Fentanyl Withdrawal Symptoms (Page 66)
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I'm trying to wean myself off the Fentanyl patch. I went from 75 micro-gms to 50 now I'm on 25. Having a problem and not sure it is related to the decrease in the med. It's been 20 days on the 25 micro-gm and I'm going crazy. I need to keep rocking, moving in any way b/c my body is very restless. Is this a symptom of withdrawal and what do I do? I cannot take it any more.

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I am trying to come off the patch as well and have started having seizures. Anyone else?

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I have been on the Fentanyl patch for over 5 years and before that there were too many medications (opiopids) to even mention. I made the decision a few months back to get off all of them. I am 55 and have been on opioids since a very serious almost life ending trauma when I was 8. My doctors were unhappy with my choice to end this plan to continue with meds but I wet from 75 mcg to 50 mcg in one month and then down to the 25 mcg for 3 weeks and now take 7.5/500 vicoden 2 tabs up to 6 tabs every 24 hours along with oxycodone instant release 15 mg every 4 hours to help me come off this patch. It has been 4 days and the withdrawals are hell. It isn't like I have a nurse bringing the needed meds on a schedule and night time is the worse part. Once I get the meds in my system when I get up in the morning the withdrawals start to slowly go away but now on night 4 I wake up sick, cramps, nausea, the whole works so I have to hit the oxycodone and Vicoden. This is barely working because they also had me on oxycontin 30 mg and 10 mg for breakthrough pain that I stopped a few weeks back. It is like having the flu constantly along with some of the really bad things that happen with withdrawal such as hallucinations, etc.
This SUCKS. I do have constant contact from my doctor who can only say good job, keep it up. I had heart surgery 2 months ago and also have a heart monitor in my chest so should any issue arise with my heart it will be noticed by those who monitor this thing via electronics but still these withdrawals I would NOT wish on my worse enemy. They are really bad and I just don't know what to do. It isn't like I need to go without sleep for weeks just to make sure that I fill myself with the meds to make sure they don't happen and then I need to ween of the meds they prescribed to help get me off this crazy patch.
HELP!

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If I live another 10 years,how high of a dose will they be able to give me?I have digestive system issues as well as spine problems and a few unmentionables,too graphic today for me to say out loud, I now administer two patches at a time as was prescribed.One 100 mcg patch and one 50 mcg patch.Yes,150 mcg every 48 hours and it still hurts where my joints are deteriorating and where I had my cervical spine fused with 14mm screws and two plates between c-5 c-6 c-7 and other surgeries that were meant to fix some of the pain.
How high of a dose wil I need if I live another 10 years? TY

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We are coaches & patient advocates for those that are disabled and/or have had extreme pain issues. There are many OTC drugs that can ruin lives more than being on a minimal amount of fentanyl. If the right dosage is given, even for cancer patients, they can function close to normal as possible among family & friends. We worry that too many people believe any addiction is bad. Please, find people that deal with pain management & have not only empathy, but have been in similar circumstances. Pallative care is important for the chronically ill no matter what level. It is even cheaper & safer for many if monitored regularly. With computers & 24/7 phone contact with medical staff--we no longer have to suffer unbearable pain. While we still look for new ways to help those that fall thru the cracks, we can work together in finding ways to exchange our stories, ways we deal with pain, how our spouses & doctors can help us thru the worst times. We would like more input from people that are living a more normal life while being medicated, even on the various pain patches.

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Worried Wife -- tell your husband to hang in there -- it is a tough battle. I am on day 10 of going cold turkey (20 months at 25 mcg and the last 2 at 50 mcg.) If he can get a prescription of Valium or Alprozolam for the skin on fire -- it may help. As Virgil above stated -- I had to use Clonidine from time to time to help control the rolling hot flashes.

I don't fault my doctor for putting my on the patch -- it gave me almost two years of quality of life (if you can call it that). But I do fault him for not having a plan to take me off the patch.

I don't know if it will help, but I've been trying to eat foods that will boost my serotonin levels as I am going through withdrawal. At day 10 -- I am past most of the physical effects -- but I am having trouble mentally engaging back into life. So I am eating eggs, taking Omega 3, eating lot's of vegetables, and whey protein. Will it work? I will let you know in about 2 weeks if I seem to be getting some emotion (good emotion that is) and a eagerness to reengage life.

It is rough -- and many people have posted several other medications that are used to get people through it. Do not be afraid to find a detox councilor and give them a call.

More to follow and my prayers to all those above going through the same issues.

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2cor129, I'm really sorry to hear this. My only thought is that the taper down or coming off was done too fast. Has he tried benzodiazepenes? This is a very common thing to do. People also try diphenydramine and/or hydroxyzine. So clonidine, hydroxyzine, a benzo, and perhaps even gabapentin.

