Drug interactions
Fentanyl + Ziconotide
Severity: Moderate
Fentanyl and Ziconotide: 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
Intrathecal ziconotide causes sedation, confusion and decreased alertness, and these effects may be amplified by opioids such as fentanyl. Combined use can worsen cognitive impairment and CNS depression.
What this interaction means in plain words
Fentanyl and Ziconotide 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; Ziconotide belongs to Central Nervous System.
Why it happens
Additive CNS depression via N-type calcium channel blockade and opioid receptor agonism.
What to do
Monitor mental status and sedation closely and reduce the dose of the opioid or ziconotide if cognitive impairment develops. Ziconotide can be stopped quickly if needed.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fentanyl and Ziconotide, 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 Ziconotide
- Clozapine + Ziconotide Major
- Alprazolam + Ziconotide Moderate
- Amitriptyline + Ziconotide Moderate
- Amobarbital + Ziconotide Moderate
- Aripiprazole + Ziconotide Moderate
- Armodafinil + Ziconotide Moderate
Frequently asked questions
Can I take Fentanyl with Ziconotide?
MediHelp rates the interaction as moderate. Fentanyl and Ziconotide 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. Intrathecal ziconotide causes sedation, confusion and decreased alertness, and these effects may be amplified by opioids such as fentanyl. Combined use can worsen cognitive impairment and CNS depression.
How serious is the interaction between Fentanyl and Ziconotide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor mental status and sedation closely and reduce the dose of the opioid or ziconotide if cognitive impairment develops. Ziconotide can be stopped quickly if needed.
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.
