AboutNigel Simmons Expertise I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised.
Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner.
I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question.
Consider.. would you want me to discuss your care with a friend or relative without your knowledge?
Experience Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire.
Past/Present clients Previously Sysop on CompuServe UK Professionals forum.
Question Doctor,
I have been taking fentanyl 100mcg ptaches for some years but now a promising surgery may rid me of the majority of my pain. My question is, what are the symptoms of fentanyl withdrawal, how long it lasts etc. I realize I could 'wean' myself down but want to know what I would experience going cold turkey. Please answer as if I were going cold turkey (stopping immediately) as others I have asked speak only of weaning and I'd just like to know what simply stopping would be like. So please, just an honest answer as to the level of unpleasantness I would be in for, and for how long. Please be specific as to symptoms, i.e. vomiting, irritability or whatever may occur. You're a good man for providing this service.
Thank You Very Much,
Jeremy B.
Answer Jeremy
Some of the key benefits of Fentanyl are its short duration of action and a low likelihood of causing dependency.
Although you will probably require pain relief for the period immediately after surgery, if this is based on using fentanyl or a patient-controlled infusion of morphine, then you should find that you can manage the immediate pain and then move on to simpler analagesics such as acetaminophen (US name - paracetamol in the UK) or a non-steroidal drug such as ibuprofen. There would then be no need to wean yourself off the fentanyl as it will happen as you manage the pain.
What I would have reservations about is using oral opiates such as hydrocodone. These will have a much greater risk of creating dependence.
Obviously, if the surgery does not produce the pain-relief you expect in the short-medium term, then you will need to continue using an analgesic. If this is the case, then again fentanyl would be preferable over oral opiates as you can always reduce the strength of the patch, or simply remove it for a while and see if acetaminophen / ibuprofen is sufficient. Take the analgesia at least an hour before removing the patch and be prepared to use at least 400mg ibuprofen per dose. If you can manage on simple analgesia, then continue to do so, reducing to as required dosing when you are able. If they are insufficient, then you can apply a new fentanyl patch which will become effective in a short time.
