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Stopping Fentanyl patch...

AnonymousUserAAnonymousUser Posts: 49,550
edited 06/11/2012 - 7:34 AM in Pain Medications
I have been on fentanyl 25 patch for a few months. My new doctor wants me back on Lortab.

How long does it take to get off the patch? I heard that you're just supposed to leave the last one on for 10 days.

I am having so much anxiety, some headaches, a little dizziness, generally feel crappy, etc. But the pain is still the same. No worse.

This is day 6.

Any suggestions would really be appreciated. I feel terrible.

Thank you,


  • Did your doctor not provide you with a written taper schedule? If not, I would call back and ask for one, because trying to taper by leaving the same patch on for 10 days isn't a very good plan. :?

  • No, when I asked him how to wean off it he said to take the Lortab.

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  • Camille,
    He can either give you a 12.5 microgram patch for a week or so before giving you the lortab or he can switch you right over to the Lortab.
    I am not sure of what the dose would be on the Lortab, but if you are experiencing any withdrawal symptoms, contact your doctor. There is NO way that you should be wearing that patch any more than 3 days , no matter what.
  • Long story but I have been on pain meds for about 10 years. I had a cervical fusion at C-45-5-6 with Myelopathy in 2001 and then several episodes of kidney stones ( severe) and then I had a T-8 Thoracic Myelopathy that required surgery in 2005. It was a MAJOR surgery. Thoracotamy with rib removal etc etc etc. I feel I had a GREAT Outcome and feel very blessed. Still lots of pain but I am getting my life back. I walk a mile 5 days per week and exercise daily. I am working on going back to work but am concerned that I am a RN and feel that I would be crucified if I ever were to have a problem with a patient and my history came out. SO... I want to attempt to go off of my patch. I understand that after this long my brain has changed. I am sure the pain sensory system does not work normally. ( I also had 13 abdominal surgeries and other orthopedic surgeries prior to the spinal issues. I have successfully weaned many times over the years. I am just scared about what I am going to face off of the meds but I feel that I must try. OH... 3 months after my surgery ( thorocotomy) I tried to come off of the meds in 2006 but was not successful. I was still having too much pain. My doctor was fine with me being on them ( surgeon and PCP) but I went to a Pain Rehab Program at Mayo and was treated with very little compassion. (they treated me like an addict and kept talking about pain behaviors), I was devastated by the experience and lost a great deal of trust in the medical field again. I had gone there for support to get stronger and they would not look at anything except my use of the meds.
    So here I am a couple of years later ready to go off because I want to and feel the old feelings coming back. I would LOVE to hear anyone elses experiences especially anyone who has gone off successfully. I am on the Duragesic patch and I do not like all of the side effects, ( chronic withdrawal symptoms due to the patch and absorbtion issues, sleepinesss, gut issues etc etc. Any suggestions regarding protocol? My PA told me to go to 50mcg for a month and to use Hydrocodone for breakthrough. Then 25 the next month. Any other suggestions other than activity and fluids??
  • I called the PM since I was like *going crazy* after 7 days with same patch. His nurse said to take the Lortab 10/500 as prescribed and all will work itself out.

    Well, I have offically been through my first withdrawal of any medication I have ever taken. This is my 2nd day with NO patch! I am still having symptoms. They really haven't gotten any better yet.

    The anxiety is the worst. The spins, dizziness, chills, sweats, and nausea come and go.

    I am all out of Ativan and I am not allowed to get anymore from my PCP even though when I called to give him an update (been seeing him since 1995 so, we have a close relationship) he insisted I could see him and accept the script. I explained about the PM Drs damn *contract* but he was pissed he left me high and dry.

    I will see my PCP tomorrow (sat. morning) because he insists on checking my vitals and seeing my present condition himself.

    I just knew the whole *contract* thing would come back to bite me in the ASS!!!!!!!!!!

