Drug interactions
Fentanyl transmucosal + Meperidine
Severity: Major
Fentanyl transmucosal and Meperidine: 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
Using two opioids together increases the risk of profound sedation, respiratory depression, hypotension and death. Transmucosal fentanyl is typically used for breakthrough pain, so combination with meperidine may lead to unintended opioid excess.
What this interaction means in plain words
Fentanyl transmucosal and Meperidine 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 mu-opioid receptor agonism causing CNS and respiratory depression.
What to do
Avoid combining when possible; if necessary, lower doses of one or both agents and monitor respiratory status and sedation.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Fentanyl transmucosal with Meperidine?
MediHelp rates the interaction as major. Fentanyl transmucosal and Meperidine 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. Using two opioids together increases the risk of profound sedation, respiratory depression, hypotension and death. Transmucosal fentanyl is typically used for breakthrough pain, so combination with meperidine may lead to unintended opioid excess.
How serious is the interaction between Fentanyl transmucosal and Meperidine?
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 combining when possible; if necessary, lower doses of one or both agents and monitor respiratory status and sedation.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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