Taper Down From 50mcg Fentanyl Patch To 25mcg Withdrawal Help (Page 3)

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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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41

Step slow add 12 25 = 37 you have come a long way you can do this commence panadine osteo every 6 hrs to take edge off.

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42

I advise people not to read these website.Me been feytnal 7 years went from 50mg to 12 mg within 3 days the only withdraw I had was rls.All these websites just make people more afraid and stress you out Everybody is different I'm on day 7 no patch no withdrawl

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43

You are VERY fortunate then, huh? This forum IS for those of us who have had very BAD WDs. Be thankful you haven't had them, and are responding differently than those here. We are each different in our response to meds-I, for one, could not take the patch-on it for almost 2 years, or any of the substitutes-longest MS contin for about 4 months(?). The patch had horrible effects on me, not eating, and when I did I was bound up like nobodies business. Even with meds to treat that. Which lead to even more side effects, which lead to more meds. Screw that! For me, I had to either get off of the patch, or eventually die. For me, it was that simple, because that's where it was leading to. I don't need a doctor practicing which meds may or may not work for me. I'm not a guinea pig, I'm a naturally born man. It's been almost exactly one year since I left the patch and went to methadone, oxy, then morphine (all legally prescribed). I titrated off the morphine down to the norco's, and then off those with in 2 months. So by April/May of this year I was off everything except supplements. Yeah, I was weak and in pain (still), but I believe I can 'heal thyself'. Beats being all medded-up and foggy brained, walking around like The Walking Dead. Again, you have an incredible praise for not having to go through withdrawls! I would not want that pain and suffering on anyone! Be greatful for it, and maybe pray for those that do go through WD. Every time I receive one of these emails of a new response, I pray for those going through what has to be the worst time of their (our) lives, for peace of mind, and healing and strength in spirit.

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44

Hi W I am sorry you have had a ad time of it all.everyones body is different you are not mentally weak your body had been through a coctail of hell.yes I agree the drs can be ott when it comes to transferring from fe ntynal to methadone.i refused the offer.i was on 70 when I left hospital.while in hospital I collapsed non responsive deceased 5 mins ended up in ccu.they had not changed the med chartpost op I had a ga general anaesthetic and pca patient control analgesic 70 patch was put on by staff.all equivalent to 130.7 days in ccu not knowing if I was going to die or brain damage.i have heart palpitations see cardiology next week.i am sure it is side effect of patch.will continue undermed supervision after Christmas to lower.get down to 12 hospital for iv treatment have this from pain specialist.however I may have to live with the 12. Your brain is telling your body it is in pain saying give me more of the good stuff. look at it like a fire false alarm stuck on circuit. but the complicated bit is you really do have pain but pha tom pain as well.thats why its good to drop down to a level to see what is real and what is not. I stick my patches with hyperfix or me fix the patch is not to me occluded ut they can come off when swimming or shower.try now to rest in bed allday I find I sleep in one position and this causes pain. Nice fresh shower not too hot heat can give you overdose with the patch.the codine is stopping the bowels regular medication eg nulax or senna coloxyl.microlax mini enema from pharmacy it desperate need.no shame in that.i find my moods get off balance and dont make rash decisions.i cry I yell I hide in the pantry.yes I have pain then I stop.i couldnt walk prior to the op.i thought I had a stroke.i get so frightened.i have family comming home for christmas I know he will have a shock.i have lost a lot of weight and resigned form my office even though I am still registered with the govt.my life will have to change but remember there is life out there and good life.i have been on this horrid med for 18 months when tiezities was first diagnosed. Then the back. eat fresh every day just a little keep up fluids you are strong and have come a long way. I wish you well especially at this time of year.?J

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45

Wow-you went/are going through the wringer, Georgie! I found I was sleeping in the same position too-for several months. Very stiff on the bad back. Sounds like we both tried the same fixes for some of our problems. Since I've left the patch, I've regained 30 lbs. Not good, but now I have a chance to loose them in a more health manner. Almost back down to 'singing' weight, but the insides were messed up bad. Had a bunch of people telling me how good I looked-never judge a book, huh! No doubt. Stick with it, Georgie! I'm praying for you.

