Drug interactions
Alprazolam + Fentanyl transmucosal
Severity: Major
Alprazolam and Fentanyl transmucosal: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Concurrent use of a benzodiazepine and an opioid can cause profound sedation, respiratory depression, coma and death. This is a boxed-warning class interaction for opioids.
What this interaction means in plain words
Alprazolam and Fentanyl transmucosal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression from opioid and benzodiazepine activity.
What to do
Reserve the combination for patients without adequate alternatives, with the lowest doses and shortest duration. Monitor for respiratory depression and sedation, and counsel patients and caregivers.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Fentanyl transmucosal?
MediHelp rates the interaction as major. Alprazolam and Fentanyl transmucosal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Concurrent use of a benzodiazepine and an opioid can cause profound sedation, respiratory depression, coma and death. This is a boxed-warning class interaction for opioids.
How serious is the interaction between Alprazolam and Fentanyl transmucosal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve the combination for patients without adequate alternatives, with the lowest doses and shortest duration. Monitor for respiratory depression and sedation, and counsel patients and caregivers.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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