Drug interactions
Fentanyl + Oxymorphone
Severity: Major
Fentanyl and Oxymorphone: 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
Two full mu-opioid agonists given together produce additive analgesia and also additive respiratory depression, sedation and hypotension. Profound sedation, coma or death can occur, particularly in opioid-naive patients or with high doses.
What this interaction means in plain words
Fentanyl and Oxymorphone 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; Oxymorphone belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism causing CNS and respiratory depression.
What to do
Avoid concurrent use unless alternatives are inadequate, such as breakthrough pain in an established regimen. Use the lowest doses for the shortest time and monitor respiration and sedation 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 Oxymorphone
- Alvimopan + Oxymorphone Contraindicated
- Ethanol + Oxymorphone Contraindicated
- Isocarboxazid + Oxymorphone Contraindicated
- Olanzapine / samidorphan + Oxymorphone Contraindicated
- Oxymorphone + Phenelzine Contraindicated
- Oxymorphone + Selegiline transdermal 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 Oxymorphone?
MediHelp rates the interaction as major. Fentanyl and Oxymorphone 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. Two full mu-opioid agonists given together produce additive analgesia and also additive respiratory depression, sedation and hypotension. Profound sedation, coma or death can occur, particularly in opioid-naive patients or with high doses.
How serious is the interaction between Fentanyl and Oxymorphone?
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 concurrent use unless alternatives are inadequate, such as breakthrough pain in an established regimen. Use the lowest doses for the shortest time and monitor respiration and sedation closely.
What other medicines interact with Oxymorphone?
MediHelp also lists interactions of Oxymorphone with, for example, Alvimopan, Ethanol, Isocarboxazid. The full list is on the Oxymorphone page.
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