I have been on fentanyl for almost 3 years. I have a disease called genetic pancreatitis, that I use fentanyl for. I tried to get off this medicine, for it seems to be taking control of my life. I am on 100 mcq every 48 hrs. I started with 75 every 72 hrs. I then went to 100 every 72 hrs, then every 48 hrs. which I am at now. My doctor and I tried to reduce the amount down to 75 mcq, but I went into withdrawals. It seems like my patch is not working after the first day, in fact it feels like it's not working after a few hours. I start getting real anxious, I feel like I'm going to jump out of my skin. I start to sweat, and get real cold. My skin gets clammy. I can't sleep, and I start getting blackouts where I throw myself around, or so I'm told. I don't want to feel like this anymore. I just want to be off this medicine, and my doctor and I are at a dead end. Is there anyone out there who has had this happen to them? Is there anyway to get off fentanyl without reducing. That is not an option. Tried it, did not work. Actually, tried it a few times. Failed each time. I had to beg the doctor to put me back on 100. I really need some help here. I'm at my breaking point. I've never felt helpless like this before. Thanks for taking the time to look at my question. Andrew
Last edited by hawkman81980; 11-13-2007 at 12:48 AM.
Reason: Messed up, sorry
I saw your post on the addiction board as well. I have the same problem you are having now. I could not get past the 50 mcg patch. I couldn't take it. The pain was so bad, and I got so depressed this past weekend that I seriously thought of offing myself. My doc. knew right away that we had to change to something that I can cut or go down slower. He prescribed me Norco's, starting off with 24 so we can see how much I am taking. Today is day two, 24 hours off the patch with clonidine. The physical withdrawals are bad, sweats, diarhea, shaking but taking a clonidine .1 and two norcos alllows me to feel so much better. The depression left yesterday, THANK GOD, I can handle the withdrawals now that I know they will subside. I don't know if that helps you at all. We also considered percocet or oxycodone. The oxycodone is shorter release so you, i think can cut it or take it at less lower levels when you are ready to go down.
pS. I have to come off to see where my pain levels really are after my acdf in April, I also have endometriosis and chronic pain. We are hoping to use less narcotics and more anti-inflammatory or whatever else is out there.
I still may need another surgery but really hope I don't.
Hi Andrew - are you still suffering from pain? If you are, how do you plan on treating it when you have discontinued the Duragesic? I was on the patch (100 mcg/h) and changing it every 2 days, just like you. In addition, I was taking oxycodone 30mg. for breakthrough pain (up to 4 per day). I didn't want to deal with the side-effects from the patch any longer. My skin was breaking out in a rash from the adhesive that was around the edges of the patch. The rash was getting infected and would bleed now and then and I asked to be taken off the med. The way my doctor did the taper was easy and straight forward. I took off the 100 mgc/h patch and replaced it with a 75 for 2 days, then to a 50 for 2 days and finally to a 25 for 2 days. I was totally off the patch in 6 days. Since I didn't experience any withdrawal symptoms, I am assuming that the oxycodone held them at bay. After about 10 days without the patch I realized just how much the patches were masking my pain. It was clear that the 120 mg. of oxycodone would not take care of my pain. After a few weeks of a trial of oxycontin in a couple of combinations, I am now back on 180mgs of oxycodone per day. I don't need any other drug to cover my pain. So, the only thing that I can recommend is having your doc do a quick taper off the Duragesic while placing you on something else like oxycodone. Perhaps once you have been off the patch for a few weeks you can start to taper from the oxycodone and switch to something less potent or try over the counter meds if your pain isn't too severe. Good luck to you - I hope you get through this with as little stress and symptoms as possible. Memere (K'Mac)
I would highly suggest a slow taper process. I have heard of people on the fentanyl patch on doses around 100mcg that took 4 months to get off of. They do make a 12 mcg patch which is beneficial for reducing. You could maybe try
75mcg + 12mcg = 87mcg (for 2-3 weeks)
75mcg (for 2-3 weeks)
50mcg + 12mcg = 62mcg (for 2-3 weeks)
50mcg (for 2-3 weeks)
25mcg + 12mcg = 37mcg (for 2-3 weeks)
25mcg (for 2-3 weeks)
12mcg (for 2-3 weeks)
Then you can cut it down to Vicodin and slowly taper off of that say for 2-3 weeks. This is a total of 4 months. You have to be dedicated and vigilant but it can be done and this schedule greatly minimizes the withdrawals and allows you to function.
If you can't do it by yourself then you may have to consider going into a detox center.
Great post! I just wanted to let you know you have really become an asset to this board. Your post was informative and knowledgeable. I would highly recommend that you take his advice and reduce your suffering! I hope this works for you. Withdrawals are no joke, so do this slowly. Good Luck!
Brian's post is full of excellent advice and if you want to go all the way off that's the way to go.
There is another option - Methadone. This requires a doc that really know's his/her stuff but you could transition to Methadone and feel no withdrawal at all. Once someone has been on another potent opioid like Fentanyl (the patch) there's a conversion ratio that must be applied to find the proper Methadone dose. It starts by determining the morphine equivalent to the patch dose and then applying the ratio (e.g. 5:1, 10:1, whatever is right).
I went from Duragesic patches to Methadone and it went very well. I was on about 200mcg of patches avery 48 hours and was converted to Methadone 80mg per day and my pain was much better controlled and I needed no breakthrough meds. I was started at a lower methadone dose to start and worked up to the 80mg/day.