Hi Angel, 50ugh would be a rough ride if you went cold turkey, It would start about 15 hours after you took off the patch and then the worst would be from day 3-10 after that it would start to get better but I wouldn't recommend it.
The right way to do it is to reduce patch size. There is a trick to reduce the size of each step. 25mics at a time is a big step. If you only remove half the backing of each patch that touches the skin and apply it and tape it down you have effectively created a patch half the strength since the amount absorbed is based on the amount of patch exposed to the skin. Dropping in 12.5 increments would be much easier than 25mic increments.
If your on 50 you could use one 25 totally normal and one 25 half exposed to your skin, creating a 37.5 dose, then go to just a 25 then go to half a 25 to nothing. Although Fentanyl is unique and hits the Kappa receptor along with the MU, Demerol can be used short term since it's in the same family.
Using a different med that doesn't bind to the Kappa wouldn't be much help. Hydro,Oxy,Morph,Hydromorph are all strong MU binders but don't hit the Kappa. Demerol does but should only be used short term. I would definitely talk to your PM doc about DCing your meds. If you have blood pressure problems or seizure disorder or any other health problems rapid withdrawal could become very dangerous.
There are also meds that would make the process much easier like Clonodine and a benzo short term and something for nausea. Good luck, Ocean
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