Drug interactions
Dronedarone + Fentanyl
Severity: Major
Dronedarone 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
Dronedarone is a moderate CYP3A4 inhibitor and can raise fentanyl concentrations, prolonging and intensifying opioid effects. This increases the risk of respiratory depression and excessive sedation, especially with transmucosal or higher fentanyl doses.
What this interaction means in plain words
Dronedarone 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.
Dronedarone belongs to Cardiovascular; Fentanyl belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated fentanyl metabolism by dronedarone reduces fentanyl clearance.
What to do
Monitor closely for respiratory depression and sedation, and reduce the fentanyl dose when needed. Consider an alternative analgesic with less CYP3A4 dependence, and take care again if dronedarone is stopped.
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
Other interactions of Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Frequently asked questions
Can I take Dronedarone with Fentanyl?
MediHelp rates the interaction as major. Dronedarone 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. Dronedarone is a moderate CYP3A4 inhibitor and can raise fentanyl concentrations, prolonging and intensifying opioid effects. This increases the risk of respiratory depression and excessive sedation, especially with transmucosal or higher fentanyl doses.
How serious is the interaction between Dronedarone 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: Monitor closely for respiratory depression and sedation, and reduce the fentanyl dose when needed. Consider an alternative analgesic with less CYP3A4 dependence, and take care again if dronedarone is stopped.
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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