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Drug interactions

Diltiazem + Fentanyl transdermal

Severity: Major

Diltiazem 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

Diltiazem can raise fentanyl concentrations, and with a transdermal patch the effect is prolonged and may lead to serious respiratory depression.

What this interaction means in plain words

Diltiazem 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.

Evidence level: Moderate

Why it happens

Diltiazem inhibits CYP3A4-mediated fentanyl metabolism.

What to do

Monitor for respiratory depression and sedation, and reduce the fentanyl dose if needed. Remember effects persist after patch removal.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Diltiazem with Fentanyl transdermal?

MediHelp rates the interaction as major. Diltiazem 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. Diltiazem can raise fentanyl concentrations, and with a transdermal patch the effect is prolonged and may lead to serious respiratory depression.

How serious is the interaction between Diltiazem 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: Monitor for respiratory depression and sedation, and reduce the fentanyl dose if needed. Remember effects persist after patch removal.

What other medicines interact with Diltiazem?

MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.

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