Drug interactions
Fentanyl + Meperidine
Severity: Major
Fentanyl and Meperidine: 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
Combining two opioids increases sedation, respiratory depression, hypotension and risk of coma or death. Both meperidine and fentanyl have some serotonergic activity, which adds a small risk of serotonin syndrome.
What this interaction means in plain words
Fentanyl and Meperidine 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; Meperidine belongs to Musculoskeletal.
Why it happens
Additive mu-opioid CNS and respiratory depression, with minor additive serotonergic activity.
What to do
Avoid duplicate opioid therapy where possible, or use the lowest effective doses for the shortest duration. Monitor respiratory rate, sedation and blood pressure closely.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
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 Fentanyl with Meperidine?
MediHelp rates the interaction as major. Fentanyl and Meperidine 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. Combining two opioids increases sedation, respiratory depression, hypotension and risk of coma or death. Both meperidine and fentanyl have some serotonergic activity, which adds a small risk of serotonin syndrome.
How serious is the interaction between Fentanyl and Meperidine?
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 duplicate opioid therapy where possible, or use the lowest effective doses for the shortest duration. Monitor respiratory rate, sedation and blood pressure closely.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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