Drug interactions
Fentanyl transmucosal + Ramelteon
Severity: Moderate
Fentanyl transmucosal and Ramelteon: moderate 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
Opioids taken together with other sedative hypnotics may add to CNS depression, causing marked drowsiness, hypotension and slowed breathing. Transmucosal fentanyl is potent and fast acting, so oversedation is a particular concern. Ramelteon has relatively mild sedative properties, which may lessen but not remove the risk.
What this interaction means in plain words
Fentanyl transmucosal and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive CNS depressant effects through pharmacodynamic synergy.
What to do
Keep doses and treatment duration to the minimum needed and monitor for sedation and respiratory depression. Advise patients and caregivers on warning signs and on avoiding driving.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
Frequently asked questions
Can I take Fentanyl transmucosal with Ramelteon?
MediHelp rates the interaction as moderate. Fentanyl transmucosal and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Opioids taken together with other sedative hypnotics may add to CNS depression, causing marked drowsiness, hypotension and slowed breathing. Transmucosal fentanyl is potent and fast acting, so oversedation is a particular concern. Ramelteon has relatively mild sedative properties, which may lessen but not remove the risk.
How serious is the interaction between Fentanyl transmucosal and Ramelteon?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep doses and treatment duration to the minimum needed and monitor for sedation and respiratory depression. Advise patients and caregivers on warning signs and on avoiding driving.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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