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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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This is probably a difficult question so I only want someone

Customer Question

This is probably a difficult question so I only want someone to take this question if they are knowlegable about drug interactions and can offer concrete advice. My daughter has been on a fentanyl patch for years for chronic back pain. Recently she was prescribed the antibiotic Rifampin for a recurring uti. About 24 hours after taking the first Rifampin capsule she began experiencing all of the signs of opioid withdrawal. We used an online drug interaction checker and found that Rifampin can put opioid users into withdrawal. She immediately stopped the Rifampin but this is her third day of horrible withdrawal symptoms. Our question is - how long will the Rifampin continue to block the fentanyl and how long should she expect to have the withdrawal symptoms - also is there anything she can do to lessen the symptoms?
Submitted: 4 months ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 4 months ago.

Hello

I am a double board certified US doctor and I can help you with this.

The first question is why was she on rifampin.

This is only used for certain illnesses, and she can not just stop treatment for those illnesses.

That is concerning.

Secondly

Rifampin is out of the system in 18 hours, approximately.

Since the last dose.

If there are symptoms much beyond that, then something else is amiss.

This is not a self help situation, and any such situation should be brought to her doctor's attention immediately.

Or answering service

Or urgent care.

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Customer: replied 4 months ago.
My daughter is on rifampin because of a 22 month recurring urinary tract infection caused by the e faecalis bacteria. Many other antibiotics have failed to treat it successfully. But the main question here is why did she go into an opioid/ Fentanyl withdrawal after taking the rifampin? Also even though she stopped the rifampin after the second dose which was at 4 am on this past Wednesday she is continuing to have terrible withdrawal symptoms and we are wondering when we can expect those to end.
Expert:  Dr. Thomas, MD replied 4 months ago.

Past 18 hours this is NOT from the antibiotic.

There are other reasons withdrawl can happen.

Tolerance to the opioid.

The use of other mixed opiod medications such as suboxone.

As I said, i would contact the prescribing doctor if symptoms have not resolved after 18 hours since the last dose.

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. Also, please click a positive rating [hopefully excellent (5)—that’s how we are paid, per rating]. If you forgot something, just use reply and come back. I am here http://www.justanswer.com/medical/expert-dr-thomas/

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