Drug interactions
Fentanyl transdermal + Fluconazole
Severity: Major
Fentanyl transdermal and Fluconazole: 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
Fluconazole can raise fentanyl levels, and with a transdermal depot the effect can persist and cause serious sedation and respiratory depression. Risk continues after the azole is stopped because of ongoing skin absorption.
What this interaction means in plain words
Fentanyl transdermal and Fluconazole 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
Inhibition of CYP3A4-mediated fentanyl metabolism by fluconazole.
What to do
Monitor closely for respiratory depression and sedation and consider reducing the patch dose or an alternative opioid. Continue monitoring for a prolonged period after changes in fluconazole.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fentanyl transdermal with Fluconazole?
MediHelp rates the interaction as major. Fentanyl transdermal and Fluconazole 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. Fluconazole can raise fentanyl levels, and with a transdermal depot the effect can persist and cause serious sedation and respiratory depression. Risk continues after the azole is stopped because of ongoing skin absorption.
How serious is the interaction between Fentanyl transdermal and Fluconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor closely for respiratory depression and sedation and consider reducing the patch dose or an alternative opioid. Continue monitoring for a prolonged period after changes in fluconazole.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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