Fentanyl and buprenorphine

Common Questions and Answers about Fentanyl and buprenorphine

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I too tried coming off yesterday - Doc said it would be OK - after 5 hours I started getting shakes, an itching feeling under my skin and in my bones,nausea, sweating, a slight fever, unable to close my eyes and sleep, psychotic, I felt like dying, just so awful, a nightmare. I called the Doc he suggested cutting 25 mcg patch in half, so 12.5 mcg, and let that level me out. It is now 12 hours since I put this one on and I have calmed down a lot but still am a little shakey, itchy, restless etc.
I've had a cranial MRI which didn't show anything and I'm still awaiting LP results for the MS. I've been checked for most things, not Lyme, because it is not active in this part of the UK (it's only in southern counties, not this far north). Just got to keep slogging on I suppose...
I tried to jump at 2mg last week but felt so rotten within 2 days that I was back at the docs and back on 2mg (I had the worst shivers / hot flushes and bad stomach and left work early). My aim is to reduce by 0.4mg each week until 23 Dec and then come off it completely. The reason for doing it over Christmas is that I am off work for 9 days in total and so will be over the worst of it, if not completely better! So I will be coming off 0.4 - 0.8mg.
hydromorphone, hydrocodone, oxycodone, oxymorphone and desomorphine, buprenorphine. Heroin and the other morphines can actually be put in this category as well - as they are derived from natural opiates. Fully synthetic: fentanyl, pethidine, methadone, and propoxyphene. There is a huge difference in the terms synthetic and semi-synthetic. But neither has anything to do on if they are produced in a lab. They all are.
For the past year I have been taking 75 mcg fentanyl patches every three days.I need and want to stop and get back to living a clean FUN life.I don't get them by prescription so I can not goto a dr to taper off.I have tried on my own and it was total HELL! The thought of those feelings again scares me to death.I read about Suboxone and wonder if someone here can tell me how it worked for them.Also money wise how much did it run?
Getting it cleared from your body will depend on your percentage of body fat, your metabolic rate, and the ability of your liver to break down the fentanyl. I would imagine that fentanyl could be found in your body for a month or so after stopping it, but the last couple weeks it would be in very low concentrations-- too low to measure by the standard urine tests out there, and too low to have much of an affect on you. OK... hallmark of addiction...
My husband and I decided to try and have a baby which means I have to bite the bullet and just deal with the pain and get off all the drugs. I have never abused my meds and always followed my doc's orders... which I know really doesn't make a difference in the grand scheme of things since abused or not I know I will be having a ***** of a time getting off these things. I had quite dilaudid last year cold turkey to see where my pain levels were at which was absolutely horrible...
I too use Fentanyl. I am on 100mcg every 48hrs. I couldn't go the 72hr. and it wasn't because I felt weird or uncomfortable in my skin. I was in added pain by the third day and needed to change the patch more often. I had originally started on the 75mcg patch and that worked good for about a year. Until recently I was up graded to the 100mcg. I haven't had the tolerance issues when using the Fentanyl as I did with other pain medications.
I never seen him take so much as tylenol without doing a week's study on the product and all possible side effect's , and i think god for his knowledge no matter how he got it , in my eyes he is a good kid and has always helped me with anything and everything , never disrespectful etc , But back to my point at hand , as with any opoid medication or '' any med '' your taking as a regimen , u can become tolerant/dependant , just like a person who goes cold turkey off coffee is a total grump duri
I just came off Fentanyl- It completely changed my personality and I started to isolate- and it was hard. I was also taking oxycodone and for the first 11 days I went CT off everything hoping that my pain would settle and I would be able to get by using OTC medication. I ended up getting back on percs after 11 days and those 11 days were the hardest and most grueling experience I ever had. It was torture. My Mom helped with the kids for the first 5 days.
It is pure Buprenorphine, and they are afraid addicts will melt it down and inject it. Suboxone has Naloxone in it so you cannot do that with it. The Naloxone really helps with the cravings I think. I often wonder why they didn't put Naloxone or Naltrexone in with oxys. It would have prevented a lot of deaths.
hey, as far as i am aware, buprenorphine and fentanyl have not yet been approved for the management of chronic pain. I tried patches for a while but got nowhere near the relief of my oxycontin pills.
There are so many crazy symptoms with fentanyl w/d. Just let me know if you need me! Jacqui805 and emtrmeski both detoxed of fentanyl too and they were there for me.
Eagle is correct, Cathy-- buprenorphine, Suboxone, and Subutex are all essentially identical. Buprenorphine has been around for 30 years; it used to be sold under the brand 'temgesic' in liquid form before being made as Suboxone, which is easier to dose. Buprenorphine is used for pain, mostly in Europe-- a skin patch in the UK called 'buTrans' releases 5-20 micrograms of bupe per hour through the skin. Six years ago, in 2003, Suboxone became available in the US.
I'm sorry tonskat, but I didn't receive anything from you. But I now have some options to discuss with my Dr.Thanks again for responding.
