Changing ER meds

I've been on Fentanyl patches for (at least) 3, maybe 4 years now. Things just aren't getting any better so PM doc is working with me & my meds to try and help me.

I should say here, that along with the med changes, we have been trying various other treatments, as well (RFA, ESI). The goal, likely, at this point, is to get me to summer (I am a teacher) so I can have surgery. As of late, I'm having difficulty simply getting through the day.

I wouldn't mind switching the Fentanyl if we find another ER that works, however I am terrified of the physical effects of lowering my dose. A few years ago, I was able to step the Fentanyl down, but it was summer and I had a very rough week then things settled down and I was fine. I can't have a week like that and still work!

I have tried Exalgo and things seem slightly better. However, the nurse left a message Friday evening that if I switch completely, he wants to drop one patch (I am on a pretty high dose of Fentanyl.... one patch is 75 mcg!). Seems like way too big of a step to me.

Just looking to see if anybody else has made this switch? At this point, I am planning to talk with my doc, as I had smaller steps of the Fentanyl in mind! As I said, I wouldn't mind at all getting off of the Fentanyl, I am just terrified of feeling the way I felt before when I stepped down. Any thoughts?

There are also non narcotic medications available to help manage any withdrawal symptoms. I am not sure if they will work though or what effect they might have on other narcotic pain meds while you are taking them. It is something though you can discuss with your doctor.

…yes that is a pretty fast reduction, and the 75mcg is a fairly high dose to pull all at once, so make sure you have a good talk with him about it. You should not have to suffer hard withdrawals.

I do remember you! LOL …and it is amazing how much can change in a few missed weeks.

SE

Hi there....

I would hope that you can speak directly with your PM (not the nurse) about being nervous about the transition off the Fentanyl and making sure you all go slow enough to prevent any major withdrawal symptoms.

Now that they have the 12mcgh patch (along with the 25 and 50)...it seems there are ways to easily go in smaller increments down on the Fentanyl...

Can you call and get an appt. with your Dr. to talk with him about this?

Jay,

I was on the fentanyl patches several years ago, but they did not work well for me. When my doc tapered me off the patch, we went very slowly. I think I was on 150/200 mg at my highest. My doc ordered smaller patches for me so that I could decrease by 25 mg every 6 days (2 cycles). Even decreasing via slow taper was rough for me. I've never had any problems with withdrawal before, but for whatever reason, with the fentanyl I had a bit of a rough time.

Best of luck with your transition. If you are worried that your doc is tapering you too quickly, please do ask him to order you some smaller patches, so that you can slow down the taper. I'm sure he'd be happy to reevaluate his taper plan. There is nothing wrong with taking things slowly. Withdrawal is certainly no fun.

Skeye

…forgive me if this has already been discussed, but if your Dr adds another med during the taper, you might find very little in the way of withdrawals. Just another thought to ponder. I just cannot imagine a Dr doing that steep of a reduction to a patient…especially so with Fentanyl.

Good luck!

SE