Drug interactions
Fentanyl transdermal + Secobarbital
Severity: Major
Fentanyl transdermal and Secobarbital: 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 causes additive CNS and respiratory depression with a risk of profound sedation, coma and death. Enzyme induction by secobarbital may lower fentanyl levels, and stopping the barbiturate can later raise them to toxic concentrations.
What this interaction means in plain words
Fentanyl transdermal and Secobarbital 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 CNS and respiratory depression, plus CYP3A4 induction by the barbiturate that increases fentanyl metabolism.
What to do
Avoid unless no alternative exists; use the lowest effective doses and monitor respiratory rate and sedation. Reassess the fentanyl dose when secobarbital is started or stopped.
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 Secobarbital
- Calcium / magnesium / potassium / sodium oxybates + Secobarbital Contraindicated
- Doravirine + Secobarbital Contraindicated
- Elbasvir / grazoprevir + Secobarbital Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Secobarbital Contraindicated
- Isavuconazonium + Secobarbital Contraindicated
- Lonafarnib + Secobarbital Contraindicated
Frequently asked questions
Can I take Fentanyl transdermal with Secobarbital?
MediHelp rates the interaction as major. Fentanyl transdermal and Secobarbital 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 causes additive CNS and respiratory depression with a risk of profound sedation, coma and death. Enzyme induction by secobarbital may lower fentanyl levels, and stopping the barbiturate can later raise them to toxic concentrations.
How serious is the interaction between Fentanyl transdermal and Secobarbital?
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 unless no alternative exists; use the lowest effective doses and monitor respiratory rate and sedation. Reassess the fentanyl dose when secobarbital is started or stopped.
What other medicines interact with Secobarbital?
MediHelp also lists interactions of Secobarbital with, for example, Calcium / magnesium / potassium / sodium oxybates, Doravirine, Elbasvir / grazoprevir. The full list is on the Secobarbital page.
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