Started on Butrans and transtec......didn't hit the spot (severe pelvic and abdominal adhesions cause my pain). Moved onto Fentanly. 50mg I have turned into Satan! Anger, moods, hatred - got im an absolute b*tch! Decided I needed to get off this crap.....pain clinic doc said 50mg for 3 patches worth (changing as per instructions on box), next comes a 12mg+25mg patch (both at same time) for 3 patches worth, then comes 25mg (3 patches worth), then finally 12mg.
I've taken hydrocodone, and oxycodone and never had a problem with addiction. But the fentanyl is really terrible. Everything everyone has said regarding how hard it is to get off of it is so very true. I'm desparate to get off the fentanyl. I would rather have the pain, than go through months of awful pain like I had when I broke my leg. My plan is to stay on the 6s for maybe a month. Then got back down to 3, then cut the 3 in half making it 1 1/2 and so on.
I've been on Fentanyl for several years (2) and am growing increasingly tired of it. The problem is that I'm really, really dependant and it doesn't last me the 2 days that it is supposed to, so every other day I jones for it and have w/d symptoms. Literally...w/d every second day of my life, it's miserable. I live with my girl of 6 years and want nothing more then to be normal again.
There is a new pain patch on the market that contains buprenorphine and is supposed to last a week. I have no personal experience with it. Bupe is a partial agonist synthetic opiate with a very long half life that is also used in oral form to stabilize opiate addicts while they get their lives together and taper off. I understand it's been used in patch form for pain management in Europe for several years. Since it's new to the US market, I would guess it's going to be expensive.
Important to add that I am in England-so meds may be different! I was on Fentanyl patches 37 mcg and 3 oxynorm 5mg per day for 5 years. I found that the tablets were becoming a problem in that I would save them for times where I felt insecure or needed a bit of courage. I had weight loss surgery and have lost 230 lbs. I am in therapy as well for body issues and feelings of self loathing. Issues which need to continue to be addressed.
Any reversible ligand (a ligand is something that binds to a receptor) is constantly in a state of binding and 'unbinding' from the receptor, and buprenorphine is no exception. There are 'association constants' and 'dissociation constants' that explain the rates of attaching and separating, and the ratio between the two determines the 'affinity' or potency of the drug at the receptor.
#Pain Killer Equivalent Doses (Oral) 1.2mg.............Buprenorphine (Bupe) 200mg............Codeine (Tylenol 2, 3, 4, etc) 30-60mg.........Diacetylmorphine (Heroin) (orally it = morphine, IV/IM/insuffilated it's 2x as strong) 100mg............Dihydrocodeine 30mg..............Hydrocodone (Vicodin, Lorcet, etc) 7.5mg.............Hydromorphone (Dilaudid) 37.5µg............Fentanyl (not sure on this one, anyone know the oral dose equivalence for Fentanyl?) 4mg................
Buprenorphine formulations, namely subutex ( buprenorphine hydrochloride) and suboxone (buprenorphine hydrochloride and naloxene hydrochloride) are the only opiate additction therapy drugs that meet the specifications of Drug Addiction Treatment Act of 2000. This enables the physicians with specialized training to carry out opiate addiction therapy in clinics with schedule III, IV and V drugs.
Hi, Congratulations on coming off the Fentanyl and the Percs! Try not to stress -- The symptoms you're feeling are common when you go from such a powerful opiate to Suboxone which, although it has a strong affinity for certain receptor sites is not as strong a pain reliever. It has a 'ceiling dose' where other opiates don't. I know that I, and many others I know experienced what you're going through. Hopefully, you'll adjust to the Suboxone soon. What's your dose?
I know of only one other opiate that will knock bupe right off its pins (I'm sure there are others) and take its place and that's fentanyl. That gives it both partial agonist and partial antagonist qualities. In case of any kind of emergency requiring in-patient pain management or anesthesia, there would be no problem. ziggy - since you're concerned about this issue, make sure you talk to your doctor or even your pharmacist about it.
In the presence of renal impairment, those drugs which exhibit the safest pharmacological profile are alfentanil, buprenorphine, fentanyl, ketamine, paracetamol (except with compound analgesics), remifentanil and sufentanil. none of these deliver a high active metabolite load, or suffer from significantly prolonged clearance.
Thank you So very much for your help and PLEASE EXCUSE the Time to REPLY, i was MOVING to a Warmer location, back Down the volcano and into town... I have read and Read ALL kinds of info and the Suboxone seems to be given as a DETOX drug for people who have been ABUSING PX MEDS Whether their Own px or Buying them illegally... ("Valium from Thailand! Real Oxy's from NIGERIA!!
If you need pain medication, the doctor (or paramedic) would need to give a higher dose than normal-- leading many patients on buprenorphine to wear a medic-alert bracelet. I have had a number of patients go through emergency and elective surgery, and things always go OK-- even though everyone is always worried!
Even if you did wait 24-48 hours, the problem is that your tolerance is much higher than the amount of opioid stimulation produced by Suboxone and buprenorphine. At the ceiling effect level, buprenorphine has the opioid effect of about 60 mg of oxycodone—much less than what you got from the oxycodone and fentanyl combined that you were taking. All is not lost. You MUST keep taking the Suboxone; over 4-6 days, your tolerance will come down and you will feel better.
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