Drug interactions
Fentanyl + Selegiline transdermal
Severity: Major
Fentanyl and Selegiline transdermal: 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
MAO inhibitors have been associated with severe, unpredictable reactions with opioids, including serotonin syndrome, and fentanyl labeling advises avoidance within 14 days of an MAOI. Transdermal selegiline can lose MAO-B selectivity at higher doses, so the risk applies.
What this interaction means in plain words
Fentanyl and Selegiline transdermal 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.
Why it happens
MAO inhibition combined with fentanyl's weak serotonergic activity can cause serotonin toxicity and potentiate opioid effects.
What to do
Avoid the combination and allow 14 days after stopping the MAOI before using fentanyl where possible. If unavoidable, monitor for serotonin syndrome, hypotension and respiratory depression.
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
Frequently asked questions
Can I take Fentanyl with Selegiline transdermal?
MediHelp rates the interaction as major. Fentanyl and Selegiline transdermal 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. MAO inhibitors have been associated with severe, unpredictable reactions with opioids, including serotonin syndrome, and fentanyl labeling advises avoidance within 14 days of an MAOI. Transdermal selegiline can lose MAO-B selectivity at higher doses, so the risk applies.
How serious is the interaction between Fentanyl and Selegiline transdermal?
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 the combination and allow 14 days after stopping the MAOI before using fentanyl where possible. If unavoidable, monitor for serotonin syndrome, hypotension and respiratory depression.
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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