Drug Interaction Report

Ozanimod and Fentanyl Transdermal Patch: Interaction Details

A pharmacist-reviewed analysis of the Ozanimod and Fentanyl Transdermal Patch 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

Ozanimod

No brand names on record
+

Fentanyl Transdermal Patch

Duragesic®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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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 86 documented Ozanimod interactions, 70 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 serious adverse reactions and an increased risk of serotonin syndrome or opioid toxicity

Interaction Deep Dive

Use of fentaNYL is not recommended for patients taking MAOIs such as ozanimod or within 14 days of stopping such treatment. Concomitant use may result in increased serotonin syndrome or opioid toxicity. Serotonin syndrome symptoms may include mental status changes, autonomic instability, neuromuscular aberrations, and/or gastrointestinal symptoms and can be fatal. The onset of symptoms generally occurs within several hours to a few days of concomitant use. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Discontinue fentaNYL if serotonin syndrome is suspected21. An active metabolite of ozanimod inhibits MAO-B in vitro, thus there is the potential for serious adverse reactions, if ozanimod is coadministered with drugs that can increase norepinephrine or serotonin (eg, opioid drugs). Serious and sometimes fatal adverse reactions have been precipitated with concomitant use of opioids and MAOIs, including selective MAO-B inhibitors 3.

Why it happens (mechanism)

MAO-B inhibition; additive serotonergic effects

Common questions

Can I take Ozanimod and Fentanyl Transdermal Patch together?

Increased risk of serious adverse reactions and an increased risk of serotonin syndrome or opioid toxicity Always confirm with your pharmacist or prescriber before making any change.

How serious is the Ozanimod and Fentanyl 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 Ozanimod or Fentanyl 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 (3)

  1. Product Information: ACTIQ(R) oral transmucosal lozenge, fentanyl citrate oral transmucosal lozenge. Teva Pharmaceuticals USA, Inc. (per FDA), Parsippany, NJ, 2023. DailyMed
  2. Product Information: Fentanyl citrate intravenous, intramuscular injection, fentanyl citrate intravenous, intramuscular injection. Hospira Inc (per FDA), Lake Forest, IL, 2023. DailyMed
  3. Product Information: ZEPOSIA(R) oral capsules, ozanimod oral capsules. Bristol-Myers Squibb Company (per FDA), Princeton, NJ, 2024. DailyMed
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Ozanimod

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Fentanyl Transdermal Patch

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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.