Taper Down From 50mcg Fentanyl Patch To 25mcg Withdrawal Help (Top voted first)

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 was on fentanyl patches for 3 years. Went from 50mcg. to 25. Almost 3 months ago I stopped the patches. The anxiety and confusion are incomprehensible! My body wants to move and never stop. My brain can't process info. I become paralyzed with fear and panic. How long does this detox take?

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I am currently on day 2 of going from 25mcg to 12 mcg fentanyl patch. It is not only hard to come off fentanyl but can be very dangerous. If you vomit and have a lot of diarrhea you will lose your electrolytes which can cause cardiac distress. It is hard enough and incredibly distressing to go from 50mcg to 25mcg for a month to 12 mcg for 3 to 4 weeks but going from 25mcg to zero without another opiod in your system, well it will be extremely hard on you medically, physically and emotionally. Make sure you have anti diahreah medicine, pain relinu uef like tylenol or alleve, a fan for hot flashes, a blanket for chills, pepto for nausea/diahreah, pediolyte to replace your electrolytes and someone on call to be with you or take you to ER as you will not be able to drive. Benzo's help a lot. Do you have any ambien or sleeping meds to help you sleep thru it day and night? Drink sprite, water, gatorade. Dont eat much as that will make you vomit more. Anti gas pills and antacids can help your stomach but zolfran, a prescription antinausea is best. Call your doctor for medical support if you are going from 25 mcg to zero, but it would be better to go to 12 mcg first. Be prepared fo call 911 if things get too hard for you to manage on your own. Good Luck!

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Fentanyl...for me was a dark dismal suicidal planet. Pain management, yes, but at a very high cost. My husband hates them and hated me on them. We split for 3yrs. He's bipolar, I was the stabalizer, now we live next door to each other. 100mgs, every 3 days for 7 yrs. 1 good day, 2 days of withdrawals. Try to convince someone they don't make you feel high. Filthy things, to manage my pathetic life, I would have to constantly be rotating 3 patches. Basically I would keep on each patch for 6 days. Filthy things. Dangerous things, I can't swim anymore, but I try sometimes, and it had to be a constant vigilance that ( I would wear only 1) it didn't come off. Extremely limiting soaps to use, because if u use anything nice for your bod, guaranteed that thing will slide off. I know it's rare, but maybe u might have intercourse, even tho your libido is zero, and life is grey, grey grey, u have to be on guard it doesn't slide off and attach to your partner. Kids and those patches on your arms, humiliating and once again always fearful ones gonna slide. What about summer, and bare arms and having to show those thing off or sticking them on the underside so they don't show and then u tear the crap out if ur skin. Fentanyl.. I get it. My dr retired, I moved from a metropolitan city to urban country. Not working, no money. I'm not the only one who moved. No drs. Saw a horrible dr,, after 3 mos. he wrote my scrip, He said my specialist was wrong, I handed back the scrip and walked out. I had two weeks left of my original scrip. Went to a segue clinic, they said because I had chronic pain they couldn't touch me. Had to go to a pain clinic. Realizing at this point, with the new rules it's going to take 3 mos for a dr. To write a scrip for a narcotic, 6 mos for a pain clinic.

So it happens, I'm down to 3 patches left. My original dr. Had been trying to get me on gabapentin for years. I didn't like taking it because my vision would get all messed up. And I'd get euphorically high( not the chemical highway) and fentanyl is scary, I was a heavy drinker before I started the patch. After, I literally did not, would not touch a drop. It was like a visual anti-abuse. So I had these bottles and bottles of gabapentin. I'm voraciously reading everything I can on detoxing. I was concerned either my pain would slay me down or if I would have a heart attack because of my high dosage and length of time on it.and then cold turkey. So I started poppin gabas. Those gabapentin saved my life. I had mild discomfort ( no big deal at all) one bad day where I rolled around in my backyard and had my husband trying to knock me out with sleeping pills, and a big bottle of booze(I'm iff the patch at this time, well I had a real old dingy one on) . It was like a rollover in one day. The next day was the best day of my life. We r talking about 7-10 days from the last patch I put on. Clean from fentanyl, no more grey,dismal, suicidal life, the colour of life was and is back in my life. I feel alive, I am no longer sleeping my life away. I still have my last patch 100mg patch that I never had to use.

