Drug interactions
Diazepam intranasal + Fentanyl
Severity: Major
Diazepam intranasal and Fentanyl: 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
Co-use of a benzodiazepine and an opioid can cause profound sedation, respiratory depression, coma and death. This risk is highlighted in regulatory boxed warnings.
What this interaction means in plain words
Diazepam intranasal and Fentanyl 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 via GABA-A potentiation and mu-opioid agonism.
What to do
Use together only when alternatives are inadequate, with the lowest effective doses and shortest duration, and monitor for respiratory depression and sedation.
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 Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
Frequently asked questions
Can I take Diazepam intranasal with Fentanyl?
MediHelp rates the interaction as major. Diazepam intranasal and Fentanyl 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. Co-use of a benzodiazepine and an opioid can cause profound sedation, respiratory depression, coma and death. This risk is highlighted in regulatory boxed warnings.
How serious is the interaction between Diazepam intranasal and Fentanyl?
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 together only when alternatives are inadequate, with the lowest effective doses and shortest duration, and monitor for respiratory depression and sedation.
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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