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46

Thanks for your kind reply. I need my health back and will continue to reduce fentynal after christmas with medical supervision.i am allergic to tramadol and lyrica I see spiders and become paranoid.i have to laugh but I was hiding fruit under my bed from my friends.i have a very competent gp.
I read the others and feel for them so much.i thankyou for your prayers and will make another entry after my next step.i hope this has helped someone a little.i know reading others has given me hope.kind regards J

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47

Ps. May I ask "singing weight"? I too have lost weight and can hardly stand some days.yes people say I look good I have had to order in new clothes.but when I look seriously I look like death. I eat I go to the bathroom bowels. imodium helps.i keep cereal fruit soup plain food sushi is good.i have synopy heart bp can range from 120/70-1 0/120-90/80.I have had a couple of nasty falls.i can not stress enough to the community here fentynal is heat sensitive a hot shower for pain can see you with an overdose and kissing the deck.be careful with other meds including diazapan.it can cause anxiety and is addictive. use cognitive therapy as much as you can.i no longer live alone I have friends stay in guest room at night then go to their home.i have had to put a good nursing career on hold and living off savings.we are going to be ok oh no champagne this christmas.its going to be alright.J

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48

Ummm...yeah. I was a wanna-be singer back in the day-in my own mind, I guess. During that time I was rather trim and fit. Unlike the 'Fentanyl weight loss program', where if you looked close enough, death warmed over did sum it up. I had days where I just couldn't think straight. Walking/balance was ok, but thinking-oi vay. I'm having some residual effect on my short-term memory. I'll completely forget a conversation I had 30 minutes before. But a few days later I'd remember it. Or, senility is creeping in early.

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49

Hi W
Yes the kiss of death.my brother is flying in tonight for christmas week.i have not seen him in 2 years boy is he in for a shock.
Dont let go of your dreams.we were all young and good looking.senility no.the morphine has taken something.I miss words names of people places and speak backwards.but I am still on37 mcg after christmas drop to 25 then 12 then all well off. Be gentle with yourself.Regards J

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50

I am coming off fentanyl patches and have reduced very slowly from 100microgram/hr patch. I am now on 62mcg and should be free in 6 months time God willing. Although the manufactures say not to cut the patches I know of others who have and I have had no problems. I had to be very careful with my calculations and used to reduce by 1mm every 4 days. A very long a patience testing process but I am getting there. It is probably one of the hardest drugs to come off. I have not worked out how to do the drop from 12.5 mcg. I guess the same way?

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51

Hi john,
Please dont be afraid you are doing well do not cut the patches. you are not getting the correct dose you think you are. the big drop is 70 -50 then a 25+12 then just 25 then just 12. use diazapam to ease the way and your body will let you know where your pain level is at.leave it for a week then see your gp.withdrawl pain is your brain wanting more. use codine moderately. then off. you should be so proud getting off 100mcg. i am at 25 and brighter in the mind. my best friend is staying nights here in the next room. keep hydrated. Dont cut the patches dont be near heat and dont be afraid.

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52

John-Who told you about cutting the patch? Where did you hear about this? My pain management doctor prescribed two different types of patches-one that had the gel inside, and another that the plastic was impregnated with the 'medicine'. I'm assuming you have the non-gel filled patch. If that is possible, to cut off a mm at a time, I'd be surprised. Pleasantly so. But I have no knowledge of experience with cutting. BE FRIKKEN CAREFULL! You might wake up dead. By your calculations given, you're saying every 1mm of the 100mcg patch is how many mcg's?
Hope you had a good Christmas, Georgie.

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53

Hi. Please allow me to tell you that the fentanyl patches gave me no trouble after stopping the 100 mcg size. I was on them for over a year. Its the sudden decrease of any opiate that makes you sick. As long as you have other opiates to take you'll be fine. Getting off the oxy's will take a couple weeks of being sick. Good luck.

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54

They also mke a 12 mcg fentanle patch i would ask dr rmaybe 5 of those and change them at longer interfuls may 80 hrs then 88 hrs 96 hrs check with dr first for the professional opinion i have been on 75s for a long time i started on lower dose but this one works for me. I find changing manufacturers helps to keep them and my hydrocodones working. Properly

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55

I was on 75 every 72 hours for 6 yrs. my pain management Dr. gave me a heads up that thanks to the new regs coming out it would be much harder to continue with them as they are only supposed to be for short term after surgery or for cancer so why we were all put on them is a very valid question. I am also on Neurotin, Percocet, Valium, Wellbutrin and something that starts with a "P" can't remember the name that helps me stay asleep at night. I have M. S. and a car accident that resulted in a failed back surgery. My Dr. had me go to the 50 for two months, now on the 25. So far I have had no problems and feel much better as far as memory issues and fatigue go then when I was on the 75.

