Drug interactions
Fentanyl + Verapamil
Severity: Major
Fentanyl and Verapamil: 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
Verapamil inhibits CYP3A4, the main enzyme metabolizing fentanyl, so fentanyl concentrations can rise. This may cause deeper sedation and respiratory depression, and additive hypotension or bradycardia may occur.
What this interaction means in plain words
Fentanyl and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Moderate CYP3A4 inhibition by verapamil reduces fentanyl clearance.
What to do
Monitor for respiratory depression and sedation, and reduce the fentanyl dose as needed. Monitor heart rate and blood pressure.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Fentanyl with Verapamil?
MediHelp rates the interaction as major. Fentanyl and Verapamil 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. Verapamil inhibits CYP3A4, the main enzyme metabolizing fentanyl, so fentanyl concentrations can rise. This may cause deeper sedation and respiratory depression, and additive hypotension or bradycardia may occur.
How serious is the interaction between Fentanyl and Verapamil?
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 for respiratory depression and sedation, and reduce the fentanyl dose as needed. Monitor heart rate and blood pressure.
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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