Drug interactions
Brimonidine + Fentanyl transmucosal
Severity: Moderate
Brimonidine and Fentanyl transmucosal: 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
Brimonidine has central alpha-2 agonist activity that can cause sedation, especially with significant systemic absorption. Combined with a potent opioid such as transmucosal fentanyl, sedation and respiratory depression may be increased. The risk is greatest in children and with high systemic exposure.
What this interaction means in plain words
Brimonidine and Fentanyl transmucosal 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.
Why it happens
Additive central nervous system depression from alpha-2 adrenergic agonism and mu-opioid agonism.
What to do
Monitor for excessive sedation and respiratory depression when brimonidine is used in a patient on transmucosal fentanyl, and reduce the opioid dose if sedation develops. Use topical ophthalmic brimonidine with punctal occlusion to limit systemic absorption.
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 Brimonidine
- Brimonidine + Isocarboxazid Contraindicated
- Brimonidine + Linezolid Contraindicated
- Brimonidine + Phenelzine Contraindicated
- Brimonidine + Procarbazine Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Brimonidine + Selegiline Contraindicated
Frequently asked questions
Can I take Brimonidine with Fentanyl transmucosal?
MediHelp rates the interaction as moderate. Brimonidine and Fentanyl transmucosal 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. Brimonidine has central alpha-2 agonist activity that can cause sedation, especially with significant systemic absorption. Combined with a potent opioid such as transmucosal fentanyl, sedation and respiratory depression may be increased. The risk is greatest in children and with high systemic exposure.
How serious is the interaction between Brimonidine and Fentanyl transmucosal?
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 for excessive sedation and respiratory depression when brimonidine is used in a patient on transmucosal fentanyl, and reduce the opioid dose if sedation develops. Use topical ophthalmic brimonidine with punctal occlusion to limit systemic absorption.
What other medicines interact with Brimonidine?
MediHelp also lists interactions of Brimonidine with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Brimonidine page.
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