Can You Have Withdrawls From Oxycodone When Switching To Fentanyl Patch?

Updated

Seven years of back pain with long history of muscle relaxant and more recently oxycodone and lorazepam. Docs finally did MRI and found Spondylolisthesis Grade 3-4 with bulging disc and appears vertebrae have already fused. Still being worked up by Neuro surgeon. Pain mgmt. just switched me from 10mg Vicodin every 4 hrs to 25mcg Fentanyl patch every 3 days with 7.5 Vicodin every 6-8 hrs for breakthrough. Started patch last week. First seemed to work okay but over the last two patches breakthrough pain has increased with increased pain down my legs. I get sweats then chills with pain in all my joints, arms, legs, hands, feet. Seems increasing my Vicodin and taking it more frequently is the only thing that relieves it but sometimes need 30mg of Vicodin in a short time-frame. Not sure if the symptoms are because my fentanyl needs are higher or if I am having withdrawls from the oxycodone despite the Vicodin. Any suggestions?

15 Replies

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1

Yes, you could be having some withdrawal effects, accompanied with side effects from starting the new medication.

However, Vicodin contains Hydrocodone, not Oxycodone.

Both of these medications carry the risk of being habit forming and could cause side effects, such as nausea, dizziness, dry mouth and constipation.

If it continues, you'll need to speak to your doctor as you may need your dosages adjusted to combat the problem.

Is there anything else I can help with?

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2

Did anybody answer this? I'm on 12mcg fentanyl patch, only 3 patches so 9 days. I don't expect I'll have much withdrawal. Does anyone know or have had the same usage/experience? I'll have percocet 10/325 (I hope) afterwards as needed but hope not to need it much. Please advise. I have a huge amount of responsibility coming up coinciding with when I finish the last patch!! I'm very worried. Please help! Thanks.

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3

Yes, there can be some withdrawal effects and rebound pain from even short term usage.

It really depends on the person and how quickly their body has gotten used to having the drug added regularly. Some people don't experience problems, but some do.

But they won't be the severe, dangerous withdrawals that an addict or drug abuser might experience.

Withdrawal symptoms can include nausea, dizziness, diarrhea, chills, fever and rebound pain.

Are there any other questions or concerns?

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4

For the people looking for a new doctor or any doctor to prescribe any oxy's is going to be rough. I'm in your boat! I moved 65 miles from my doctor but didn't even think that I couldn't find another doctor to see me, WRONG! The federal government is coming down on doctors prescribing any opiates. Therefore, the doctors are now on the "hot seat", to get their patient off the opiates and not to prescribe ANY opiates unless they can prove it's absolutely the only route to go. That's it people, all wrapped up with a pretty bow!

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5

Well then for those who really are in severe chronic pain or chronic nerve damage. Those ppl like myself will have absolutely nothing to worry about. Bcuz they should not be prescribed such powerfull drugs unless it's the Final straw anyway. .so anyone not in pain n getting patches or oxys shouldn't be getting them anyway. .

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6

Verwon - what is re-bound pain? I was on a lot and I mean a lot of oxy's per a doctors script. He is now weaning me down, slow, and I love him for that. Still can't find a doctor where I live and it's really sad. I am still in a lot of pain but at least I'm getting off the oxy's. Don't know if I can take the pain after all is said and done. My question that is always with me is, is the pain in my head or my dislocated shoulder that I have had for over 15 years. I guess we will find out. Thanks!

