Anticholinergics, drugs extensively metabolized in liver (digitoxin, phenytoin, rifampin):Paralytic ileus may result from drug accumula-tion. Use together cautiously.
Cimetidine: May increase respiratory and CNS depression, causing confusion, disorientation, apnea, or seizures. Reduce fentanyl dosage by one-quarter to one-third.
CNS depressants (antihistamines, barbiturates, benzodiazepines, general anesthetics, muscle relaxants, narcotic analgesics, phenothiazines, sedative-hypnotics, tricyclic antidepressants):May potentiate drugs respiratory and CNS de-pression, sedation, and hypotensive effects. Avoid concomitant use.
Diazepam: May produce CV depression when given with high doses of fentanyl. Monitor child closely.
Droperidol: May cause hypotension and decrease in pulmonary artery pressure. (A droperidol fentanyl combination, Innovar, is available.) Use very cautiously together.
General anesthetics: May result in severe CV de-pression. Monitor child closely.
MAO inhibitors: Concomitant use may cause ad-ditive CNS depressant effects, including hY-poventilation, hypotension, profound sedation or coma. Avoid using within a 2-week period of MAO administration.
Narcotic antagonists: Acute withdrawal may occur in children who become physically dependent on drug. Withdraw cautiously. |