I myself tried to go down from 50mcg/hr to 25mcg/hr and I was okay for about 4-5 days (since I had built up to a steady state with the 50mcg/hr patch) and suddenly the WD hit (since I had been sleeping) and I felt very dizzy, and couldn't walk, and started throwing up and felt like I was going to die (horrible feeling). My first experience ever with real opiate WD. So I slapped on a higher dose patch and in 30 minutes it started to subside and in 2-3 hours I was feeling better.

So, went to the doc, and he suggested dropping down by 12.5mcg/hr to 37.5mcg/hr, gave me hydroxyzine for anxiety (I didn't use it). I then did the drop, took some extra gabapentin, and there was no problems whatsoever that I can think of. I'm now on a steady state of 37.5mcg/hr.

The only experience for me has been that my pain was indeed serious and 37.5mcg/hr is barely controlling it. I'm now contemplating what to do (if I should go back or if I should stay down and tough it out though the pain affects my spine and I start to walk poorly and it curves my spine).

Worried Wife, if your husband came off the patch without a taper, it's very likely he is going to feel miserable for a few days at least. The skin being on fire is one of the ways WD can manifest. Basically your body is thinking that something really important (like food) is being deprived from it and/or something really bad is happening to it. So it's reacting that way.

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My husband is trying to get off the fentanyl patch too. He has been without the patch for 7 days. He is experiencing a feeling of his skin being on fire all over his body. Has anyone else had that withdrawal symptom?

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Well guys we are day 43 off fentanyl.. and I can't believe we are still having problems.. the zapping in the brain, ringing in the ears and only 4-5 hours of sleep and thats with ambien. I am starting to wonder if this is ever gonna end. Not to mention his pain is still there but after the pain for fentanyl withdrawal he says this pain is way more manageable. You don't know true pain till have you to get off the junk. Oh and did I mention our doctor who had him on the junk dropped us.. after we confronted him about how he was over prescribing. We got a copy from the pharmacy and realize by him refilling them early all the time just how much of this crap he was taking. Yeah not good. Hope you guys are doing better. Praying things will get back to a normal someday..

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Cyndib, it seems your taper is going too fast. You should slow it down a bit and/or augment it with pills (which I can't do). 225mcg/hour is a huge amount of fentanyl to come off from in a short span of 3 months. That would seem to resemble a dependence that'd take a year to come off. If you're not stabilising at a lower dose, no point in going down since you'll just get worse.

I myself stabilised onto a 25mcg from a 50mcg patch with no problems for 7 days but then realised my pain hadn't gone away yet and I am going to try something in between 25mcg and 50mcg. I do want to be off opiods and I can't comply well with a pill taper but I can with a patch taper.

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Everyone seems to be on small doses. I have been on fentanyl for 13 years. My dosage was 225 mcg every 36 hours. I started my cutback 3months ago and I am now down to 100 mcg but the withdrawals are extreme from severe freezing cold sweats to on fire with body shakes. My pain is getting worse and I am getting quite worried. Does anyone have any solutions.

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Keng52, how's it going if you're still reading this?

Sonja: The oxycontin is an extended (sustained) form of oxycodone and they're almost always a better way of getting off opiods provided you don't have trouble with overpopping pills (which I do; hey, I even drink too much coke). Gabapentin may be your friend during WDs; I upped my dose my a bit when I shifted from my pills to the patch and had very minor troubles but I've been very good with the patch (on the other hand, see previous sentence about being able to pop pills easily :).

2cor, 3day: I see you guys are almost done with your (or yours') tapers. It's great you're hanging around to help us newbies.

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Sorry, I am just reading this ENTIRE thread and wanted to correct some misinformation AFAIK (or pretty sure). One is that the patches are not consistent with tapering off because they provide a steady stream of drug to your body. On the contrary, this helps tapering off much the way an extended release form of a drug helps taper off better than an immediate release form, by smoothing out the ups and downs, and by building a reservoir of drug in your system at any given time so you generally are dealing with steady state kinetics and it's more like a ramp down than steps down (until the very last patch is removed)--the steepness is about the same. As people have said, you may not even notice WD for 72 hours, which is because the drug has built up in your system and that's a good thing, so you just don't drop off a cliff which you'd get from short acting oral usage, as you go down dosages.

But stopping 120mg of oxycodone equivalent (25mcg patch) even with a 72 hour ramp down abruptly is still dealing with a huge cliff when you get to the point your body realises no more drug is going to be supplied to it. While one wouldn't do it with the oxycodone, one shouldn't do it with the 25 mcg patches either. In this sense, the patches can be misleading since you're no longer taking so many pills (in my case, every few hours), that you may think getting off them might be a lot easier than getting off an equivalent amount of pills, but there's no reason for that.

Again, a big difference I see is between long term vs. short term usage of the patch. My comments in general are limited to short term use (few to several weeks).