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7

Oh my god I hope you get this message and take me seriously! Your pain sounds as severe as mine, I too was on oxy 80mg and then went to fentanyl 7.5 milligrams, then 12.5 mg then 25mg, 50mg, 75mg etc etc and like you my body started needing more breakthrough relief so back came the oxy for that and up went the patch dose, STOP taking both please I am not crazy but I beg of you, I am a professional self employed level headed mother of four, fentanyl almost destroyed my life! It was increased bit by bit as I got accustomed to the dose and then topped up with oxycodone, I got to the stage where I was so physically and mentally addicted to it that I very nearly committed suicide, the rest of my worlds priority slowly faded away children and husband included while the fentanyl and oxycodone became my number one focus, I wish Id never been put on it, wean off asap trust me on top of pain like we have we don't need a severe addiction to go with it, not one that controls your life. I am now on methadone program for pain and to wean off the other drugs, methadone is enough to just take the edge off and it does not take away your life or take over your thoughts every day. Please reply to me and say you will at least consider what I'm suggesting. Research fentanyl patch you won't find anyone who has found it good, it was wonderful for pain at first I thought I was on to a winner but soon realized I was the biggest loser in all of this. See what others have to say before you get in too deep and by in too deep I mean any more than the 12.5 mg patch each three days and maybe 2 tablets of low dose oxycodone for breakthrough a day, any more than this you will most certainly find yourself in the same boat that I was in, the boat that very nearly cost me my business, my husband my children, my life. Please let me help you.

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8

You're body becomes dependant. It doesn't matter who you are or the amount taken. All doctors should be put on a morpine drip for a few weeks, and then taken off. Then you will know 1st hand what it feels like to withdrawal, rather than listing off symptoms that you were taught in school. Furthermore, a lot of Dr's would think twice before giving or taking away strong pain meds. Don't cops have to be tazed so they know what it's like???

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9

I agree the Only reason i apply that Patch 25mg Fentayln is because of pain 2 herniated buldg disc constant lower bck pain omg

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10

Hello,

I am currently prescribed a 25mcg fentanyl matrix patch and 15 Mg's of oxycodone instant release 4 times a day. I am awake and functioning 16-18 hours a day. And some days I am crippled crying in bed. I have noticed that if I do not take a 15mg oxycodone every three hours that I begin to become anxious, nauseous, heart rate goes up, sweat a lot, start getting confused, fidgety, have trouble comprehending things, feel panic, vision, trouble focusing visual disturbances...Essentially what feels like tortuous withdrawal starting...the cognitive wd is as bad as the physical. As, well as increased pain. So I am stuck every day for that hour feeling pain like I may pass out, throw up etc and feeling terribly ill. Bc I want to keep it at every 4 hours like the instructions say. I couldn't possibly wait 6 hours or I would be a wreck. I work 12-16 hour days and can no longer tolerate this. I fear disability and have taken a lot of time off work bc of this. There have been times that I have had to give in to the 15mg of oxycodone on the third hour just to take myself out of this withdrawal to be able to drive myself 2 hours home from work. Unfortunately if I did not take it there would have been no way for me to be able to drive home. This may sound insane but, it is the absolute truth. If I am on 25 mcg of fentanyl then why on earth am I having such bad oxycodone withdrawals. Shouldn't the patch be slowly releasing medication in my body so that I do not go in to any sort of opioid withdrawal while it is stuck to my skin? Keeping me out of opioid withdrawal of any sort?

I even wake up in the morning wearing the patch with a lot of nausea, pain, fast heart, a bit lethargic... I take my "break through" med oxycodone and wait about 30 minutes and I am out of withdrawal and my pain is decreased some what. What is going on and why is this happening? Also the only change my dr made was changing it every 48 hours which has still not changed my situation at all. This is having a severe impact on my life and overall well being. A few years ago I was on 100 mcg of fentanyl and 30 Mg's of oxycodone 3 times daily. Or my Dr at the time said I could spread out my doses of oxycodone just as needed long as I did not go over 180 milligrams a day prescribed dose. I was in college functioning with his help. So some days I would wake up and need 60 milligrams of oxycodone as my pain is horrible when I wake up and then other days I would just take 30 in the morning and then 4 hours later need 60 and so on. But, I never went over my limit prescribed. Even when he had me on 25 mcg of fentanyl and 30 mg of oxycodone 4 times a day I was functioning better than I am now.

While on that regiment I still had physical pain but, it was manageable and I never experienced any withdrawal symptoms.

