Drug interactions
Buprenorphine + Fentanyl transdermal
Severity: Major
Buprenorphine and Fentanyl transdermal: 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 combining them adds to sedation, respiratory depression and hypotension. Buprenorphine may also block fentanyl analgesia or cause withdrawal in patients physically dependent on full agonists.
What this interaction means in plain words
Buprenorphine and Fentanyl transdermal 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 competitive partial-agonist antagonism by buprenorphine.
What to do
Avoid concurrent use where possible and choose a single opioid strategy. If both are needed, monitor sedation and respiration closely and use the lowest effective doses.
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 transdermal?
MediHelp rates the interaction as major. Buprenorphine and Fentanyl transdermal 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 combining them adds to sedation, respiratory depression and hypotension. Buprenorphine may also block fentanyl analgesia or cause withdrawal in patients physically dependent on full agonists.
How serious is the interaction between Buprenorphine and Fentanyl transdermal?
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 concurrent use where possible and choose a single opioid strategy. If both are needed, monitor sedation and respiration closely and use the lowest effective doses.
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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