Drug interactions
Aprepitant + Fentanyl
Severity: Moderate
Aprepitant and Fentanyl: moderate 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
Aprepitant inhibits CYP3A4, which metabolizes fentanyl, and may raise fentanyl concentrations. This could increase sedation and respiratory depression, especially with repeated or multi-day aprepitant dosing.
What this interaction means in plain words
Aprepitant and Fentanyl can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Aprepitant belongs to Gastrointestinal Tract; Fentanyl belongs to Musculoskeletal.
Why it happens
Moderate CYP3A4 inhibition by aprepitant reduces fentanyl clearance.
What to do
Monitor sedation and respiratory rate at frequent intervals and reduce the fentanyl dose if needed. Take particular care with extended aprepitant exposure.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
Frequently asked questions
Can I take Aprepitant with Fentanyl?
MediHelp rates the interaction as moderate. Aprepitant and Fentanyl can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Aprepitant inhibits CYP3A4, which metabolizes fentanyl, and may raise fentanyl concentrations. This could increase sedation and respiratory depression, especially with repeated or multi-day aprepitant dosing.
How serious is the interaction between Aprepitant and Fentanyl?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and respiratory rate at frequent intervals and reduce the fentanyl dose if needed. Take particular care with extended aprepitant exposure.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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