Drug interactions
Chlorpromazine + Fentanyl intranasal
Severity: Major
Chlorpromazine and Fentanyl intranasal: major interaction.
Last updated Sources: UK SmPC
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
Combining fentanyl with a sedating phenothiazine can cause profound sedation, respiratory depression, hypotension, coma and death. The effect is more pronounced at higher doses and in opioid-naive patients.
What this interaction means in plain words
Chlorpromazine 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, with added alpha-blockade related hypotension from chlorpromazine.
What to do
Reserve combined use for patients lacking alternatives, and reduce the dose of one or both drugs. Monitor sedation, respiratory rate and blood pressure.
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
- Chlorpromazine 100mg Tablets - SmPC sections 4.3/4.5 (class statement: morphine derivatives; "Other CNS depressants: morphine derivatives (analgesics, antitussives and substitution treatments), barbiturates, benzodiazepines, anxiolytics other than benzod") — electronic medicines compendium (UK SmPC)
Other interactions of Chlorpromazine
- Chlorpromazine + Dofetilide Contraindicated
- Chlorpromazine + Dronedarone Contraindicated
- Chlorpromazine + Droperidol Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Chlorpromazine + Metrizamide Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
Frequently asked questions
Can I take Chlorpromazine with Fentanyl intranasal?
MediHelp rates the interaction as major. Chlorpromazine 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. Combining fentanyl with a sedating phenothiazine can cause profound sedation, respiratory depression, hypotension, coma and death. The effect is more pronounced at higher doses and in opioid-naive patients.
How serious is the interaction between Chlorpromazine 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 combined use for patients lacking alternatives, and reduce the dose of one or both drugs. Monitor sedation, respiratory rate and blood pressure.
What other medicines interact with Chlorpromazine?
MediHelp also lists interactions of Chlorpromazine with, for example, Dofetilide, Dronedarone, Droperidol. The full list is on the Chlorpromazine page.
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