Drug interactions
Fentanyl transmucosal + Hydroxyzine
Severity: Major
Fentanyl transmucosal and Hydroxyzine: 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
Hydroxyzine adds sedation to transmucosal fentanyl, which is intended for opioid-tolerant patients. The combination may cause excessive sedation and respiratory depression.
What this interaction means in plain words
Fentanyl transmucosal and Hydroxyzine 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 from opioid agonism and H1-antihistamine sedation.
What to do
Reserve combined use for patients without alternatives, with the lowest doses. Monitor sedation and respiratory rate and advise against driving.
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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Fentanyl transmucosal with Hydroxyzine?
MediHelp rates the interaction as major. Fentanyl transmucosal and Hydroxyzine 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. Hydroxyzine adds sedation to transmucosal fentanyl, which is intended for opioid-tolerant patients. The combination may cause excessive sedation and respiratory depression.
How serious is the interaction between Fentanyl transmucosal and Hydroxyzine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve combined use for patients without alternatives, with the lowest doses. Monitor sedation and respiratory rate and advise against driving.
What other medicines interact with Hydroxyzine?
MediHelp also lists interactions of Hydroxyzine with, for example, Droperidol, Pimozide, Thioridazine. The full list is on the Hydroxyzine page.
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