the 50mcg/hr patch. Epidural opiates produce minimal effects. Ephedrine, B-blockers, vasodilators, metoclopramide, and atropine cross the placenta, although glycopyrrolate (which also does not pass the blood-brain barrier) does not.

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I was on 75 mcg patch for 2 yrs. Then my doctor decided to lower my dose, only lowered it by 12 mch at a time every three weeks. Now I am off the patch completely. But still weaning with oral dilaudid, first with 8mg a day. 2mg, 4x/day for 2 months due to withdraw symptoms, then 6 mg, 3x/day now, however I think she will want to go down to 2x/day. It's been only one month, and I'm having a lot of pain so I'm hoping to go another month. Goal is to continue tapering the dilaudid until I'm off, but then I don't know how she plans to control my pain. I had to get off due to chronic narcotic constipation.

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Hi Holly, Well done! I know how you feel. I fell and had x2 spinal surgery so I could walk within x3 months under a year ago. In hospital I collapsed non responsive. toxicology full resus ccu 10 days. Morphine was up to 130. Left hospital 70 now down to 12. And panadine oesto 6/24. The odd oxy contin prn. Did it by 70 50 37 12. It was hellish. Walk get as active as you can. Holly, diet, fresh salad, veggies, soup, fruit. I seem to have more neuropathic pain if I eat junk food. Sounds silly but thats how it seems to be. top up vitamins, sleep. You have come a long way and your doc sounds like he/she wont let you down. I have Tiezies disease. cheers G

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Holly! I had EXACTLY the same problems! Along with the foggy brain, the constipation was horrible, and believed it was only time before it killed me. I'm also in the same boat concerning what am I to do now since I still have the pain, but no pain meds. Well, I got in touch with Dr. Norm Shealy, the guy who invented the TENS Unit. He's helped me with supplements, and other advice for managing the pain. Also, have you ever heard of a PEMF device? I also use one of those daily. Google both Dr. Shealy and PEMF for more info. Dr. Oz did a show on the device, the book PEMF - The Fifth Element of Health, by Bryant Meyers is also a big help to understand what a PEMF device is, does and why. I have recently celebrated one year of being off the heavy meds! Yes I still have pain, but my photographic/genic memory is slowly coming back! I'll never use that crap again. Good to see your still around, Georgie-I'll be praying for all of you!

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Hi W, good post. Yes I am here And pleased to be. I read others and think I am lucky. The surgery was successful but have some neuralgia. Hey I can walk and drive short distances. I won't be returning to duty after 36 years. Still doors close, doors open. I am trying to get it together I have to relax music therapy. I hold my self at "attention". May I ask what do you do to relax. Confrontation and threat of life also bring back memory pain especially with the tiezies. I dont sleep much have to see mo next week spiking low grade temps think the LFTs are off again.

Also how was your last jump off the fentynal? I will try it in a couple of months as I am going on holiday. In Australia the govt are ceasing authority for long term patients to have opioids. The patient has to see the pharmacy every day for methadone along with the illegals.they have to go into rehab..public. not a pretty stigma. I am not one because of physical inability to take oral meds. (Liver). It frightened me enough to get it down quick.especially being deceased 4-5min. My concern is how the genuine cases going to cope. I have a hand tens unit and its great. we are coming into winter here and I feel the cold evenings this too brings pain. praise God I am alive to feel it. Take care regards G

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I put mine on my back, just below the collarbone, where it's nice and flat. I hold the patch with backing still attached in my hands to warm it to body temp. My fiancé puts it on my absolutely clean and dry skin, then presses the patch to my skin with his palm to really help it stick. Then he puts a 4"x 4 1/4" sheet of Tegaderm over it, as close to centered as possible. We sometimes use Skin Prep wipes to make them stick even better.

I've never lost one, and I sweat in S. Louisiana.

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I just found out that I am pregnant. I have been on 100 mcg Fentanyl patches every 48hours for 2 years due to back surgery. I wanted to come off them before, but now I must for my baby. Too bad I can no longer just go into a rapid detox center and sleep through the w/d's. The doctor has me dropping 25mcg per week. Friday I took off my 100 patch and waited untill my body started to ache, then I put on a 50 +25. I was nauseous and ached but its doable alternating clonadine and .O25 xanex when unbarable. Sweating, nausea, headache, muscle ache but not as bad as missing a dose.

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I put them on my hips and put 3M Tegaderm Transparent Dressing on top otherwise they just fall off. You can order the covers on amazon, or you can tape the edges with waterproof tape.

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just an update on my previous post. After getting down to 50mcg patch I swapped to 2 x 100mg morphine /day. I have reduced to 2 x &0 mg / day. I am having real trouble coping. Very depressed and weak and getting worse. I hope this will pass. The pain gets intolerable every second day and I feel that I can't go on like this. I hope it will pass soon.

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John, IT WILL PASS! But, not to bullsh*t you, it won't be easy or fun. It WILL be easier than going cold turkey-did that with the patch twice (per Dr. orders) and it about ruined me. Also, since being off all my pain meds, I've realized something important...I still have pain! (yeah....no sh*t) Like what the hell was I thinking would happen? But I'm getting my mind back slowly and I'm no longer frikken wasting away. John, I'm praying for you to get through this, YOU CAN and must! and Pinky-I'm praying for you too. I'm without words for you, dear. I pray for your babies good health and for yours!

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Thanks W. I went to a meeting last night and got the same message. Give my body a chance to get back to normal and the thinking to change. It is just the pain takes over my whole existence. If I am vertical the pain increases steadily. If I am horizontal the pain is still there but not increasing. I have no peace of mind when in pain like this. I got through yesterday so I can get through today. I am 74 and wonder if there is time to get back to normal. Thanks for you encouragement. Encouragement from others really helps me out of my own negativity.

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i would try sfakering days put on 50 tben add 25 on last day of 50 to help with potency drop. just a thougb ask da doc.....i am on 75mcg x 72hr wish that could do 50 & 25 stagger cause 48-72 are painful time & wont s ript it @ 48hrs

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The only way I have found us to stick over the patches with sticking plaster.
If you know if a better way please advise

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I was on that patch at 125. I went to the 75 then 50 then 25 and really had very minor if any problems. I hope this makes you feel better. I hate this drug and will never take it again!!

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Bill, I'd use surgical tape, cut long ways and place on just the edges (about 1/4 inch onto patch, 1/2 inch or more onto skin-depends on the size tape you use) of the patch so the tape didn't cover alot of the med part, thereby insulating/keeping more body heat (even a little bit). During summer I wore them on my upper arm, winter was on my upper stomach. Hot/cold weather made a difference to me. It was rough taking showers-first couple times...WOW! Not good-dumped alot of the meds into my system. I can see if you're in a nursing home, not active at all where these might be good, but they never were consistant what so ever, for me.

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