Drug interactions
Fentanyl + Tapentadol
Severity: Major
Fentanyl and Tapentadol: 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 opioids together cause additive respiratory depression, sedation and hypotension. Tapentadol also has serotonergic and noradrenergic activity, which may add some risk of serotonin syndrome with fentanyl.
What this interaction means in plain words
Fentanyl and Tapentadol 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; Tapentadol belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism, with additional serotonergic and noradrenergic effects of tapentadol.
What to do
Avoid concurrent use of two opioids unless clearly necessary; if combined, use reduced doses and monitor respiratory status and sedation. Watch for serotonin syndrome signs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fentanyl and Tapentadol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Tapentadol
- Calcium / magnesium / potassium / sodium oxybates + Tapentadol Contraindicated
- Isocarboxazid + Tapentadol Contraindicated
- Linezolid + Tapentadol Contraindicated
- Methylene blue + Tapentadol Contraindicated
- Olanzapine / samidorphan + Tapentadol Contraindicated
- Phenelzine + Tapentadol Contraindicated
Frequently asked questions
Can I take Fentanyl with Tapentadol?
MediHelp rates the interaction as major. Fentanyl and Tapentadol 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 opioids together cause additive respiratory depression, sedation and hypotension. Tapentadol also has serotonergic and noradrenergic activity, which may add some risk of serotonin syndrome with fentanyl.
How serious is the interaction between Fentanyl and Tapentadol?
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 of two opioids unless clearly necessary; if combined, use reduced doses and monitor respiratory status and sedation. Watch for serotonin syndrome signs.
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
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
