Donot use benzos, the problem going from 8 to 6 dilaudid, theamount is too much. 25% is far too great when you get down to these low doses when tapering. I try going with 0.5 mg which is 6-7% of dilaudid continue this for at least three weeks. The firstbweek is getting adjusted to the change. Clonidine may also help but remember it causes hypotension amd it too can be abused. Lofexidine is a better option. Far safer. 6% is usually tolerated. The problem will be aches and pains plus akathesia like feelings, these are not helped with alpha agents. Benadryl sometimes helps with higher doses of ibuprofem max 2400 per day limit of two day max before break or holiday. If you need more let me know. Please do not under any circumstances use benzos, avoid clonidine. There is a reason why substance use disorder patients request it and it has little to do with benefit In discontinuation . An alternative is use buprenorphine patch in butrans, a month worth costs 70$ and will dc most all at that low dose. What i do is get them down to as low as possible then start a butrans patch. Continue lowest dose of dilaudid for a week then increaee the butrans to ten mcg/hr, continue dilaudid reducing the dose at start of next week, week three increase butrans to 15/hr the stop the dilaudid. You may need to increae again the butrans or give 2 mg suboxone within 24 hours off stopping The dilaudid. Ive done it all ways. All work but each patient is individual
