Drug interactions
Fentanyl + Gabapentin
Severity: Major
Fentanyl and Gabapentin: 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
Gabapentin combined with opioids increases the risk of sedation and respiratory depression, as reflected in regulatory warnings. The risk is greatest in elderly patients, those with COPD or renal impairment, and at high doses.
What this interaction means in plain words
Fentanyl and Gabapentin 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 belongs to Musculoskeletal; Gabapentin belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression; gabapentin may also increase opioid-related respiratory effects.
What to do
Start with low doses and titrate cautiously, reducing the dose of either drug if sedation occurs. Monitor respiratory status, especially in older patients and those with renal impairment.
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 Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
Other interactions of Gabapentin
Frequently asked questions
Can I take Fentanyl with Gabapentin?
MediHelp rates the interaction as major. Fentanyl and Gabapentin 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. Gabapentin combined with opioids increases the risk of sedation and respiratory depression, as reflected in regulatory warnings. The risk is greatest in elderly patients, those with COPD or renal impairment, and at high doses.
How serious is the interaction between Fentanyl and Gabapentin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and titrate cautiously, reducing the dose of either drug if sedation occurs. Monitor respiratory status, especially in older patients and those with renal impairment.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
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