Drug interactions
Fentanyl intranasal + Secobarbital
Severity: Major
Fentanyl intranasal and Secobarbital: 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 an opioid with a barbiturate produces additive CNS and respiratory depression. This can cause profound sedation, hypotension, coma and death. Secobarbital may also induce CYP3A4 and reduce fentanyl levels, with a risk of overdose if the inducer is stopped.
What this interaction means in plain words
Fentanyl intranasal and Secobarbital 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 and respiratory depression, plus CYP3A4 induction by the barbiturate that increases fentanyl metabolism.
What to do
Avoid unless no alternative exists; use the lowest effective doses and monitor respiratory rate, sedation and blood pressure. Reduce the fentanyl dose if secobarbital is stopped.
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 Secobarbital
- Calcium / magnesium / potassium / sodium oxybates + Secobarbital Contraindicated
- Doravirine + Secobarbital Contraindicated
- Elbasvir / grazoprevir + Secobarbital Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Secobarbital Contraindicated
- Isavuconazonium + Secobarbital Contraindicated
- Lonafarnib + Secobarbital Contraindicated
Frequently asked questions
Can I take Fentanyl intranasal with Secobarbital?
MediHelp rates the interaction as major. Fentanyl intranasal and Secobarbital 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 an opioid with a barbiturate produces additive CNS and respiratory depression. This can cause profound sedation, hypotension, coma and death. Secobarbital may also induce CYP3A4 and reduce fentanyl levels, with a risk of overdose if the inducer is stopped.
How serious is the interaction between Fentanyl intranasal and Secobarbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid unless no alternative exists; use the lowest effective doses and monitor respiratory rate, sedation and blood pressure. Reduce the fentanyl dose if secobarbital is stopped.
What other medicines interact with Secobarbital?
MediHelp also lists interactions of Secobarbital with, for example, Calcium / magnesium / potassium / sodium oxybates, Doravirine, Elbasvir / grazoprevir. The full list is on the Secobarbital page.
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