Drug Interaction Report

Fentanyl Transdermal Patch and Infliximab: Interaction Details

Name: Fentanyl Transdermal Patch and Infliximab Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Fentanyl Transdermal Patch and Infliximab interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Fentanyl Transdermal Patch

Duragesic®

Infliximab

Avsola Inflectra Remicade Renflexis Zymfentra

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Moderate

Can be significant — usually manageable with monitoring.

Minor

Moderate

Major

Contraindicated

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 493 documented Fentanyl Transdermal Patch interactions, 15 are rated moderate — including this one.

Onset

unspecified

Evidence

theoretical

Severity

Moderate

What happens

Decreased fentanyl plasma concentrations

Interaction Deep Dive

In states of chronic inflammation, the formation of CYP450 enzymes is suppressed by increased levels of cytokines such as tumor necrosis factor (TNF) alpha. Upon administration of a TNF alpha antagonist, such as infliximab or infliximab biosimilar products, the formation of CYP450 enzymes could be normalized. If infliximab or infliximab biosimilar products are initiated or discontinued in a patient being treated with a CYP450 substrate with a narrow therapeutic index, such as fentanyl, monitor the effects of fentanyl and adjust the dose as needed¹²³.

Why it happens (mechanism)

Increase in CYP450-mediated fentanyl metabolism

Common questions

Can I take Fentanyl Transdermal Patch and Infliximab together?

Decreased fentanyl plasma concentrations Always confirm with your pharmacist or prescriber before making any change.

How serious is the Fentanyl Transdermal Patch and Infliximab interaction?

It is rated moderate. Can be significant — usually manageable with 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 Fentanyl Transdermal Patch or Infliximab 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 anything you'd monitor while I'm on both?

References (3)

Product Information: RENFLEXIS(TM) intravenous injection powder for solution, infliximab-abda intravenous injection powder for solution. Merck Sharp & Dohme Corp (per FDA), Kenilworth, NJ, 2017. DailyMed
Product Information: INFLECTRA intravenous injection, infliximab-dyyb intravenous injection. Hospira (per FDA), Lake Forest, IL, 2016. DailyMed
Product Information: REMICADE(R) lyophilized concentrate for intravenous injection, infliximab lyophilized concentrate for intravenous injection. Janssen Biotech, Inc. (per FDA), Horsham, PA, 2011.

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Fentanyl Transdermal Patch

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All Fentanyl Transdermal Patch interactions (493) Fentanyl Transdermal Patch drug information

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Infliximab

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All Infliximab interactions (21)

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HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

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.