Drug Interaction Report

Alfentanil and Asenapine Transdermal Patch: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Alfentanil

No brand names on record
+

Asenapine Transdermal Patch

Secuado Secuado®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jul 11, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 100 documented Alfentanil interactions, 97 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased risk of respiratory or CNS depression and hypotension

Interaction Deep Dive

The concomitant use of ALfentanil with other CNS depressants may result in profound sedation, respiratory depression, coma, and/or death. Reserve concomitant use to clinical settings where alternative treatment options are inadequate. If combination therapy is required, reduce the initial dose of the newly prescribed medication and titrate to clinical response while monitoring for respiratory depression and sedation1. Vasodilation and hypotension caused by concomitant use may delay recovery. If hypotension occurs consider hypovolemia as a cause and manage with parenteral fluids. Consider repositioning the patient to improve venous return to the heart, however, use caution moving the patient due to risk of orthostatic hypotension. If hypotension is not adequately corrected with fluids, consider pressor agents other than EPINEPHrine. Following ALfentanil administration, reduce the dose of other CNS depressants. If the decision is made to manage postoperative pain with ALfentanil concomitantly with or other CNS depressant, start dosing with the lowest effective dosage and titrate based on clinical response. Fluids or other measures to counter hypotension should be available. Limited clinical experience indicates that requirements for volatile inhalation anesthetics are reduced by 30% to 50% for the first 60 minutes following ALfentanil induction 2.

Why it happens (mechanism)

Additive CNS depression; enhancement of vasodilation

Common questions

Can I take Alfentanil and Asenapine Transdermal Patch together?

Increased risk of respiratory or CNS depression and hypotension Always confirm with your pharmacist or prescriber before making any change.

How serious is the Alfentanil and Asenapine Transdermal Patch interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Alfentanil or Asenapine Transdermal Patch need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. US Food and Drug Administration (FDA): Drug Safety Communications: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. US Food and Drug Administration (FDA). Silver Spring, MD. 2016.
  2. Product Information: Alfentanil HCl intravenous injection, alfentanil HCl intravenous injection. Rising Pharma Holdings, Inc (per FDA), East Brunswick, NJ, 2025.
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Beyond drug–drug

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.