Drug interactions
Fentanyl intranasal + Ramelteon
Severity: Moderate
Fentanyl intranasal and Ramelteon: moderate 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
Ramelteon may add to the sedative effects of fentanyl. Respiratory depression is chiefly driven by fentanyl, and ramelteon has little respiratory effect.
What this interaction means in plain words
Fentanyl intranasal and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive CNS depression between a melatonin receptor agonist and an opioid.
What to do
Monitor for excess sedation and respiratory depression, and counsel patients on avoiding driving and alcohol.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
Frequently asked questions
Can I take Fentanyl intranasal with Ramelteon?
MediHelp rates the interaction as moderate. Fentanyl intranasal and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ramelteon may add to the sedative effects of fentanyl. Respiratory depression is chiefly driven by fentanyl, and ramelteon has little respiratory effect.
How serious is the interaction between Fentanyl intranasal and Ramelteon?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for excess sedation and respiratory depression, and counsel patients on avoiding driving and alcohol.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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