Drug interactions
Fentanyl intranasal + Fluconazole
Severity: Major
Fentanyl intranasal and Fluconazole: 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
Fluconazole can increase fentanyl concentrations, potentially causing profound sedation and life-threatening respiratory depression. Effects may be prolonged after fluconazole is started or stopped.
What this interaction means in plain words
Fentanyl intranasal and Fluconazole 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.
Why it happens
Inhibition of CYP3A4-mediated fentanyl metabolism by fluconazole.
What to do
Monitor frequently for respiratory depression and sedation and reduce fentanyl dose as needed. Reassess when fluconazole is started or stopped.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fentanyl intranasal with Fluconazole?
MediHelp rates the interaction as major. Fentanyl intranasal and Fluconazole 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. Fluconazole can increase fentanyl concentrations, potentially causing profound sedation and life-threatening respiratory depression. Effects may be prolonged after fluconazole is started or stopped.
How serious is the interaction between Fentanyl intranasal and Fluconazole?
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 frequently for respiratory depression and sedation and reduce fentanyl dose as needed. Reassess when fluconazole is started or stopped.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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