Drug interactions
Fentanyl transdermal + Hydromorphone
Severity: Major
Fentanyl transdermal 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
Hydromorphone used with a fentanyl patch adds opioid effect to a sustained baseline, increasing the risk of sedation, respiratory depression and hypotension. This is commonly intentional for breakthrough pain but carries risk if doses are excessive.
What this interaction means in plain words
Fentanyl transdermal 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 causing CNS and respiratory depression.
What to do
Use only in opioid-tolerant patients, titrate breakthrough doses carefully, and monitor for sedation and respiratory depression. Reassess total opioid exposure regularly.
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 transdermal with Hydromorphone?
MediHelp rates the interaction as major. Fentanyl transdermal 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. Hydromorphone used with a fentanyl patch adds opioid effect to a sustained baseline, increasing the risk of sedation, respiratory depression and hypotension. This is commonly intentional for breakthrough pain but carries risk if doses are excessive.
How serious is the interaction between Fentanyl transdermal 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: Use only in opioid-tolerant patients, titrate breakthrough doses carefully, and monitor for sedation and respiratory depression. Reassess total opioid exposure regularly.
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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