Drug interactions
Fentanyl iontophoretic transdermal system + Methadone
Severity: Major
Fentanyl iontophoretic transdermal system and Methadone: 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
Concurrent use of two opioids raises the risk of deep sedation, respiratory depression, hypotension and death. Methadone's prolonged and variable duration of action adds to the unpredictability.
What this interaction means in plain words
Fentanyl iontophoretic transdermal system and Methadone 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 CNS and respiratory depression.
What to do
Use together only when other options are inadequate, with minimal doses and duration. Monitor for sedation and respiratory depression, and consider prescribing naloxone.
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 Methadone, 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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Frequently asked questions
Can I take Fentanyl iontophoretic transdermal system with Methadone?
MediHelp rates the interaction as major. Fentanyl iontophoretic transdermal system and Methadone 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. Concurrent use of two opioids raises the risk of deep sedation, respiratory depression, hypotension and death. Methadone's prolonged and variable duration of action adds to the unpredictability.
How serious is the interaction between Fentanyl iontophoretic transdermal system and Methadone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use together only when other options are inadequate, with minimal doses and duration. Monitor for sedation and respiratory depression, and consider prescribing naloxone.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone 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.
