Weaning from Butrans

[NJPAIN]

I have a patient who has been on Butrans 5mcg/hr for the last 3-4 months. Pain is now resolving as lower extremity lesions are almost healed. Time for Butrans to exit. First time I’m looking to stop Butrans. Looking for experience of others. At this dose just stop? Peel off half of the backing and guesstimate 2.5mcg prior to stopping? My only other experience with Buprenorphine weaning is with Suboxone which is a freaking nightmare; though I understand that is a much larger dose.

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[painfree23]

1-2 tramadol every few days for break through pain for a week and then stop

 

[Ronin1]

I have a patient who has been on Butrans 5mcg/hr for the last 3-4 months. Pain is now resolving as lower extremity lesions are almost healed. Time for Butrans to exit. First time I’m looking to stop Butrans. Looking for experience of others. At this dose just stop? Peel off half of the backing and guesstimate 2.5mcg prior to stopping? My only other experience with Buprenorphine weaning is with Suboxone which is a freaking nightmare; though I understand that is a much larger dose.

just stop it. No issues really

 

[Orin]

You're on the lowest dose. I wouldn't mess around with trying to decrease the effective surface area.

Have them leave it on past the 7 days and provide some moral support. It'll wean itself slowly from the fat depot. You can provide some clonidine but please don't switch to another opioid agent here. They'll be fine.

 

[BobBarker]

Just have them leave the last patch on until it falls off