Drug interactions
Fentanyl + Zileuton
Severity: Moderate
Fentanyl and Zileuton: 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
Fentanyl is cleared mainly by CYP3A4, and zileuton is a weak CYP3A4 inhibitor. Higher fentanyl levels could cause excess sedation and respiratory depression, but the effect is expected to be small.
What this interaction means in plain words
Fentanyl and Zileuton 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; Zileuton belongs to Respiratory.
Why it happens
Weak CYP3A4 inhibition by zileuton reduces fentanyl metabolism.
What to do
Monitor for sedation and respiratory depression, particularly when starting zileuton or changing fentanyl dose. Reduce the fentanyl dose if signs of excess opioid effect appear.
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 Zileuton
- Fezolinetant + Zileuton Contraindicated
- Pimozide + Zileuton Contraindicated
- Alosetron + Zileuton Major
- Clozapine + Zileuton Major
- Lomitapide + Zileuton Major
- Lonafarnib + Zileuton Major
Other interactions of Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
Frequently asked questions
Can I take Fentanyl with Zileuton?
MediHelp rates the interaction as moderate. Fentanyl and Zileuton 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 is cleared mainly by CYP3A4, and zileuton is a weak CYP3A4 inhibitor. Higher fentanyl levels could cause excess sedation and respiratory depression, but the effect is expected to be small.
How serious is the interaction between Fentanyl and Zileuton?
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 for sedation and respiratory depression, particularly when starting zileuton or changing fentanyl dose. Reduce the fentanyl dose if signs of excess opioid effect appear.
What other medicines interact with Zileuton?
MediHelp also lists interactions of Zileuton with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Zileuton page.
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