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  • BDD Moderators: Keif’ Richards | negrogesic

Going from fentanyl to suboxone

W

will430

Bluelighter
Joined
Dec 21, 2011
Messages
92
Ok, I read the wait times on most opiates when switching to suboxone. But fentanyl to me is a confusing one. I'm going from wearing a 75mcg patch for 3 days to suboxone. Now i've seen where fentanyl is a short half life and i understand that. But i need to know since i've worn the patches the correct way. How long does it take for fent to leave the body to properly take suboxone.

I've seen where it makes the fent deposit in the skin and is still releasing medicine in the body even after you take the patch off. There is alot of stories of people switching to sub from fent and going through PW's. Now, i do not want to be one of those people. Can someone show me the info as to a timeline when fent is done deposting into your body after taking a patch off. I can not think of a worst way to go into precipitated withdraws then going from fent to sub to early.

Please please do not just say "wait till your in withdraws Or use the COWS sheet. To me that should be common knowledge. : /

If i find this info out. I can multiply that half life of the fent from the time i take it off. To the proper wait time that i feel will be in sufficent withdraws. I want to run 0 risk of PW's aswell as minimal suffering to getting back to suboxone. Thanks for any stabs at this question. And anytime you put into answering.
 
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You are correct; after using the patch the fentanyl takes much longer to leave your body because it deposits in the skin and is slowly absorbed even after you remove the patch. How long this takes is going to vary a lot from person to person. The average amount of time for the fentanyl to be around 97% eliminated from the body after patch removal should be around 3.5 days (but could be up to 5 days or even more for some people). I'm not really sure how long would be ideal to wait before using Suboxone. I would wait as long as you can handle and start with a low dose of the Suboxone (like 1mg), then take more a few hours later if the first dose left you feeling ok and so on. Doing that should help reduce the risk of PWS.

Hopefully this info helps:

The pharmacokinetics of the fentanyl transdermal patch (FTP) shows broad interpatient and intrapatient variability. Elimination of fentanyl after discontinuation is slow, with an elimination half-life after patch removal of about 17 hours, ranging from 13 to 22 hours. This is due to the slow release of drug from the skin depot commensurate with transdermal delivery. However, the elimination half-life in the elderly may be prolonged. Careful consideration should be taken transitioning from FTP to an extended-release morphine product, particularly if the patient is on high-dose opioids.

Once the fentanyl patch is removed, the patient may be transitioned to morphine by administering half of the morphine-equivalent dose in immediate release (IR) formulation every 4 hours for 2 to 4 days, until the lowest possible pain level is maintained. Afterward, the IR formulation may be converted to a sustained-release (SR) formulation given at appropriate dosing intervals. Due to prolonged pharmacokinetics associated with FTP, the dose titration phase may be extended as fentanyl is slowly released from the depot and ultimately metabolized. After patch removal, the analgesic effects of fentanyl may continue for 12 to 24 hours. [source]
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So far i took a little less then 1mg and that was about 10mins ago. I am 20 hours off of the second patch i used. I only wore 2 patches for two days each. So i am waiting to see how i react to that little dose of subs. Ugh i hope i don't hit that infamous Precipitated withdraw.... : (
 
Ok took .5mg as stated above like two hours ago. Felt ok. About 15 mins ago just dissolved roughly 1.5mg under tongue. This is going to be the real test here as i am still typing and praying to the junkie gods that i do not experience this so called PW's. So far so good. I'm typing, chugging water, waiting for relief or all hell to break loose. How long would you say i am in the clear after this last dose? Is it within 30 mins i'll know if im hitting PW's? I do NOT want it to creep up on me!?

Swimmingdancer your probably like the most helpful mod i've encountered here. You've helped me with alot of stuff. And i am very thankful for your help
 
Smart idea titrating up with small doses of suboxone, i am willing to bet you will already avoided PWs since its been a couple hours since the initial dose.
 
Crashing said:
Smart idea titrating up with small doses of suboxone, i am willing to bet you will already avoided PWs since its been a couple hours since the initial dose.
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crashing... Whats up man? Yeah i just chomped down the rest of the sub i had. Like 4 mg more. This precipitated withdraw thing must only be a myth. I took sub 19 hours after wearing a 75mcg fentanyl gel patch. I seriously feel way better after the sub and im kissing the floor that i wasn't met with horrid withdraw times 10. I have to be at work in 2 hours and it would look freaking terrible showing up there in fucked up shape.
 
Thanks for your kind words and glad it worked out!

Precipitated withdrawal is no myth. But it's possible fentanyl may actually be less likely to cause it compared to many other opioids. Add to that the fact that you waited a good chunk of time after removing the patch and used the gradual dose titration when starting the bupe and those things probably really decreased your chances of PWS.
 
Buprenorphine has little to no effect on fentanyl. I could take my subutex some hours after removing the fentanyl patches without problems. It seems incapable of blocking fentanyl's effect completely and therefore should not cause precipitated withdrawal (never happened to me at least).

edit: suboxone? nevermind I've never used these pills with naloxone...
 
