Drug interactions
Fentanyl intranasal + Nevirapine
Severity: Major
Fentanyl intranasal and Nevirapine: 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
Nevirapine may lower fentanyl concentrations, causing reduced analgesia or withdrawal. Stopping nevirapine can raise fentanyl levels and cause respiratory depression.
What this interaction means in plain words
Fentanyl intranasal and Nevirapine 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
Nevirapine induces CYP3A4, accelerating fentanyl metabolism.
What to do
Titrate fentanyl to response and monitor for withdrawal. When nevirapine is stopped, reduce fentanyl dose and monitor for respiratory depression.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Fentanyl intranasal with Nevirapine?
MediHelp rates the interaction as major. Fentanyl intranasal and Nevirapine 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. Nevirapine may lower fentanyl concentrations, causing reduced analgesia or withdrawal. Stopping nevirapine can raise fentanyl levels and cause respiratory depression.
How serious is the interaction between Fentanyl intranasal and Nevirapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate fentanyl to response and monitor for withdrawal. When nevirapine is stopped, reduce fentanyl dose and monitor for respiratory depression.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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