Drug interactions
Fentanyl + Topiramate
Severity: Moderate
Fentanyl and Topiramate: 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
Topiramate commonly causes somnolence, dizziness and cognitive slowing, which can add to the CNS depression produced by fentanyl. This may impair alertness and psychomotor function.
What this interaction means in plain words
Fentanyl and Topiramate 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; Topiramate belongs to Central Nervous System.
Why it happens
Additive CNS depressant effects.
What to do
Use the lowest effective fentanyl dose and monitor for sedation and respiratory depression. Counsel patients about driving and machinery.
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 Topiramate
Frequently asked questions
Can I take Fentanyl with Topiramate?
MediHelp rates the interaction as moderate. Fentanyl and Topiramate 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. Topiramate commonly causes somnolence, dizziness and cognitive slowing, which can add to the CNS depression produced by fentanyl. This may impair alertness and psychomotor function.
How serious is the interaction between Fentanyl and Topiramate?
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 the lowest effective fentanyl dose and monitor for sedation and respiratory depression. Counsel patients about driving and machinery.
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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