    Camille <--suffering and in pain
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  • Your PM's plan is pretty typical for a taper from fentanyl. There is a 12.5 mcg patch if you have too much difficulty with the taper at 25 mcg a month. The good thing with fentanyl is that it has a short half life, so the withdrawal symptoms if you have them are shorter lived than those of other narcotics.
    Your PM might also use some clonodine to help with the symptoms if you need him too. Some PM's do use it and it does help ease most of the side effects.
    I wish you plenty of good luck when you begin your taper and remember that it will be over soon. The worst of the symptoms in the taper should be over by the end of the third day and then you should start to feel better .
  • It seems to me that your doctor has no idea what the heck he's doing as a taper for you. :/
    Can you print off anything on the internet about a proper taper from fentanyl and bring it to him? Do you think that he might read it? /:)
    What he is doing is what is making you feel so lousy.
    You can't wear the patch as I said, any longer than 3 days . It is on the manufacturer's patient and prescribing instructions. I believe there is also some references to a tapering plan for fentanyl as well but I am beginning to wonder if this guy even reads?
    There is a huge disparity between fentanyl and lortab, even at 10/500mg. It's no wonder that your regular doc wants to see you.
    Do you have any immodium? Gingerale, or gatorade to drink? The spins, I can't really help you with, but the upset tummy and the resulting problems with the frequent visits to the toilet, the legs twitching....are all part of the withdrawal. Some people have taken tylenol pm to help them sleep but with the amount of tylenol in the lortab, I am not sure how often you are taking them so the tylenol pm might not be an option.
    Can you ask your regular doctor for some clonodine? It helps with the withdrawal symptoms and some doctors use it quite often to help people ease some of the symptoms. And it won't violate your PM contract.
    How long have you been taking the ativan? That might also be contributing to how you feel tonight. It's a benzodiazapien and they are not supposed to be just stopped if you are taking them regularly. Copied from Drugs. com

    Do not stop using Ativan suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.
    Your symptoms may return when you stop using Ativan after using it over a long period of time. You may also have seizures or withdrawal symptoms when you stop using Ativan. Withdrawal symptoms may include tremor, sweating, muscle cramps, stomach pain, vomiting, unusual thoughts or behavior, and seizure (convulsions).

    I am worried about you. If you aren't taking the ativan regularly, you should be okay, but if you are, you need to watch for worsening symptoms listed above. The fentanyl withdrawal should start getting better tomorrow and then the day after should be better than tomorrow. Hang in there. You're almost there, even if your doctor doesn't seem to know what he is doing. :( You might want to consider seeking out a new PM after this. I can't beleive he is presribing and telling patients to keep these patches on for 10 days at a time as a "taper" plan.
  • I don't think he would want to read anything about tapering. How I see it is - he didn't prescribe so, he doesn't want anything to do with it.

    He is my new PM. My last one was a horror with medical board/legal issues.

    I was only on Ativan for anxiety at night because of severe relux that lead to aspiration pneumonia and 4 days in the hospital. Ativan was just very temporary and all done.

    Gatorade is my only drink. Food is very minimal since I have no appetite. I am really feeling weak now.

    I saw my PCP this morning and blood pressure was through the roof but my pulse was very low. My dr is very upset.

    I can't accept any new prescription unless it is for infection; antibacterial, fungal, viral, or respiratory medication according to my contract.

    I am on my own and not doing very well!!

    Thanks for the response - Camille

  • Hello - I know how you feel. It is heck! I went from a 75 patch to 0 - as the patch was running out at 72 hours.

    My choice- I had no BT meds, never provided by my Dr. I got tired of the hill and valley trip that was my experience with the med. I had about 28 to 36 hours of feeling like the pain was controlled.

    It took me 5 days to feel better. I was off work for the week. I walked every day, about 10 minutes at a time, and did it once an hour. It was heck! Nauseous, yes, Diarhea was the worse. My bones ached, deep crushing pain. I don't know that I slept at all. I think I did but it was for very short periods. The emotional roller coaster is just as bad, but I kept telling myself that I was going to be just fine. Eventually, I was, but in order to decrease the back pain, I had to go back onto ER Morphine. Have been on it ever since.

    I do hope your feeling at little better.
  • I know you feel terrible , but you really do need to get something solid into your body. The not eating is probably contributing to the spinning/dizziness.
    Eat some toast and peanut butter and jelly or some rice with butter or something.
    You can't not eat for days without that making you feel worse.
    Even if this is a new PM, he could have given you the 12.5 patches to slow down the taper, and given you the lortab to ease the transition. Even using the lower strength patches for a week would have made the transition easier, or he could have given you clonodine which is simply a blood pressure med that for many eases the symptoms of withdrawal.
    I'm sorry hon that you are going through this.
    Wish that I could offer you some alternative. Hang in there, it is almost over.
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