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The naloxone shouldn't make a difference. The reason I said its possible that fentanyl may be less likely to cause PWS when used before buprenorphine is that I THINK it might have a similar or higher binding affinity for opioid receptors than bupe, therefore bupe may not be as able to rip it painfully off the receptors like it does with most other opioids. I'll try to see if I can confirm this. The OP said they had heard of people getting PWS switching from fent to bupe though...
 
Swimmingdancer said:
The naloxone shouldn't make a difference. The reason I said its possible that fentanyl may be less likely to cause PWS when used before buprenorphine is that I THINK it might have a similar or higher binding affinity for opioid receptors than bupe, therefore bupe may not be as able to rip it painfully off the receptors like it does with most other opioids. I'll try to see if I can confirm this. The OP said they had heard of people getting PWS switching from fent to bupe though...
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Yea I think so too. Using fentanyl only hours after taking a whole 8mg buprenorphine pill still gets you high. Using buprenorphine while still wearing fentanyl patches will diminish the effects but never caused precipitated withdrawals for me. I've only found fentanyl and tramadol to work this way. All other opiates would make me feel like complete crap if I dosed buprenorphine too soon after them.
 
Toz said:
Yea I think so too. Using fentanyl only hours after taking a whole 8mg buprenorphine pill still gets you high. Using buprenorphine while still wearing fentanyl patches will diminish the effects but never caused precipitated withdrawals for me. I've only found fentanyl and tramadol to work this way. All other opiates would make me feel like complete crap if I dosed buprenorphine too soon after them.
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I know this is kind of an old thread but I'm looking for more information on this seemingly unique situation with suboxone and fentanyl.

There's been a few studies.
http://jeccr.biomedcentral.com/articles/10.1186/1756-9966-28-61

Is one, and I can't find the links to the others but it seems to suggest as above states. Fentanyl has a higher binding affinity or close enough to equal to prevent PW from suboxone.

I can find lots of anicdotal evidence that supports the opposite in forums and posts but most of those include people taking other drugs along side fentanyl or people stating they were still "sick" for days which could just be extended withdrawals and not PW at all.

I should probably start my own thread but I'm looking for more first hand accounts of people NOT previously taking suboxone recently (which could suggest successful induction already removing the chance for PW) that have been able to switch from fentanyl to suboxone?

The journals leave questions unanswered....or it would be a slam dunk. They use transdermal bupe and fent and replace one patch with the other. That could suggest a "build time" before absorbtion through the skin while the other was eliminating?

I'm personally in this scenario and trying to avoid PW while switching so super curious
 
I meant, Does anyone know what the conversation is switching from 100 mcg fentanyl to suboxone?
 
I know this is an old thread but.....I took off a 100mcg patch and 4 hrs later took 2mg suboxone. I also shoot fentanyl while I have a patch on. I can shoot 100mcg patch, so my tolerance is high. As I said I took patch off, shot up what was left then took 2mg of an 8mg sub. NO PW at all. This is odd. Its been 24 hrs now, still fine. 4 hours ago I took another 2mg 4hrs ago and I'm ok. I'm still worried some, but so far so good. It seems little amount is best. I could have taken the full 8mg but I didn't. It was a sort of experiment as myself as the guine(sp) pig. That's my story.
 
Freakyunoco said:
I know this is kind of an old thread but I'm looking for more information on this seemingly unique situation with suboxone and fentanyl.

There's been a few studies.
http://jeccr.biomedcentral.com/articles/10.1186/1756-9966-28-61

Is one, and I can't find the links to the others but it seems to suggest as above states. Fentanyl has a higher binding affinity or close enough to equal to prevent PW from suboxone.

I can find lots of anicdotal evidence that supports the opposite in forums and posts but most of those include people taking other drugs along side fentanyl or people stating they were still "sick" for days which could just be extended withdrawals and not PW at all.

I should probably start my own thread but I'm looking for more first hand accounts of people NOT previously taking suboxone recently (which could suggest successful induction already removing the chance for PW) that have been able to switch from fentanyl to suboxone?

The journals leave questions unanswered....or it would be a slam dunk. They use transdermal bupe and fent and replace one patch with the other. That could suggest a "build time" before absorbtion through the skin while the other was eliminating?

I'm personally in this scenario and trying to avoid PW while switching so super curious
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read my post
 
Gwar, you shoot fent patches? How? Let them soak in water? I'm very curious, never heard of that before :)
 
Rachella666 said:
Gwar, you shoot fent patches? How? Let them soak in water? I'm very curious, never heard of that before :)
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Not a good way buddy. I get a spoon, boil water, cut out a corner, squeeze the gel into a spoon, then with a huge needle that has a luer lock twist off tip, take the luer lock needle off, suck it all up and bang. I think they are 18 gauge or 20. I buy them off Amazon. I know the Gel can't be good but I've been doing it for three years. PLEASE be careful. I have a VERY high tolerance so I'm able to do a whole hundred mcg patch. BUT I've found myself in the floor a number of times. Not anymore though. Please please, be careful. I started out slowly. I have SEVERE chronic pain from numerous issues and that's the reason I do it. The needle is painful. I use a water based lube on the area the needle is going in to help it slide in easy. OR you could use a regular needle. But you can put as much in it and sometimes it's hard to push the Gel through. The Luer lock is the best way to go. Careful.
Take care.
 
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