Dilaudid vs. Fentanyl Strength Comparison for Pain, Dosage & Uses

What are the drug interactions of Dilaudid vs. fentanyl?

Dilaudid drug interactions

Hydromorphone should be used very cautiously with medications that depress the central nervous system (for example, hypnotics, anesthetics, tranquilizers, phenothiazines, and alcohol).

Hydromorphone should be used with caution with mixed agonist/antagonist opioid analgesics (for example, pentazocine, nalbuphine, butorphanol, and buprenorphine) because it may take away the analgesic effect of hydromorphone.

Fentanyl drug interactions

The use of fentanyl with other central nervous system depressants can intensify the depressant effect of fentanyl on breathing, depress the brain, sedate, and lower blood pressure. Other drugs that should be used cautiously with fentanyl include antipsychotics, for example, thorazine, stelazine, and haloperidol (Haldol), anxiolytics, for example, diazepam (Valium), lorazepam (Ativan), and zolpidem (Ambien), certain antihistamines, for example, diphenhydramine (Benadryl) and hydroxyzine (Vistaril), barbiturates, for example, phenobarbital (Donnatal), tricyclic antidepressants, for example, amitriptyline (Elavil, Endep) and doxepin (Sinequan), alcohol, and skeletal muscle relaxants, for example, carisoprodol (Soma), cyclobenzaprine (Flexeril) and baclofen (Lioresal). The use of fentanyl with amiodarone (Cordarone) may result in a slow heart rate.

Cimetidine (Tagamet) when used with fentanyl can cause confusion, disorientation, or seizures due to impairment in breathing and brain function.

The monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) significantly increase the action of fentanyl resulting in more side effects. Fentanyl should not be used in patients taking MAOIs or within 14 days of stopping MAOIs.

Combining fentanyl with drugs that reduce activity of liver enzymes that breakdown fentanyl, for example, ritonavir (Norvir), ketoconazole (Nizoral, Extina, Xolegel, Kuric), itraconazole (Sporanox), troleandomycin, clarithromycin (Biaxin, Biaxin XL), nelfinavir (Viracept), nefazadone, amiodarone, amprenavir (Agenerase), aprepitant, diltiazem (Cardizem, Dilacor, Tiazac), erythromycin, fluconazole (Diflucan), fosamprenavir, and verapamil (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS), may result in an increase in fentanyl blood levels, increasing or prolonging side effects of fentanyl.