Drug interactions
Fentanyl intranasal + Oxcarbazepine
Severity: Major
Fentanyl intranasal and Oxcarbazepine: 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
Oxcarbazepine can lower fentanyl concentrations, risking reduced analgesia or withdrawal in opioid-dependent patients. When oxcarbazepine is stopped, fentanyl levels rise and may cause serious respiratory depression.
What this interaction means in plain words
Fentanyl intranasal and Oxcarbazepine 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
CYP3A4 induction by oxcarbazepine accelerates fentanyl metabolism, and this reverses after the inducer is withdrawn.
What to do
Monitor analgesia and withdrawal during coadministration, and adjust the fentanyl dose as needed. After stopping oxcarbazepine, monitor for sedation and respiratory depression and reduce the dose.
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 Oxcarbazepine
- Cabotegravir + Oxcarbazepine Contraindicated
- Oxcarbazepine + Rilpivirine Contraindicated
- Artemether / lumefantrine + Oxcarbazepine Major
- Atazanavir + Oxcarbazepine Major
- Benzhydrocodone / acetaminophen + Oxcarbazepine Major
- Bictegravir + Oxcarbazepine Major
Frequently asked questions
Can I take Fentanyl intranasal with Oxcarbazepine?
MediHelp rates the interaction as major. Fentanyl intranasal and Oxcarbazepine 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. Oxcarbazepine can lower fentanyl concentrations, risking reduced analgesia or withdrawal in opioid-dependent patients. When oxcarbazepine is stopped, fentanyl levels rise and may cause serious respiratory depression.
How serious is the interaction between Fentanyl intranasal and Oxcarbazepine?
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 analgesia and withdrawal during coadministration, and adjust the fentanyl dose as needed. After stopping oxcarbazepine, monitor for sedation and respiratory depression and reduce the dose.
What other medicines interact with Oxcarbazepine?
MediHelp also lists interactions of Oxcarbazepine with, for example, Cabotegravir, Rilpivirine, Artemether / lumefantrine. The full list is on the Oxcarbazepine page.
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