Drug interactions
Fentanyl iontophoretic transdermal system + Meperidine
Severity: Major
Fentanyl iontophoretic transdermal system and Meperidine: 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 two opioid agonists increases the risk of profound sedation, respiratory depression, coma and death. The risk is greatest in opioid-naive patients, the elderly and those with lung disease.
What this interaction means in plain words
Fentanyl iontophoretic transdermal system and Meperidine 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 mediated central nervous system and respiratory depression.
What to do
Avoid concurrent use where possible; if unavoidable, use the lowest effective doses for the shortest time and monitor respiratory rate and level of sedation closely. Be aware that meperidine metabolite accumulation can add neurotoxicity in renal impairment.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Fentanyl iontophoretic transdermal system and Meperidine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Fentanyl iontophoretic transdermal system with Meperidine?
MediHelp rates the interaction as major. Fentanyl iontophoretic transdermal system and Meperidine 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 two opioid agonists increases the risk of profound sedation, respiratory depression, coma and death. The risk is greatest in opioid-naive patients, the elderly and those with lung disease.
How serious is the interaction between Fentanyl iontophoretic transdermal system and Meperidine?
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 where possible; if unavoidable, use the lowest effective doses for the shortest time and monitor respiratory rate and level of sedation closely. Be aware that meperidine metabolite accumulation can add neurotoxicity in renal impairment.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
