Drug interactions
Fentanyl + Remifentanil
Severity: Moderate
Fentanyl and Remifentanil: moderate 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
Both are potent mu-opioid agonists, and their effects add together, increasing respiratory depression, bradycardia, hypotension and muscle rigidity. The combination is used deliberately in anesthesia, where it allows lower doses of each drug.
What this interaction means in plain words
Fentanyl and Remifentanil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fentanyl belongs to Musculoskeletal; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism.
What to do
Use only with ventilatory support and continuous monitoring, and reduce doses accordingly. Remember that remifentanil is very short-acting, so plan postoperative analgesia and watch for hyperalgesia or withdrawal.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
Frequently asked questions
Can I take Fentanyl with Remifentanil?
MediHelp rates the interaction as moderate. Fentanyl and Remifentanil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both are potent mu-opioid agonists, and their effects add together, increasing respiratory depression, bradycardia, hypotension and muscle rigidity. The combination is used deliberately in anesthesia, where it allows lower doses of each drug.
How serious is the interaction between Fentanyl and Remifentanil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only with ventilatory support and continuous monitoring, and reduce doses accordingly. Remember that remifentanil is very short-acting, so plan postoperative analgesia and watch for hyperalgesia or withdrawal.
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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