Drug interactions
Fentanyl transdermal + Ramelteon
Severity: Moderate
Fentanyl transdermal and Ramelteon: moderate 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 an opioid with another sedating hypnotic can add to central nervous system depression. This may cause profound sedation, slowed breathing, low blood pressure, and in severe cases coma or death. Ramelteon is less sedating than benzodiazepines, so the added risk is probably smaller, but the opioid warning still applies.
What this interaction means in plain words
Fentanyl transdermal and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive CNS depressant effects through pharmacodynamic synergy.
What to do
Use the lowest effective doses and monitor for excessive sedation and respiratory depression, especially when starting treatment or raising doses. Counsel the patient about impaired alertness.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
Frequently asked questions
Can I take Fentanyl transdermal with Ramelteon?
MediHelp rates the interaction as moderate. Fentanyl transdermal and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Combining an opioid with another sedating hypnotic can add to central nervous system depression. This may cause profound sedation, slowed breathing, low blood pressure, and in severe cases coma or death. Ramelteon is less sedating than benzodiazepines, so the added risk is probably smaller, but the opioid warning still applies.
How serious is the interaction between Fentanyl transdermal and Ramelteon?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor for excessive sedation and respiratory depression, especially when starting treatment or raising doses. Counsel the patient about impaired alertness.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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