Hi Dean H, Fentanyl is a unique opiatee as far as what receptors it binds too. It's one of the few that has Kappa activity where Dilauaidid has virtually none which means you can expereince withdrawal even given the most generous dose of Dilaudid. You really have to get passed the differential withdrawal before fine tuing and adjusting the Exalgo. You can always adjust but increasing in the hopes of decreasing Fent withdrawal will just make your tolerance higher than if you had toughed out the withdrawal a little lomger.
Good luck, Dave
The Following User Says Thank You to Shoreline For This Useful Post: deanh (09-15-2012)
It's been a while since I did patches and I switched back to methadone at the time, but I was feeling much better by the end of the week. after a week you should be able to tell the difference between dosage issue and differential withdrawal. The first 3 days are the worst, it should get better fairly quick. Seems like forever at the time but as long as you are confident your doc will work with you to find the right dose it's easier to get through the bad times.
Hope your feeling beter soon and are satisfied with the end result of switching. dave