Drug interactions
Fentanyl intranasal + Imipramine
Severity: Major
Fentanyl intranasal and Imipramine: 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
Combining imipramine with fentanyl increases sedation and risk of respiratory depression. Tricyclics may also add to serotonergic effects of fentanyl.
What this interaction means in plain words
Fentanyl intranasal and Imipramine 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 CNS depression, with possible serotonergic contribution and CYP3A4-related effects.
What to do
Reserve concurrent use for patients without adequate alternatives, using the lowest doses for the shortest time. Monitor sedation and respiratory rate, and watch for serotonin syndrome.
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 Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Fentanyl intranasal with Imipramine?
MediHelp rates the interaction as major. Fentanyl intranasal and Imipramine 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. Combining imipramine with fentanyl increases sedation and risk of respiratory depression. Tricyclics may also add to serotonergic effects of fentanyl.
How serious is the interaction between Fentanyl intranasal and Imipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve concurrent use for patients without adequate alternatives, using the lowest doses for the shortest time. Monitor sedation and respiratory rate, and watch for serotonin syndrome.
What other medicines interact with Imipramine?
MediHelp also lists interactions of Imipramine with, for example, Dronedarone, Isocarboxazid, Phenelzine. The full list is on the Imipramine page.
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