I have finally found a dr I like and respect, but as is typical in my life, there is a lot of controversy over gabapentin now, it was the wonder drug that lost a legal suit because it declared itself in an email the new snake oil that worked.and drs are scared of it. But it isn't a narcotic. Mind you it was originally declared an anti epileptic, but isn't any longer. It was then declared a neuropathic pain for diabetes, it has since been declared for all neuropathic pain. It has qualities of an anti depressment( I hate these things, the only one I would take was cymbalta)I no longer need to take the cymbalta. But it has been given to bipolar sufferers, and there have been suicudes. I'm not bipolar, but I do have depression, just from the havoc my pain creates. So after I detoxed myself, because nobody gave a crap about what I should do, I was told a year or two ago, I could take as much GABA as I wanted.i used up what I had and Now for five different interim drs, I have had 5 different dose levels, one dr dropped me right down, I was in bad pain, but I also had wicked bad headaches, the next dr told me, there's a risk of seizures if u dose down too quickly. So now I have a dr, I have a regular scrip for GABA, which hopefully will be increased my next visit and I am no longer addicted to opiates or narcotics. Right now I don't have great pain management but I also need to get a better diagnosis, because when the GABA dose is what I think it should be, I am making my injury worse by being mobile and really active. It's not a cure just pain management.So it's the same game of just waiting to take my dose to feel some relief. But I do get relief and my world has colour, I'm not forever climbing and sliding down into that dark pit. I don't cry for myself anymore, my pain isn't severe enough and I'm not emotionally and physically exhausted from the withdrawal roller coaster.

I've got a road to go, but I know I'm not restrained by my medicinal needs,and that is liberation. First time in 8 years, I don't have to get to the dr, once a month. I got a scrip for three months that will last me two to and half. Now on that note my pain doesn't have one source, same vicinity, but it's like three or 4 separate things that grow and radiate and don't have a ceiling, I just pass out. So this GABA seems to prevent that growth and radiation but their is still a source of pain and I take behind the counter acetemenophen with codeine. No scrip needed. But I definitely need a few with each dose. I find it the strangest thing in the world, I can't really believe it. If I screwed up and my dr went on vacay and I had no scrip, nobody helps, so u scrounge for oxys, coke, keep your percs, and your morphine. I've gone from all that to gabapentin and acetemenophein with codeine. Believe!! Fentanyl makes u fearful, fentanyl turns your world dark there's no hope,when u take a closer look, all u see is despair. take a chance, try something that's not a narcotic it may work.( 6 mos ago I would have said its impossible) If u r a reasonably tough individual, don't take forever to wean off. Go hard. Get it done and over with. Why drag a dead horse for the next year, when next week, ur life could be brand new. I don't know if I would have had the success I've had if I didn't do it all at once. And honestly if no one gave a rats ass( I don't look or act like a bum, and everyone was so apologetic they couldn't help, or didn't know what to advise ) that I was gonna be bumping down that hard with nowhere to land, there's no reason not to say to your dr, fast track please and thanku. Unless you've got a year with nothing better to do, but I'm probaly relating to people who've been dealing with the same miserable routine for years. Took me about three to four years to reassemble in a small way. I'm in year 8 now. I listen to music on a regular basis now, couldn't at all for the first 3 yrs. then maybe once a year. Couldn't handle the vibrations ,etc.. Now I can. Yea. I have found such solace in these forums, I hope somebody is able to find my post beneficial medically, but most of all I just want someone to know I get it... When ur in the world of chronic pain, it's a lonely place. But here is a place we can once again relate to our fellow man or woman.

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I've been on fentanyl patch 25mcg every 48hrs for almost a year. I have a 4mo old and a 2 year old and next Thurs my doc is lowering me to 12mcg. I will have family here helping me til sunday...just curious how bad this is going to be? Will I most likely still need help after a couple days? (After a month being on the 12 I will be completely taken off)

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Hiya jocelyn,
Your doc is right, add some OxyIR to help ONLY when the w/ds or pain are unbearable.

