Fentanyl

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Fentanyl

Examples of brand names: Durogesic [DE]

ATC code: N02AB03

Main use (for orientation): Severe pain

Documented research summary

Controlled human safety study, 2015: CBD 400/800 mg with intravenous fentanyl 0.5/1 µg/kg showed no additional respiratory depression or cardiovascular complications under test conditions; pharmacokinetics measured in the abstract concern CBD, not evidence of unchanged fentanyl AUC. Perioperative cannabis-user cohorts have different findings on fentanyl requirements, including non-significant adjusted results. A possible serotonin-syndrome case with intrathecal fentanyl and cannabis in addition to MDMA/ephedrine/ergot alkaloids cannot be attributed to one pair. The 2025 mouse study with very high-dose CBD pretreatment is not clinical overdose protection or a naloxone substitute. Additional anaesthesia cohorts: Ripperger 2023 (n=189, 57 regular cannabis users) found greater requirements with a combined midazolam/fentanyl/propofol/ketamine regimen; not isolated pharmacokinetics. Gangwani 2023 (n=53) found no significant adjusted requirement difference for these four substances; do not present unadjusted differences as an established interaction.

Uncertainties and limitations

Healthy people under controlled single-dose conditions are not chronic high-dose/mixed-intoxication patients. Requirements during multiple-anaesthetic regimens do not prove CYP induction. The CBD study does not justify general safety across all routes or cannabinoids.

Separately recorded findings

2 separately recorded findings. Each statement applies to its documented study context.

Cannabis, observed use – clinical signals

Finding ID: B0138

Type of result: Mixed/context-dependent finding

Observation: Cohort n=189: fentanyl 88.6 versus 75.2 µg, p=0.002. Second cohort n=53: unadjusted 83.82 versus 65 µg, p=0.02; not significant after adjustment, p=0.12.

Mechanism: Anaesthetic requirements during a multi-drug regimen

Study type: Retrospective anaesthesia cohorts

Context studied: Users/THC-positive versus comparison groups, outpatient oral surgery.

Clinical interpretation: Not an isolated pharmacokinetic interaction

Limitations and uncertainties: Multi-drug regimen, small groups and confounding; no causal dose formula.

Original sources for this finding: Cannabis Users Require More Anesthetic Agents for General Anesthesia in Ambulatory Oral and Maxillofacial Surgery Procedures. [CA_P_37783364]; Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation? [CA_P_36746375]

CBD, oral – clinically investigated

Finding ID: B0152

Type of result: No / minor effect under the conditions studied

Observation: No respiratory depression or cardiovascular complications under the investigated conditions; safety events similar between groups.

Mechanism: Controlled human safety assessment

Study type: Double-blind placebo-controlled crossover study

Context studied: Healthy people with previous opioid exposure; CBD 400/800 mg before intravenous fentanyl 0.5 or 1 µg/kg.

Clinical interpretation: Limited to controlled acute exposure

Limitations and uncertainties: n not stated in the abstract read; measured pharmacokinetics concern CBD, not evidence of unchanged fentanyl AUC. No safety guarantee in overdose/polypharmacy.

Original sources for this finding: Safety and pharmacokinetics of oral cannabidiol when administered concomitantly with intravenous fentanyl in humans. [CA_P_25748562]

References and access status

[CA_L_D0142] Fentanyl50 micrograms/ml Solution for injection – SmPC

Original source / bibliographic reference

Authors: AS Kalceks

Year: 2026

Source type: Official product information

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[CA_P_25748562] Safety and pharmacokinetics of oral cannabidiol when administered concomitantly with intravenous fentanyl in humans.

Original source / bibliographic reference

Authors: Manini AF, Yiannoulos G, Bergamaschi MM, Hernandez S, Olmedo R, Barnes AJ, Winkel G, Sinha R, Jutras-Aswad D, Huestis MA, Hurd YL.

Year: 2015

Source type: Clinical Trial; research-article; Journal Article; Research Support, N.I.H., Extramural

DOI: 10.1097/adm.0000000000000118

PMID: 25748562

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[CA_P_41132595] Proof of concept for high-dose Cannabidiol pretreatment to antagonize opioid induced persistent apnea in mice.

Original source / bibliographic reference

Authors: Wiese BM, Bondarenko E, Feldman JL.

