Drug interactions
Diphenoxylate-atropine + Fentanyl transmucosal
Severity: Major
Diphenoxylate-atropine and Fentanyl transmucosal: major interaction.
Last updated
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
Transmucosal fentanyl is a potent rapid-onset opioid, and diphenoxylate adds further CNS and respiratory depression. Atropine and fentanyl together may also increase constipation, urinary retention, and the risk of paralytic ileus.
What this interaction means in plain words
Diphenoxylate-atropine and Fentanyl transmucosal 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 opioid CNS/respiratory depression and additive antimuscarinic and opioid slowing of gut and bladder function.
What to do
Avoid unless essential; monitor sedation, respiratory rate, bowel function and urinary output and use the lowest effective doses.
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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Other interactions of Diphenoxylate-atropine
- Diphenoxylate-atropine + Isocarboxazid Contraindicated
- Diphenoxylate-atropine + Phenelzine Contraindicated
- Diphenoxylate-atropine + Tranylcypromine Contraindicated
- Alfentanil + Diphenoxylate-atropine Major
- Alvimopan + Diphenoxylate-atropine Major
- Amitriptyline + Diphenoxylate-atropine Major
Frequently asked questions
Can I take Diphenoxylate-atropine with Fentanyl transmucosal?
MediHelp rates the interaction as major. Diphenoxylate-atropine and Fentanyl transmucosal 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. Transmucosal fentanyl is a potent rapid-onset opioid, and diphenoxylate adds further CNS and respiratory depression. Atropine and fentanyl together may also increase constipation, urinary retention, and the risk of paralytic ileus.
How serious is the interaction between Diphenoxylate-atropine and Fentanyl transmucosal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid unless essential; monitor sedation, respiratory rate, bowel function and urinary output and use the lowest effective doses.
What other medicines interact with Diphenoxylate-atropine?
MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.
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