People might find themselves more at risk of ‘serious side effects’
People taking one of the UK’s most commonly prescribed painkillers have been given an alert not to drink a common breakfast juice or risk suffering from a major side effect. People should cut this drink from their diet as it could turn the level of medicine toxic without even realising.
Fentanyl is a strong type of “opioid painkiller”, according to the NHS website, which is used to treat severe pain, for example, during or after an operation or a serious injury. Doctors have to prescribe this medicine, which blocks pain signals between the brain and the rest of the body, and has also been found to reduce the anxiety and stress caused by pain.
Medics may consider prescribing this for other types of long-term pain when weaker painkillers have stopped working. It is available to take in different forms, such as lozenges and tablets that dissolve in your mouth, or as patches to put on your skin or through a nasal spray.
How often you take or use fentanyl depends on the type you’ve been prescribed. During whatever period you take the drug for, it will be discussed with a doctor, as there are a few potential side effects that people should be aware of.
The drug, which was prescribed 812,439 times by NHS primary care services in England in 2022, is often in the headlines due to Donald Trump’s crackdown on illegal versions of it being trafficked into the US. However, it is, both in the UK and the US, a prescribed drug used under strict conditions.
Now the NHS has put out a warning about these on its website, so people are fully aware of the risks that come with taking this medication. It reads: “Like all medicines, fentanyl can cause side effects in some people, but many people have no side effects or only minor ones. You’re more likely to get side effects with higher doses of fentanyl.”
Common side effects include:
- Constipation
- Feeling or being sick (nausea or vomiting)
- Stomach pain
- Feeling sleepy or tired
- Feeling dizzy or a sensation of spinning (vertigo)
- Confusion
- Headaches
- Itching or skin rashes
There are some more serious side effects, such as your muscles feeling stiff for no obvious reason or generally feeling or you feel dizzy, tired and like you have low energy (a potential sign of low blood pressure), but these are rare. If you take fentanyl for a long time, it’s possible for your body to become tolerant to the dose you were initially prescribed, meaning you need higher doses to control your pain over time.
The NHS website claims that fentanyl is not generally affected by food, so you can eat normally, but it does warn that people shouldn’t drink one common fruit juice whilst taking the medication. A spokesperson added: “Grapefruit juice can increase the amount of fentanyl in your body so it’s a good idea not to drink it.”
Grapefruit contains natural chemicals that slow down the function of an enzyme in the small intestine and liver called cytochrome. This causes higher levels of the medication to build up in the bloodstream, and the drug stays in the body for longer than intended. This increased concentration can lead to an overdose or enhanced side effects.
Is there anything else I shouldn’t take with fentanyl?
There are some medicines that may affect how fentanyl works and increase the chance that you’ll have side effects. Tell your doctor if you’re taking any medicines:
- to help you sleep
- for high blood pressure
- for an irregular heartbeat
- to help stop you from feeling or being sick
- to treat symptoms of an allergy
- for mental health problems, including depression, or to reduce stress or anxiety
- for any infection (including HIV)
- to control fits or seizures
People have been warned by the NHS that it is best not to drink alcohol when you first start taking or using fentanyl until you see how it affects you. Drinking alcohol while using fentanyl will make you more sleepy and increase the risk of serious side effects.
It is generally safe to take fentanyl with some other painkillers – like paracetamol, ibuprofen or aspirin. People should avoid ones that contain codeine, including co-codamol, as they’ll be more likely to get side effects if they take any of these while using fentanyl.
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