Drug interactions
Fentanyl iontophoretic transdermal system + Hydromorphone
Severity: Major
Fentanyl iontophoretic transdermal system and Hydromorphone: 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
Fentanyl delivered by the iontophoretic system is a potent opioid, and with hydromorphone the effects on sedation and breathing are additive. Overdose risk is higher when opioid exposure is not carefully controlled.
What this interaction means in plain words
Fentanyl iontophoretic transdermal system and Hydromorphone 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 mu-opioid receptor agonism leading to CNS and respiratory depression.
What to do
Avoid concurrent use of another opioid unless clearly necessary, and monitor sedation and respiratory rate. Adjust doses to the lowest effective level.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Fentanyl iontophoretic transdermal system with Hydromorphone?
MediHelp rates the interaction as major. Fentanyl iontophoretic transdermal system and Hydromorphone 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. Fentanyl delivered by the iontophoretic system is a potent opioid, and with hydromorphone the effects on sedation and breathing are additive. Overdose risk is higher when opioid exposure is not carefully controlled.
How serious is the interaction between Fentanyl iontophoretic transdermal system and Hydromorphone?
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 concurrent use of another opioid unless clearly necessary, and monitor sedation and respiratory rate. Adjust doses to the lowest effective level.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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