Drug interactions
Fentanyl + Trazodone
Severity: Major
Fentanyl and Trazodone: 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
Trazodone is sedating and can add to the CNS and respiratory depression of fentanyl. Both drugs also have serotonergic activity, so serotonin syndrome is a rare but recognized risk. Orthostatic hypotension may also be increased.
What this interaction means in plain words
Fentanyl and Trazodone 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; Trazodone belongs to Central Nervous System.
Why it happens
Additive CNS depression plus additive serotonergic effects.
What to do
Use the lowest effective doses and monitor for sedation, respiratory depression and signs of serotonin toxicity such as agitation, tremor, clonus and fever. Stop the serotonergic agents if serotonin syndrome occurs.
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 Trazodone
- Arsenic trioxide + Trazodone Contraindicated
- Ibutilide + Trazodone Contraindicated
- Isocarboxazid + Trazodone Contraindicated
- Levoketoconazole + Trazodone Contraindicated
- Methylene blue + Trazodone Contraindicated
- Phenelzine + Trazodone Contraindicated
Frequently asked questions
Can I take Fentanyl with Trazodone?
MediHelp rates the interaction as major. Fentanyl and Trazodone 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. Trazodone is sedating and can add to the CNS and respiratory depression of fentanyl. Both drugs also have serotonergic activity, so serotonin syndrome is a rare but recognized risk. Orthostatic hypotension may also be increased.
How serious is the interaction between Fentanyl and Trazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor for sedation, respiratory depression and signs of serotonin toxicity such as agitation, tremor, clonus and fever. Stop the serotonergic agents if serotonin syndrome occurs.
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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