NOW: My Dr that I have been with for a year tells me when I hint that I am suffering and can we please change something that I am already over the daily limit allowed federally and I do not have cancer, that he "doesn't even know what he is treating" which is absolutely ludicrous to me, my mother, brother and cousin who are all Dr's. He also says that what I am experiencing is only anxiety and it IS NOT withdrawal it is anxiety (anyone who takes pain medication knows anxiety vs pain & opiod withdrawal).

Would I benefit more from being on Oxycodone ER and instant release at the same time as opposed to the fentanyl patch and 15 milligrams of oxycodone 4 times a day that are supposed to last me 18-19 hour days? I am afraid to ask my dr switch me to Oxycodone ER & IR and take away the fentanyl for fear he may think I am selling them which my hubby and I are pretty well off and abide by the law. So that is out of the question. Number two: Addicted to Oxycodone and just want to feel high, never. Number three: I will be labeled a drug seeker and the list goes on. So I am afraid to tell him what I am telling you to such a full extent. And no I have never been discharged from a doctors office and I have no criminal record.

My number one question is if I switched to Oxycodone ER and remained on my IR dose would the withdrawal's finally subside? Because I have 2 of the same meds that I know work for me? Would the extended release keep my dose level/blood level even and then the break thru dose I am on be enough for me to not have to take it not need it on that 4th hour on the dot? bc it is slowly being released in my body already which, would STOP these God awful withdrawals? Is it possible for someone to go through Oxycodone withdrawals if they are taking an ER dose and IR? I know that a lot of it depends on dose also but, Maybe just maybe you can help me with some of this nightmare.

Essentially as I mentioned I would be taking Oxycodone ER & IR together and NO more fentanyl. Would this take away the Oxycodone withdrawals??? And at what dose would I need of the Oxycodone ER replace the Fentanyl and what does would I need of the IR to make the withdrawal disappear and the pain manageable? Because As I mentioned before 25mcg of the patch before and 30 Mg's 4 x daily worked fairly well before but, who knows what will work now. And would u advise me to find a new Dr? Or am I being unreasonable? Please don't make that your answer to me. Because sometimes I ask certain professionals and they tell me why don't you just switch pain management doctors and it is Not easy. I have a friend who struggles with similar pain like me and she takes 30mg ER Oxycodone 4 times daily and 15mg IR's for breakthrough pain and doesn't need to schedule it bc it's only for when her pain gets worse like it's supposed to be so some days she only takes one break through some days she takes as much as needed but, never more than prescribed. She has no withdrawal problems. If I were to make the switch what a blessing it would be to not have to deal with this every day. I have considered trying to get off of pain medication but, I did once in the past and I was wheelchair bound for a year.

I can look at a conversion chart and I fear that he would prescribe no where near the dose of Oxycodone ER that would make this all even out so is it even worth asking? Idk that is why I am writing this... And asking him to increase my break through dose is a joke. He is stuck on 15 mg 4 times daily. Which my medical records prove my body can and certainly did much, much better on a higher dose and that I did not overdose. I am a young professional, dress professionally and speak well and am well educated and etc etc and I see some of his patients who quite honestly are just rude and look like they haven't showered for weeks on some pretty potent stuff. So maybe it is a "favorite game at that office. Some people love the patch for their pain, some people swear by dilauded... I wish I were on my old regimen. What works for one doesn't work for the other. I have seen that combination prescribed before but, have never asked the patient if it worked well for them. So please... That is all I am dying to know because I can't keep paying all of this $ to pain Mgmt Office and suffer like this any longer. My hubby is disgusted by how I am treated & I once caught him in tears as I was balled up in bed for 4 days in severe pain that isn't being addressed.

