Drug interactions
Cenobamate + Fentanyl
Severity: Moderate
Cenobamate 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
Cenobamate induces CYP3A4, which can lower fentanyl concentrations and reduce analgesia. Cenobamate also causes somnolence and dizziness, so additive sedation is possible, and fentanyl toxicity could emerge if cenobamate is stopped while the fentanyl dose has been raised.
What this interaction means in plain words
Cenobamate 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.
Cenobamate belongs to Central Nervous System; Fentanyl belongs to Musculoskeletal.
Why it happens
CYP3A4 induction by cenobamate increases fentanyl clearance, together with additive CNS depression.
What to do
Monitor analgesic response and titrate fentanyl as needed, watching for sedation. Reassess and reduce the fentanyl dose if cenobamate is discontinued.
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 Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Fentanyl?
MediHelp rates the interaction as moderate. Cenobamate 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. Cenobamate induces CYP3A4, which can lower fentanyl concentrations and reduce analgesia. Cenobamate also causes somnolence and dizziness, so additive sedation is possible, and fentanyl toxicity could emerge if cenobamate is stopped while the fentanyl dose has been raised.
How serious is the interaction between Cenobamate 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 analgesic response and titrate fentanyl as needed, watching for sedation. Reassess and reduce the fentanyl dose if cenobamate is discontinued.
What other medicines interact with Fentanyl?
MediHelp also lists interactions of Fentanyl with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Fentanyl page.
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