I would be off by now except broke my foot Sept. 4th and it is not healing, I go in for surgery on the 13th to have it pinned so have a fair amount if pain from that but have not had to increase any of my pain meds. After the surgery we are going to discuss what long acting pain drug to try to replace the patches completely. First he is going to drop me to the 12.5 patch to help ease the way and there will always be something for the break thru pain.

One thing my Dr. had me do was to continue to wear the old patch for another 24 hours after putting on the new one. There is always med still left in the old patch. I did that for the first two weeks after dropping down, first to the 50's then the 25's. I have been extending the time between changing patches also by wearing for four days before putting on the new one, so the old patch was being worn for 5 days instead of the 3. My only problem has been with the pain not w/d's. We started the spinal injections of pain meds and steroids to help with the back pain. After the foot is taken care of I look forward to being off the patches and onto something else. I am grateful to my Dr. for being proactive. I received the letter from my insurance, Federal BlueCross, telling me that after 2014 the patches will have to have preapproval before they will pay so it sounds like my Dr. was correct in starting the process of getting me off them and onto something that I won't have to jump through hoops to get.

Anyone having problems with w/d should be talking with their Dr more about the slower step down as my pain Dr says no one who is on these strong meds for true pain should have to suffer and there are ways to ease it. My state also just legalized marijuana for recreational use, we already had medical but a lot of us did not want to be on a list as using medical MJ. I have used that, before the vote, illegally and I know it helped with not having w/d, my Dr was aware of that and willing to give me the card but after Febr that will no longer be an issue. It helps tremendously for easing nausea and the jitters. I would suggest that if its legal in your state that you try it as I know quite a few people who have had luck adding it to their pain care. The medical is a great pain, nausea reliever with no "high" if you are worried about that plus with the edibles you don't have to smoke it, I make brownies. I admit that mine is not yet the pure medical as not available here yet but you don't feel so high that you can't function, just relaxed which helps with the pain.

Good luck to all coming off the patches, just know that you shouldn't have to go through terrible w/d's, just get your Dr, or a new one to manage your case correctly, which means having a good, competent Dr. willing to really hear you and work with you.

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56

Hi Georgie,
Thanks for your reply. I heard about cutting the patches (with the fentanyl embedded in the adhesive) from a pain forum. The person had been on fentanyl for ages and had many failed back ops.She had reduced successfully several times by cutting her patch with no problems.
I have had no problems over 13 months cutting back this way. I have lost my calculations for mm = micrograms per hour and it is difficult to calculate. I am going to get help from my GP or pain specialist to calculate how many mm I should cut of the 50mcg/he patch to = 12micrograms/hour. The drug withdrawal people here said it was OK to continue the way I have been, My GP said the reason they say not to cut them is the fentanyl may not be distributed evenly. This should not be a problem with such small reductions and going down? Going up could be dangerous? I switch to another opiate when I get down to 12microgram / hr patch. I have already withdrawn from about 30mg of diazepam to 7.5mg. I am not going up again. I found that for me even this withdrawal over about a year from diazepam far worse than opiates especially the massive fears.
Good to hear from you,
John

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57

Hi John I am relieved to read you are doing this under superv Cutting patches and leaving patches on longer is "not best practice" in this ancient land Australia.I even checked out the faithful Mimms.I am sure the new age internet can assist with the conversion. Just b careful .
Diazapan has a long "half life" and a kick back like a scorpions tail.it is scored so keep reducing.no laughing matter even if you get down to 2.5 and half again =1.25.
Nobodys fool -all the best with the op.day by day.
W- had a few good days Christmas.seafood a plenty.brother concerned typical country man doesnt show feelngs. Had trouble walking the length of our new international airport....like granny. reaction to heat and patch 40 Celsius.now on 25 patch bloods good just have to watch depression sneaking in. Thanks for asking.hope you had a lovely family christmas
Wishing everyone health for 2015.

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58

Hi W,
How did you get off the methadone? I expect it to be offered to me as an alternative to the fentanyl patches. I have heard of people having trouble getting off it and have not heard of or met anyone who has reduced to zero?
Good luck,
John

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59

I only took it for 3 days. That was enough to know it wasn't for me.

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60

everybody reacts differently to the step-down or withdrawal. The important thing is to make sure you are tight with your doctor before you go off or down in strength from fentanyl. Another narcotic can be used, or an increase in your breakthrough meds might work to lessen the uncomfortable process. You need to be able to communicate with the doctor, tell him or her how your doing, and keep asking what
else you can try if your withdrawal is too much too handle. Have your insurance in place, and have money for what you may need that's not covered. Also , if possible have a spouse, or nurse, to help and monitor how your doing.

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