Drug interactions
Chlordiazepoxide + Fentanyl intranasal
Severity: Major
Chlordiazepoxide and Fentanyl intranasal: 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
Benzodiazepines combined with fentanyl can cause profound sedation, respiratory depression, coma and death. Intranasal fentanyl has rapid onset, so depression can occur quickly.
What this interaction means in plain words
Chlordiazepoxide and Fentanyl intranasal 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 from opioid agonism and GABA-A potentiation.
What to do
Reserve for patients without alternatives, using the lowest doses and shortest duration. Monitor for sedation and respiratory depression and have naloxone available.
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 Chlordiazepoxide
Frequently asked questions
Can I take Chlordiazepoxide with Fentanyl intranasal?
MediHelp rates the interaction as major. Chlordiazepoxide and Fentanyl intranasal 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. Benzodiazepines combined with fentanyl can cause profound sedation, respiratory depression, coma and death. Intranasal fentanyl has rapid onset, so depression can occur quickly.
How serious is the interaction between Chlordiazepoxide and Fentanyl intranasal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve for patients without alternatives, using the lowest doses and shortest duration. Monitor for sedation and respiratory depression and have naloxone available.
What other medicines interact with Chlordiazepoxide?
MediHelp also lists interactions of Chlordiazepoxide with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Chlordiazepoxide page.
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