Drug interactions
Cyproheptadine + Fentanyl intranasal
Severity: Major
Cyproheptadine 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
Fentanyl is a potent opioid, and cyproheptadine increases sedation and has anticholinergic effects. The combination may increase CNS and respiratory depression and worsen constipation and urinary retention.
What this interaction means in plain words
Cyproheptadine 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 H1 blockade, plus additive anticholinergic effects.
What to do
Use the lowest effective fentanyl dose and monitor sedation and respiratory rate. Watch for constipation and urinary retention, and avoid cyproheptadine if possible.
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 Cyproheptadine
- Cyproheptadine + Isocarboxazid Contraindicated
- Cyproheptadine + Phenelzine Contraindicated
- Cyproheptadine + Tranylcypromine Contraindicated
- Alfentanil + Cyproheptadine Major
- Belladonna and opium + Cyproheptadine Major
- Benzhydrocodone / acetaminophen + Cyproheptadine Major
Frequently asked questions
Can I take Cyproheptadine with Fentanyl intranasal?
MediHelp rates the interaction as major. Cyproheptadine 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. Fentanyl is a potent opioid, and cyproheptadine increases sedation and has anticholinergic effects. The combination may increase CNS and respiratory depression and worsen constipation and urinary retention.
How serious is the interaction between Cyproheptadine 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: Use the lowest effective fentanyl dose and monitor sedation and respiratory rate. Watch for constipation and urinary retention, and avoid cyproheptadine if possible.
What other medicines interact with Cyproheptadine?
MediHelp also lists interactions of Cyproheptadine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Cyproheptadine page.
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