Yes, I am obviously certainly physically dependent on it but, not a drug addict and always match my pill count at the end of the month. And the truth is the truth... It has so far been the best for my pain even more so than the button drip the hospital had me on. Yes, of course in larger doses at that time. I can handle Fentanyl withdrawal but, for some reason Oxycodone Withdrawal is pure hell for me. I explained this to my PCP and she prescribed me nausea medication and clonidine to help with some of what's going on bc she too believes it is withdrawal. I see her every month and she see's what this is doing to me. However, because I have a pain contract and she doesn't prescribe pain medication I am in a terrible place right now.
I am also afraid to switch to OxyContin ER bc I have been on 10 Mg's of Oxymorphone ER 2 times daily and that was a disaster. I really think that Dr's have the misconception that Extended Release Medications really last 6 to 12 hours and are super powered and much stronger and maybe they really are or am or do at the proper dose for their patient. Like I said before it is hard to tell bc I did quite well on my dose that my former pain management dr who has since retired. He had me on that dose for quite a while but, my NEW (a little over a year pain Mgmt office) started me on 10mgs oxycodone IR 3 times daily and 10 Mg's of Morphine ER and completely discarded what I used to be on. So the only increase that I have had since being a patient there is 30 more Mg's of Oxycodone and then 10mg's of Oxymorphone ER to Oxymorphone 15 Mg's every 12 hours then the only recent change in the past 7 months is I am now on 30 mg Oxycodone IR and 25MCG Fentanyl every 48 hours or he will give me 14 patches a month... Ughhh Even when changing the patch every 48 hours I have noticed nothing.

With my experience Since being at this Pain Management Office I have been prescribed Oxymorphone ER 10mg, 15mg every 12 hours Morphine ER every 12 hours. And also Oxymorphone ER every 12 hours as far as Extended release medication goes. I had a major surgery on my rectum and all they did was give me 5 extra milligrams a day of Oxymorphone IR which didn't help much with pain at all. It got so bad that my surgeon admitted me to the ER where I was put on a pain pump bc my bp and vitals were so high bc of the pain. I ONCE took the Oxymorphone ER 15 mg at night before bed just to see if it really lasted that many hours (12) as I was told and after 9 hours woke up once again in Beginning of withdrawal and terrible pain. Or I would sleep in 9 hours instead of sleeping my normal 5-6 and once again wake up with all of the beginning withdrawal symptoms until I took my allowed dose of oxycodone. All the while last time I left his office I left in tears my legs were so bad that I have been having to take off work and somedays use my walker and I am only 35. I fear soon I will lose my job. I begged him to schedule me for the soonest Fleuroscopic Epidural for my legs because I am only getting some relief from my pain medication for my back which has become less & less and my legs bring me to the point of hurting so bad I can not walk. I am terrified of having the epidural but, if it will bring relief then so be it. 75% of the time my legs are in some sort of pain whether it is a 6 or 10 on the pain scale. My back ranges between a 4 and 7. But, my legs have horrific debilitating pain with constant flair ups.

Anyhow please if you can help me as I have been typing this for 3 hours on my phone and my fingers hurt but, perhaps you will have some good insight for me and knowledge of PA Laws and medication regulations and hopefully really experienced in Pain Management. Yes, have tried everything non medicinal with no help. Thank you!

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11

Re: Gia (# 10) Expand Referenced Message

Hello,
The best advice I can give to all is try KRATOM it really does help if not take away all withdrawals.
I have use many times to get off opiates and then taper kratom down.
The withdrawals from kratom where MUCH more mild that opiates the worst where RLS.
Hope this helps.

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12

Re: Lamb (# 7) Expand Referenced Message

Fentanyl wasn't the problem, your abuse of the drug was. Don't demonize a good medication that works very well for it's intended use for severe round the clock pain just because you chose to abuse it!

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13

Re: HarleyGurl (# 5) Expand Referenced Message

You need to pull your head out of your ass....Who the h*** are you to pass judgment on somebody else's pain !!!!!

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14

You need a higher dose of fhentonal.being on oxycodone for breakthrew, then stopping going on vicadin, is a much lower pain med. you need to be higher on the patch

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15

Re: Nota long timer (# 2) Expand Referenced Message

You might have a tiny bit. But 9 days, I don’t think a lot

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