Drug interactions
Fentanyl transmucosal + Fluconazole
Severity: Major
Fentanyl transmucosal 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 increase systemic fentanyl exposure from transmucosal products, with risk of excessive sedation and respiratory depression. The swallowed portion undergoes first-pass CYP3A4 metabolism that fluconazole can impair.
What this interaction means in plain words
Fentanyl transmucosal 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 intestinal and hepatic CYP3A4 metabolism of fentanyl by fluconazole.
What to do
Monitor frequently for respiratory depression and sedation and lower the fentanyl dose if required. Titrate carefully when fluconazole 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 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 transmucosal with Fluconazole?
MediHelp rates the interaction as major. Fentanyl transmucosal 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 increase systemic fentanyl exposure from transmucosal products, with risk of excessive sedation and respiratory depression. The swallowed portion undergoes first-pass CYP3A4 metabolism that fluconazole can impair.
How serious is the interaction between Fentanyl transmucosal 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 frequently for respiratory depression and sedation and lower the fentanyl dose if required. Titrate carefully when fluconazole is started or stopped.
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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