On day 8 of the 50mcg patch now. I've now gotten the patches to stick 48/49/66 hours thusfar (looks like I'll be taking showers every 72 hours).

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I've been thinking a bit about what it means to stick on a patch, and I started at 50mcg/hour. By really rough calculations, that's equivalent to 1.2mg of fentanyl/day which is equivalent to 120mg/day of oxymorphone (which is about what I was on, I was on 130mg/day) which is equivalent to 240mg of oxycodone a day! That is a HUGE amount of opioids.

So someone who's on a 50mcg goes cold turkey, it's like coming off 240mg of oxycodone a day cold turkey! No wonder people have trouble. So even a 12.5mcg patch would be like coming off 60mg of oxycodone/30mg of oxymorphone a day. So you really need to keep cutting the patch down to something really tiny, so 6, 3, 1.5 would be where you need to be to get to the equivalent of 30/15/7.5 or 15/7.5/3.25 mg of oxycodone and oxymorphone/day!

These are simplistic conversions based on the table available here:
http://www.globalrph.com/narcotic.cgi

But it should hold I think given how I was started. If I took the patch off now, I'm sure I'd suffer a huge amount, not because of the patch, but because I'd be coming of 120/130mg of oxymorphone a day!

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Nikonfan, I think if you taper off using the patch, it is okay. I think it is better than morphine which is considered one of the most addictive substances around. You shouldn't be feeling any euphoria or anything from the patch and you should be on a fast track taper (meaning 2-4 weeks). I can't imagine the patch hurting in such a situation.

What I think this thread clearly indicates is that being on the patch for a long time (months and years) is a recipe for disaster. It seems you build tolerance so you need stronger patches. And then once you're at a high enough patch and can't go higher, you can't get off or come down easily.

But for someone like me who was popping pills in a way that could've led to an addiction, the patch stopped that dead in its tracks (it's day 5 now) and I don't FEEL like popping patch after patch on (like someone described here, patches stuck on them---I'm sorry to laugh at your situation but it is kind of funny to imagine that on me).

So the patch so far definitely has done something good. Let's see if I can get off easily or not but I am determined to.

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I was just given the patch today after 2 years of taking 4 Norcos a day. I had an accident while driving a truck OTR and ruptured L4 &L5. I had surgery last October 2009, and my pain has increased 100% since the surgery. I see a Pain management Dr in January, but the Norco was not helping and my Dr recommended the patch, at the lowest dosage. After reading all these horror stories i am wondering if I should have opted for the Morophine instead, she gave me both options. I told her today that i wanted off all pain meds soon, and she stated that the PM Dr would work on doing that with me. I hope i do not have to go through what others have gone through with WD's, but now I am worried, and need some sort of pain intervention to get back to a normal life, as pain free as i can be. I know the pain will never subside totally, but I'd at least like to get back to the level I was pre-op. I wish i could go back 12 months, I would have never had the surgery.

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I wanted to a wax philosophically a bit about my motivations/reasons. Opiates cause physical dependency very very fast. In many cases, even without euphoria it's bad, but with euphoria, it's crossing into mental addiction territory. At what point do you separate nondependent use from dependent use to addiction? My pill popping (all prescribed, all due to legitimate pain) was getting out of control. I felt I myself couldn't judge if I was experiencing enough pain to be consuming these powerful opioids any more. I bet if you put Mother Teresa or Gandhi in this situation, they'd end up with similar dilemmas.

Make no mistake that when I started in July, these were absolutely necessary. I was in so much pain, had been for months, and these offered relief. They probably saved me from all the ills that chronic pain causes, including depression, etc. The relief they offered was awesome and justified.

Fast forward to now and my spinal problem is being treated successfully. Do I still need opiods or can I just get by with celebrex and gabapentin or even less? I'm basically getting close to zero pain meds to REEVALUATE what I need. If it turns out that I still a few more months of opioids, I can go back. If it turns out that I need to be on chronic pain management, so be it though I hope this isn't the case and there's nothing in my condition to indicate this would be the case unless I injure my spine. However, right now, I feel I'm increasing my tolerance and consumption so much so that the opiods themselves might be the cause of increased pain (a documented occurrence).

I therefore feel I need to back off and reexperience any pain again to determine what to do. This is why I'm doing what I am doing.

To so many who just dropped from 100mcgs or 50mcgs to zero, I can't imagine what you went through. It has to be horrible and I'm not sure why a taper wasn't attempted. To all those who give others (including me) support and hope and encouragement (3day and 2cor esp. now for me), I hope to be in your shoes one day. Thank you so much again.

