### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi my name is Mariana. I m taking fentanyl patch 50 mcg. I have been using it for like 2 months. I think this is giving me nausea and constipation . I am taking xeloda for my cancer treatment 2 weeks on and one week off the xeloda. On the week I m off i still think its the patch that makes me feel nausea and vomit . Cause that week I m off the chemo I still vomit so the only thing I m using is the fentanyl patch. I was using the 75 mcg but then 1 week ago I lowered it to 50 because I m afraid to just stop it once and I will feel the withdrawals. How can I get off the fentanyl patcChatDoctorpletely. Oh the patch I used it for my aching back and shoulders. I took Ondansetron 8 mg but still don t help. So I stopped taking it cause when I did I actually vomited as well. So I stopped taking it. I have the feeling the patch is causing the nausea but I m afraid of the withdrawals symptoms if I suddenly stop. What can I do, I want get off the patch.

### output:

Dear, I have not understood what type of malignancy you are suffering from yes these morphine analogues in the form of fentanyl patch does give the feeling of nausea and vomiting in a very sensitive patient. You can get rid of it by reducing the dose and substituting it with tramadol under the advice of your physician. If your malignancy is under control so must be your body pain as we. In such case you can do away with fentanyl and there will be no with Chat Doctor. Truly,