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Drug Interactions With Fentanyl

CYP 3A4 Inhibitor Medications
The body breaks down fentanyl using enzymes in the liver known as CYP 3A4 enzymes. Medications known as CYP 3A4 inhibitors can decrease the activity of these enzymes. Combining fentanyl with one of these drugs may increase the level of fentanyl in your body, increasing your risk for serious side effects, including drowsiness, confusion, and difficulty breathing. Your healthcare provider may monitor you more closely for side effects if you use fentanyl with a CYP 3A4 inhibitor.
 
Desmopressin
Fentanyl can increase the risk for desmopressin side effects. Do not use fentanyl with desmopressin without first speaking with your healthcare provider.
 
Grapefruit Juice
Grapefruit juice may increase the amount of fentanyl in your blood, potentially increasing your risk for serious side effects, such as drowsiness, confusion, and breathing problems. Talk to your healthcare provider before eating grapefruit or drinking grapefruit juice if you use fentanyl.
 
Medications That Cause Drowsiness
Fentanyl causes significant drowsiness. Combining it with other medications that cause drowsiness may lead to serious side effects, such as extreme sedation, confusion, and breathing problems. Check with your healthcare provider before taking fentanyl with other drugs that may cause drowsiness.
 
Monoamine Oxidase Inhibitors (MAOIs)
Taking fentanyl with an MAOI may cause a serious reaction known as serotonin syndrome. It can also lead to low blood pressure. Do not use fentanyl if you have taken an MAOI within the past 14 days.
 
Nasal Decongestants
Nasal sprays that are used to treat congestion may interfere with the absorption of fentanyl nasal spray through the lining of the nose, potentially making it less effective. Talk to your healthcare provider about this potential reaction before using a nasal decongestant with fentanyl nasal spray.
  
Octreotide
Taking octreotide with fentanyl may increase the pain-relieving effects of fentanyl. Your healthcare provider may monitor your pain response if you take these medications together. You might need a lower fentanyl dosage.
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