Drug interactions
Chlordiazepoxide + Fentanyl transdermal
Severity: Major
Chlordiazepoxide 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
Benzodiazepines with transdermal fentanyl can cause profound sedation, respiratory depression, coma and death. Fentanyl exposure continues long after patch removal.
What this interaction means in plain words
Chlordiazepoxide 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 from opioid agonism and GABA-A potentiation.
What to do
Reserve combination for patients with no alternatives, limiting dose and duration. Monitor for sedation and respiratory depression, particularly after dose changes, and provide naloxone.
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 transdermal?
MediHelp rates the interaction as major. Chlordiazepoxide 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. Benzodiazepines with transdermal fentanyl can cause profound sedation, respiratory depression, coma and death. Fentanyl exposure continues long after patch removal.
How serious is the interaction between Chlordiazepoxide 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: Reserve combination for patients with no alternatives, limiting dose and duration. Monitor for sedation and respiratory depression, particularly after dose changes, and provide naloxone.
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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