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Did you mean TMJ, Temporomandibula Joint Disease? Disks are in your spine and the largest muscle in your face is the Mandibula. You might want to start a new topic on this as this thread is about Fentanyl withdrawal. You'll get more answers that way, all my best . . . Q

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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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That is a very fast taper and isn't the normal way that it's done, usually it is tapered much slower, to minimize the withdrawals.

If you are on other narcotics, such as the Norco and Oxymorphone that you mentioned, that may help minimize some of the withdrawal effects.

However, Fentanyl is over 80 times stronger than Morphine, so you will probably still experience some withdrawals. Have you considered a longer taper period?

https:/­/­rxchat.com/­wiki/­Fentanyl/­

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Actually 3 months should be the mark where you wake up one day an find that you did not think of an opiate all day.. Hang in there the day will be here soon. I would give it another week, two at the most.

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i am 36yrs old i have been on fentanyl patch 100mcg for the last 13yrs, i am in the process of decreasing dosage to come off this medication and try something else, i am very fortunate that i have good doctor as my doctor made clear to me that i will have to decrease all the way down to 5mcg patch to fully get this out of my system, i went from 100 to 50 which wasnt to bad at the moment i am now on 25mcg and i am suffering but after 5days am starting to feel better, i suggest speaking to your doctor as he should not just stop these patchesx goog luckxx

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You need to make an appt with another doctor who is caring and will prescribe meds to help you come down. I had teerrible withdrawl symptoms just going down a level ( ie 75 to 50 mcg etc) I used ativan the first time and it really helped but what my new dr. agreed to put me on, which I used the 2nd time is methadone. I took 5 to 6 tablets a day for 5 days and no withdrawl at all. Then on day 14 I would go down another level and again take 5 to 6 tabs methadone a day for 5 days etc. I did not feel a thing. Once I went into the hospital and they said they were going to help me get off from 50 to 0. It was a living hell. Sweats vomiting diareah chills legs going crazy seeing things. They gave me nothing. Said I would be better in 5 days. I asked them to release me went home put on 50 mcg patch and saw my pain management doctor who put me on methadone. Worked wonders. But ativan 8 to 10 tabs a da will work too. But you said you cant use benzos. Can I ask why. Good Luck. I start going off 150 mcg/72houurs in about 2 weeks.

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I got off of the 50mg patches a few months ago after 3 or 4 years. Pain mgnt took me down to 5 25mg patches, next a month of 200mg tramadol, now a month of 100mg tramadol. I also take 2 10mg valium a day. It really wasn't that bad. You really haven't been on the patches nearly as long as I was. I'm not sure if the dr will give me anything next visit July 3, but it's working for me. I have less pain now than I did on those horrible patches--my body had gotten so use to them I guess. Good luck you can do this.

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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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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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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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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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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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As a health care professional and a person with pain my heart goes to you.
I do understand where are com ing from.i have been there personally and to be honest there is little help when it comes down to the wire.please find a moment without distress to consider your self and your beauty in this world.
As I say my heart goes out to you.with understanding G

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I agree with Vernon, this is a fast taper off Fentnyl. One bit of advice is leave your patch on for an extra day, try going 96 hrs till you are out of them. Also, use the Norcos for WD relief when you get the restless legs. That dr. has some nerve,taking away. your Rx and not supervising yout taper, shame on him. My wife's ex-dr. is doing the same to her but we've made it through.
I have tapered off off 125 mcg but twice as slow, it wasn't as bad as some people make it out to be. Bestof luck and to blazes with the DEA . . . Q

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to answer your question about why some people HAVE to get off of a certain pain med let me tell you my story . . . I have metastasized prostate cancer, mCRPC, and my wife is disabled. when it came time for my wife to have several surgeries I realized thatI would be the full time driver for quite a while. As I was then Rxed 125 mcg Fentnyl patches I had quit driving as it affected my reflexes too much. To accomplish my goal of not being "wobbly" 24/7 I had my oncologist switch me to Fentora, an IR form of Fentanyl. I'm with you on the no WDs, this way I got my cake and can eat it too. Some folks have a bad reaction to their Rxed opiate or other reasons to want to switch meds, few want to stop all pain treatment .

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