Drug interactions
Fentanyl intranasal + Hydrocodone
Severity: Major
Fentanyl intranasal and Hydrocodone: 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
Two opioid agonists together add to sedation and respiratory depression, with a risk of coma and death. Fentanyl is highly potent, which magnifies the risk.
What this interaction means in plain words
Fentanyl intranasal and Hydrocodone 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
Additive mu-opioid receptor agonism.
What to do
Use only when alternatives are inadequate, with minimum doses and duration. Monitor respiratory rate and sedation and keep naloxone available.
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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Fentanyl intranasal with Hydrocodone?
MediHelp rates the interaction as major. Fentanyl intranasal and Hydrocodone 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. Two opioid agonists together add to sedation and respiratory depression, with a risk of coma and death. Fentanyl is highly potent, which magnifies the risk.
How serious is the interaction between Fentanyl intranasal and Hydrocodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only when alternatives are inadequate, with minimum doses and duration. Monitor respiratory rate and sedation and keep naloxone available.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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