The NHS has issued a crucial health advisory for the 800,000 people in England prescribed fentanyl, one of the UK’s most potent opioid painkillers. Patients are being urged to avoid consuming grapefruit juice while taking fentanyl, as this combination can lead to harmful side effects and increase the risk of overdose.
Fentanyl is prescribed to treat severe pain, often after surgery or serious injury, and sometimes for chronic pain when other medications are ineffective. It works by blocking pain signals between the brain and body and may also relieve anxiety related to pain. Available in lozenges, tablets, skin patches, and nasal sprays, fentanyl requires close medical supervision due to its potency and potential side effects.
In 2022, over 812,000 fentanyl prescriptions were issued by NHS primary care in England, reflecting its widespread medical use. Despite its legitimate medical role, concerns persist due to the illicit trafficking of fentanyl variants, spotlighted internationally.
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The NHS highlights that while many fentanyl users experience no or only minor side effects, higher doses increase the risk of adverse reactions. Common side effects include dizziness, fatigue, and muscle stiffness, although serious reactions are rare.
Uniquely, the NHS warns against grapefruit juice because it interferes with the metabolism of fentanyl. Compounds in grapefruit inhibit the cytochrome enzyme in the liver and small intestine, causing fentanyl levels in the blood to rise dangerously. This interaction can prolong the drug’s effects and enhance side effects, potentially triggering overdose symptoms.
Doctors also caution people on fentanyl to avoid alcohol initially, as it can cause excessive drowsiness and other severe side effects. While fentanyl can be safely taken with common painkillers like paracetamol and ibuprofen, combining it with codeine-containing medicines like co-codamol increases the risk of harmful effects.
Patients prescribed fentanyl should always inform their healthcare providers about any other medications they are taking and discuss food or drink interactions. Avoiding grapefruit juice and alcohol, especially early in treatment, is an important step to ensure safety while managing pain effectively.