Drug interactions
Fentanyl transmucosal + Propofol
Severity: Major
Fentanyl transmucosal and Propofol: 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
Transmucosal fentanyl and propofol together can cause profound sedation, respiratory depression and hypotension. Patients using transmucosal fentanyl are opioid-tolerant, but the additive effect is still significant.
What this interaction means in plain words
Fentanyl transmucosal and Propofol 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 mu-opioid agonism and propofol's GABAergic action.
What to do
Titrate propofol to effect at reduced doses and monitor ventilation and blood pressure continuously. Avoid giving breakthrough fentanyl doses right before 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 Propofol
Frequently asked questions
Can I take Fentanyl transmucosal with Propofol?
MediHelp rates the interaction as major. Fentanyl transmucosal and Propofol 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. Transmucosal fentanyl and propofol together can cause profound sedation, respiratory depression and hypotension. Patients using transmucosal fentanyl are opioid-tolerant, but the additive effect is still significant.
How serious is the interaction between Fentanyl transmucosal and Propofol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate propofol to effect at reduced doses and monitor ventilation and blood pressure continuously. Avoid giving breakthrough fentanyl doses right before sedation.
What other medicines interact with Propofol?
MediHelp also lists interactions of Propofol with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Propofol page.
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