Drug interactions
Fentanyl transmucosal + Nevirapine
Severity: Major
Fentanyl transmucosal and Nevirapine: 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
Nevirapine may reduce fentanyl exposure, leading to inadequate breakthrough pain relief or withdrawal. When the inducer is withdrawn, fentanyl levels can rise and cause respiratory depression.
What this interaction means in plain words
Fentanyl transmucosal and Nevirapine 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
Nevirapine induces CYP3A4, increasing fentanyl clearance.
What to do
Retitrate transmucosal fentanyl to effect and monitor for withdrawal. Reduce the dose and monitor respiration if nevirapine is discontinued.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Fentanyl transmucosal with Nevirapine?
MediHelp rates the interaction as major. Fentanyl transmucosal and Nevirapine 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. Nevirapine may reduce fentanyl exposure, leading to inadequate breakthrough pain relief or withdrawal. When the inducer is withdrawn, fentanyl levels can rise and cause respiratory depression.
How serious is the interaction between Fentanyl transmucosal and Nevirapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Retitrate transmucosal fentanyl to effect and monitor for withdrawal. Reduce the dose and monitor respiration if nevirapine is discontinued.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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