Drug interactions
Fentanyl transdermal + Verapamil
Severity: Major
Fentanyl transdermal and Verapamil: 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
Verapamil inhibits CYP3A4 and can raise systemic fentanyl levels from a patch, including after patch removal as the skin depot persists. This increases the risk of serious respiratory depression and sedation.
What this interaction means in plain words
Fentanyl transdermal and Verapamil 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
Verapamil inhibits CYP3A4-mediated fentanyl metabolism, reducing clearance.
What to do
Monitor frequently for respiratory depression and sedation, and lower the fentanyl dose if signs of excess opioid effect appear. Continue monitoring after stopping either drug, as effects change gradually.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Fentanyl transdermal with Verapamil?
MediHelp rates the interaction as major. Fentanyl transdermal and Verapamil 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. Verapamil inhibits CYP3A4 and can raise systemic fentanyl levels from a patch, including after patch removal as the skin depot persists. This increases the risk of serious respiratory depression and sedation.
How serious is the interaction between Fentanyl transdermal and Verapamil?
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 frequently for respiratory depression and sedation, and lower the fentanyl dose if signs of excess opioid effect appear. Continue monitoring after stopping either drug, as effects change gradually.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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