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Hi guys, thanks so much for your comments. I've read these and others and most are negative and a few are positive about fentanyl patches. But I don't have any choice since my PCP who is nice and got me up to 80mg/day oxyCodone wants me in the hands of my pain doc and my pain doc is just hard to get a hold of. I was considering going to the ER the day I got the patches if I couldn't see him and he was catching a flight and I barely caught him before he flew away. :/ I had tried all week to get an appointment to see him.

Crazy, eh? These are all well respected docs who I'm sure if I had pushed would've done the right thing but I'm also an easy going person and wasn't aware of anything about the patches on Oct 8. Anyways, I took the patches. I was on 130 mg/day oxyMorphone prescription before the 50mcg x 5 patch prescription. So this is what I am trying to taper off from and the patches are my tapering method, apparently a relatively new approach that is popular among the docs.

On day 3, I saw my spinal problem doctor who said the patches were an excellent way of tapering off. He talked to me more about the patches than my pain med doc and was aware that you could go down to the 12.5mcgs and suggested a few ways to extend 12.5mcg patch life (heating, wearing it longer, on and off) to wean off more slowly (a 12.5mcg patch would be equivalent to 30mg oxyMorphone). He really honestly believed this was a good way for me to go. So my second opinion was positive and again, this is the guy who is actually treating my spinal condition and has done a great job thusfar in resolving it. In a sense, he's the reason I can taper off, though it was my PCP who discovered my condition that went undiscovered for a year or more and I could've died or been paralysed because of previous misdiagnoses---all the physical therapy and chiropractry (who seem really intent on keeping you as a customer no matter what) is pointless if there's an underlying condition for the back pain like an infectious disease.

For me, the patches HAVE been a godsend in the 5 days I've had them. I was out of control with the pill popping. There's NO way I would've tapered down a pill by myself unless they gave me a daily pill dosing and weaned me off over a couple of months or so (which I asked my PCP for and she could've done it since the pharmacy and her clinic are in the same floor/building and 5 minutes from my home but she refused---this was my first preferred solution before the patches and if any of this goes wrong, you read all this here first). The 50mcg is probably a slightly lower dose than the 130mg/day oxyMorphone so I had a very mild case of the sniffles which was cured by taking my daily gabapentin dose all at once.

What I am going to do: on Oct 20 (day 13), I'm allowed to switch to the 25 mcgs. I am going to try to do that. If it becomes hard, I will get back to the pain doc and see what should be done. If it's indeed hard, I'm going to suggest a 37.5mcg dose to see if it'll work. If 37.5mcg then doesn't work, then it's going to be a daily pill med regimen somehow (even if I have to switch doctors). If it's not hard, I'm going to stay at 25mcgs for a few days and ask for some 12.5mcgs. After 5 patches of 25mcgs, I'm going to switch to 4-5 patches of 12.5mcgs, and then 4-5 patches of 6.25mcgs, and then 4-5 patches of 3.125mcgs, and so on. This is my plan. BTW, I'm using the Teva matrix (not gel) patches that can indeed be cut.

I will report back on what works. Please keep in mind I'm constrained until Oct 20 to these 50mcg patches so it's only after that I can even talk to my pain med doc about doing something different. At this point I'd have been 13 days on the patch. I'm hoping my short time on it is different from other experiences of tapering off. But I am coming down from a moderately high dose of opiods, i.e., 130mg oxyMorphone.

I really really hope this approach works and gives everyone here a chance to see how to taper down from fentanyl. So far going from 130mg/day oxyMorphone to 50mcg/hour fentanyl has been rather painless. :/

Thanks to everyone here who has shared their experience strength and hope!

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Virgil Smith, Stay away from the Fentanyl if you possibly can. Maybe you should talk to your doctor about what people are saying on this site. There is no easy way to taper off Fentanyl. It is really, really nasty stuff no matter how the tapering is handled.

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To: Keng52 how's it going?? are you hanging in there? we are on day 25 fentanyl free.. and he still has good days and bad days. Still dealing with zap's in his brain and blood pressure out of wack. The rest of the side effects are manageable. Don't know if he can drive a car yet.. still shaky. Just hoping your are still hanging on and beating this junk. Good luck and hang in there

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Virgil Smith: My husband weened on Oxy in 2008 and it was much easier process once the three days were over so were most of the symptoms. But Fentanyl we are on day 25 and still major symptoms I were you I would evaluate that a little closer. This is nasty stuff and it stores so it takes longer to get out of your system. I would hate to see you with a bigger problem on your hands. But never the less will pray God gives you direction on whats best for you. Also the patches were designed for 72 hours but my husbands body went through them in 48 and we were told that was a malpractice rate.. so to hear 30 hours really scares me! I tell everyone I know unless your dieing stay away from Fentanyl! The side effects are worse than any pills he has taken we still don't know if he will ever stop having the zap's in his brain and his blood pressure is still having highs and lows we are talking 160/110 down to 97/57. Its bad stuff! Be Careful!

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