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Fentanyl Buccal mucosa, Oromucosal and Repan

Determining the interaction of Fentanyl Buccal mucosa, Oromucosal and Repan and the possibility of their joint administration.

Check result:
Fentanyl Buccal mucosa, Oromucosal <> Repan
Relevance: 13.11.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using fentaNYL together with other medications that cause central nervous system depression such as butalbital can lead to serious side effects including respiratory distress, coma, and even death. Additionally, butalbital may reduce the blood levels of fentaNYL in some cases, which may make the medication less effective in treating your condition. If you have been receiving treatment with fentaNYL, adding butalbital may cause you to experience unpleasant withdrawal symptoms such as watery eyes, runny nose, sneezing, yawning, excessive sweating, goose bumps, fever, chills, flushing, restlessness, irritability, anxiety, depression, pupil dilation, tremor, rapid heart beat, body aches, involuntary twitching and kicking, abdominal cramping, loss of appetite, nausea, vomiting, diarrhea, and weight loss. On the other hand, if you have been receiving both medications, discontinuing butalbital may increase the blood levels of fentaNYL, which could lead to an overdose. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Barbiturates may potentiate the central nervous system (CNS) depressant effects of opioids. Concomitant use may result in profound sedation, respiratory depression, coma, and death. On the other hand, some barbiturates can also induce the hepatic metabolism of opioids that are metabolized by CYP450 3A4 such as butorphanol, fentanyl, hydrocodone, methadone and oxycodone, resulting in enhanced clearance. Reduced analgesic efficacy or withdrawal symptoms may occur in patients maintained on their opioid regimen following the addition of a barbiturate. Conversely, discontinuation of the barbiturate may increase plasma concentrations of the opioid and potentiate the risk of overdose and fatal respiratory depression.

MANAGEMENT: The use of opioids in conjunction with other CNS depressants such as barbiturates should generally be avoided unless alternative treatment options are inadequate. If coadministration is necessary, the dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect, and patients should be closely monitored for signs and symptoms of CNS and respiratory depression. Particular caution is advisable when a barbiturate is added to or withdrawn from therapy in patients receiving opioids that are CYP450 3A4 substrates, as there may be an increased risk of withdrawal symptoms (e.g., restlessness, insomnia, sweating, lacrimation, or rhinorrhea) following initiation of the barbiturate and overdose following discontinuation. A dosage adjustment for one or both drugs may be required.

References
  • "Product Information. Apadaz (acetaminophen-benzhydrocodone)." KemPharm, Inc, Coralville, IA.
  • Liu S-J, Wang RI "Case report of barbiturate-induced enhancement of methadone metabolism and withdrawal syndrome." Am J Psychiatry 141 (1984): 1287-8
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • "Product Information. Butorphanol Tartrate (butorphanol)." Apotex Corporation, Weston, FL.
  • Bell J, Seres V, Bowron P, Lewis J, Batey R "The use of serum methadone levels in patients receiving methadone maintenance." Clin Pharmacol Ther 43 (1988): 623-9
  • "Product Information. Zohydro ER (HYDROcodone)." Zogenix, Inc, San Diego, CA.
  • "Product Information. Duragesic Transdermal System (fentanyl)." Janssen Pharmaceutica, Titusville, NJ.
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • "Product Information. Ionsys (fentanyl)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  • "Product Information. OxyContin (oxycodone)." Purdue Frederick Company, Norwalk, CT.
Fentanyl Buccal mucosa, Oromucosal

Generic Name: fentanyl

Brand name: Duragesic, Abstral, Fentora, Subsys, Actiq, Ionsys, Lazanda, Onsolis, Sublimaze

Synonyms: Fentanyl Patch, FentaNYL

Repan

Generic Name: acetaminophen / butalbital / caffeine

Brand name: Capacet, Esgic, Fioricet, Margesic, Medigesic, Orbivan, Repan, Vanatol LQ, Zebutal, Esgic-Plus, Arcet, Isocet, Pharmagesic, Anoquan, Two-Dyne, Tenake, Anolor 300, Femcet, Geone, Tencet, Triad, Fiorpap, Dolmar, Endolor, Ezol, Ide-cet, G-1, Minotal, Mygracet, Pacaps, Alagesic, Americet, Nonbac, Dolgic LQ, Dolgic Plus, Vanatol S, Alagesic LQ

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle