Drug interactions
Buprenorphine + Fentanyl iontophoretic transdermal system
Severity: Major
Buprenorphine and Fentanyl iontophoretic transdermal system: major interaction.
Last updated Sources: US FDA label
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
Both are opioids, so combined use increases sedation, respiratory depression and hypotension. Buprenorphine may also reduce fentanyl's analgesic effect through competition at the receptor.
What this interaction means in plain words
Buprenorphine and Fentanyl iontophoretic transdermal system 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 at mu-opioid receptors, plus partial-agonist competition by buprenorphine.
What to do
Avoid the combination unless alternatives are inadequate; if used, monitor for respiratory depression and sedation and titrate the fentanyl cautiously.
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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References
Other interactions of Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
Frequently asked questions
Can I take Buprenorphine with Fentanyl iontophoretic transdermal system?
MediHelp rates the interaction as major. Buprenorphine and Fentanyl iontophoretic transdermal system 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. Both are opioids, so combined use increases sedation, respiratory depression and hypotension. Buprenorphine may also reduce fentanyl's analgesic effect through competition at the receptor.
How serious is the interaction between Buprenorphine and Fentanyl iontophoretic transdermal system?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination unless alternatives are inadequate; if used, monitor for respiratory depression and sedation and titrate the fentanyl cautiously.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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