Drug interactions
Fentanyl + Zuranolone
Severity: Major
Fentanyl and Zuranolone: 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
Zuranolone is a neuroactive steroid GABA-A modulator that causes sedation and psychomotor impairment. Combined with fentanyl, the central nervous system and respiratory depressant effects add together, which can lead to profound sedation, respiratory depression and impaired driving ability.
What this interaction means in plain words
Fentanyl and Zuranolone 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; Zuranolone belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic CNS depression from GABA-A positive modulation and mu-opioid receptor agonism.
What to do
Avoid the combination where possible; if both are required, reduce the dose of one or both drugs and monitor sedation level and respiratory rate. Counsel the patient not to drive or operate machinery.
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 Zuranolone
- Alprazolam + Zuranolone Major
- Amobarbital + Zuranolone Major
- Apalutamide + Zuranolone Major
- Asenapine + Zuranolone Major
- Brexpiprazole + Zuranolone Major
- Butorphanol + Zuranolone Major
Frequently asked questions
Can I take Fentanyl with Zuranolone?
MediHelp rates the interaction as major. Fentanyl and Zuranolone 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. Zuranolone is a neuroactive steroid GABA-A modulator that causes sedation and psychomotor impairment. Combined with fentanyl, the central nervous system and respiratory depressant effects add together, which can lead to profound sedation, respiratory depression and impaired driving ability.
How serious is the interaction between Fentanyl and Zuranolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if both are required, reduce the dose of one or both drugs and monitor sedation level and respiratory rate. Counsel the patient not to drive or operate 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.
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