Drug interactions
Fentanyl + Rifapentine
Severity: Major
Fentanyl and Rifapentine: 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
Rifapentine induces CYP3A4 and can lower fentanyl concentrations, leading to reduced analgesia or withdrawal. Fentanyl exposure may increase again when rifapentine is stopped.
What this interaction means in plain words
Fentanyl and Rifapentine 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; Rifapentine belongs to Anti Bacterial.
Why it happens
Rifapentine induces CYP3A4, increasing fentanyl metabolism.
What to do
Monitor analgesic response and withdrawal and titrate fentanyl upward as needed. Reduce the dose and monitor for respiratory depression after stopping rifapentine.
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 Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Fentanyl with Rifapentine?
MediHelp rates the interaction as major. Fentanyl and Rifapentine 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. Rifapentine induces CYP3A4 and can lower fentanyl concentrations, leading to reduced analgesia or withdrawal. Fentanyl exposure may increase again when rifapentine is stopped.
How serious is the interaction between Fentanyl and Rifapentine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor analgesic response and withdrawal and titrate fentanyl upward as needed. Reduce the dose and monitor for respiratory depression after stopping rifapentine.
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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