What is the Fentanyl Transdermal patch time table for stopping use?

Answer 1

It depends entirely on the patient, length of use, and overall dosage of the patch. In general, the longer you've used it, the longer it will take you to wean yourself off of it, unless you're switching to an acute med of a lower strength. In those cases, the dosage equivalent of the target drug needs to be matched with the current patch dose (keeping in mind that the dosage tables for patches are conservative estimates), and then from there incrementally reduce the dose until you're completely off of it, or you're at a new maintenance level using the new drug.

I know from experience (having had to increase and decrease my dosages) that it takes longer than you might think if you've been using them for some time. After 10 years of continual use (200mcg's), last year I spent approximately 8 months dropping my dosage levels to the point where I was able to finally stop using them and continue solely on Percocet. That was accompanied by 2 major withdrawal periods; one that lasted 5 days, the other one 3 weeks. Having been through such periods several times over the years, I knew what to expect, but it still wasn't easy. The key is to do it slowly, and when you're at a mental state that you can deal with the hard withdrawal periods (something you can't avoid), hydration, sedation, and good movies, music, or games are essential in getting through it. Toward the end, an anti-anxiety med from your doctor will really help the last stages as it purges from your system.

Keeping hydrated is very important - not only does it help flush it out of your system faster, you'll be sweating buckets while freezing at the same time. Think having the flu, only 10 times worse. I always use water and Gatorade for hydration - Gatorade helps replace what your body is sweating out. You'll know the Fentanyl is coming out too - you can literally smell it as it sweats out of your pores.

As far as sedation, anything you can do to stay asleep or relaxed really helps as well. For music, my personal preference is David Gilmour's "Night to Remember" BD, recorded at the Royal Albert Hall.

It's important that you're both physically and mentally prepared for such an attempt, and that you've got time set aside to accomplish it. To say you're going to be extremely irritable and not good company is an understatement, so doing it while you've got work/school/family commitments on a regular basis isn't recommended. You need someone who can help you and knows what to expect, as your pain will of course get worse as the drug leaves your system. At some point, the withdrawal pain will go away, leaving you with a true indication of your normal pain levels.

Always have a good supply of an acute med on hand as well to help alleviate the symptoms. Percocet or Vicodin works pretty well - you can cut them in half to stretch your supply. A good anti-inflammtory (Naproxen, Bextra) as well as OTC meds (I use Bayer Back & Body Aspirin and Tylenol Rapid Release Gel Tabs) will also help you through the process.

Having said all that, I know that at some point soon I'll need to start using them again, as my pain levels are too high for just Percocet or OTC meds.