Drug interactions
Fentanyl + Pregabalin
Severity: Major
Fentanyl and Pregabalin: 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
Pregabalin causes sedation and dizziness, and opioids can worsen these effects. Regulators have warned of respiratory depression when gabapentinoids are used with opioids, especially in older patients and those with lung disease.
What this interaction means in plain words
Fentanyl and Pregabalin 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; Pregabalin belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression through different central mechanisms.
What to do
Use the lowest effective doses and consider lower pregabalin starting doses. Monitor for sedation and respiratory depression, especially in older adults and those with COPD or 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 Pregabalin
Frequently asked questions
Can I take Fentanyl with Pregabalin?
MediHelp rates the interaction as major. Fentanyl and Pregabalin 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. Pregabalin causes sedation and dizziness, and opioids can worsen these effects. Regulators have warned of respiratory depression when gabapentinoids are used with opioids, especially in older patients and those with lung disease.
How serious is the interaction between Fentanyl and Pregabalin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and consider lower pregabalin starting doses. Monitor for sedation and respiratory depression, especially in older adults and those with COPD or 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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