Year: 2025

Source type: brief-report; Journal Article

DOI: 10.3389/fnins.2025.1654787

PMID: 41132595

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[CA_P_36753805] Effects of Δ⁹-tetrahydrocannabinol (THC), cannabidiol (CBD), and THC/CBD mixtures on fentanyl versus food choice in rhesus monkeys.

Original source / bibliographic reference

Authors: Carey LM, Maguire DR, France CP.

Year: 2023

Source type: Research Support, Non-U.S. Gov't; research-article; Journal Article; Research Support, N.I.H., Extramural

DOI: 10.1016/j.drugalcdep.2023.109787

PMID: 36753805

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_29807027] Ventilatory-depressant effects of opioids alone and in combination with cannabinoids in rhesus monkeys.

Original source / bibliographic reference

Authors: Weed PF, Gerak LR, France CP.

Year: 2018

Source type: research-article; Journal Article

DOI: 10.1016/j.ejphar.2018.05.041

PMID: 29807027

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[CA_P_16288738] Enhancement of transdermal fentanyl and buprenorphine antinociception by transdermal delta9-tetrahydrocannabinol.

Original source / bibliographic reference

Authors: Cichewicz DL, Welch SP, Smith FL.

Year: 2005

Source type: Journal Article; Research Support, N.I.H., Extramural

DOI: 10.1016/j.ejphar.2005.09.039

PMID: 16288738

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_18410872] A possible perianesthetic serotonin syndrome related to intrathecal fentanyl.

Original source / bibliographic reference

Authors: Ozkardesler S, Gurpinar T, Akan M, Koca U, Sarikaya H, Olmez T, Elar Z.

Year: 2008

Source type: Journal Article; Case Reports

DOI: 10.1016/j.jclinane.2007.06.024

PMID: 18410872

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_36746375] Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation?

Original source / bibliographic reference

Authors: Gangwani P, Lillian D, Dobbins J, Feng C, Vorrasi J, Kolokythas A.

Year: 2023

Source type: Journal Article

DOI: 10.1016/j.joms.2023.01.007

PMID: 36746375

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_37783364] Cannabis Users Require More Anesthetic Agents for General Anesthesia in Ambulatory Oral and Maxillofacial Surgery Procedures.

Original source / bibliographic reference

Authors: Ripperger D, Atte A, Ritto F.

Year: 2023

Source type: Journal Article

DOI: 10.1016/j.joms.2023.09.008

PMID: 37783364

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_36269560] Baseline Cannabinoid Use Is Associated with Increased Sedation Requirements for Outpatient Endoscopy.

Original source / bibliographic reference

Authors: Nasser Y, Biala S, Chau M, Partridge ACR, Yang JY, Lethebe BC, Stinton LM, Cooray M, Cole MJ, Ma C, Chen YI, Andrews CN, Forbes N.

Year: 2024

Source type: Journal Article

DOI: 10.1089/can.2022.0203

PMID: 36269560

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_34042571] Anesthesia for Patients Who Self-Report Cannabis (Marijuana) Use Before Esophagogastroduodenoscopy: A Retrospective Review.

Original source / bibliographic reference

Authors: King DD, Stewart SA, Collins-Yoder A, Fleckner T, Price LL.

Year: 2021

Source type: research-article; Journal Article

PMID: 34042571

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

Unresolved access questions / further review: No new complete methodological assessment; original direct PubMed retrieval incomplete.

PubMed Central – freely accessible full text

[CA_P_38215858] Marijuana and endoscopy: the effects of marijuana on sedation.

Original source / bibliographic reference

Authors: Kosirog J, Bouvette C, Pannu J, Gondal J, Madhoun M.

Year: 2024

Source type: Journal Article

DOI: 10.1016/j.gie.2024.01.013

PMID: 38215858

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_32931961] Nurse-Administered Propofol Continuous Infusion Sedation for Gastrointestinal Endoscopy in Patients Who Are Difficult to Sedate.

Original source / bibliographic reference

Authors: Lee HS, Nagra N, La Selva D, Kozarek RA, Ross A, Weigel W, Beecher R, Chiorean M, Gluck M, Boden E, Venu N, Krishnamoorthi R, Larsen M, Lin OS.

Year: 2021

Source type: Journal Article

DOI: 10.1016/j.cgh.2020.09.018

PMID: 32931961

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

Drug search and explanation of the evidence · Guide: cannabinoids and medicines · Author and responsibility