Drug interactions
Procarbazine + Sufentanil sl
Severity: Major
Procarbazine and Sufentanil sl: major interaction.
Last updated Sources: Health Canada product monograph
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
Procarbazine has MAO-inhibiting activity, and opioids given with MAOIs may produce serotonin syndrome or opioid toxicity, including respiratory depression and coma. Sublingual sufentanil adds a potent opioid exposure to this risk.
What this interaction means in plain words
Procarbazine and Sufentanil sl 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 serotonergic and CNS-depressant effects, with MAO inhibition potentially potentiating opioid effects.
What to do
Avoid the combination and allow 14 days after procarbazine before using sufentanil. If urgent analgesia is required, give small titrated doses and monitor blood pressure, sedation and respiratory rate.
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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References
Other interactions of Procarbazine
- Adenovirus types 4 and 7 live + Procarbazine Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amoxapine + Procarbazine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Bcg vaccine live + Procarbazine Contraindicated
- Brimonidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Procarbazine with Sufentanil sl?
MediHelp rates the interaction as major. Procarbazine and Sufentanil sl 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. Procarbazine has MAO-inhibiting activity, and opioids given with MAOIs may produce serotonin syndrome or opioid toxicity, including respiratory depression and coma. Sublingual sufentanil adds a potent opioid exposure to this risk.
How serious is the interaction between Procarbazine and Sufentanil sl?
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 the combination and allow 14 days after procarbazine before using sufentanil. If urgent analgesia is required, give small titrated doses and monitor blood pressure, sedation and respiratory rate.
What other medicines interact with Procarbazine?
MediHelp also lists interactions of Procarbazine with, for example, Adenovirus types 4 and 7 live, Amitriptyline, Amoxapine. The full list is on the Procarbazine page.
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