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Is Fentanyl safe with Suboxone for cardiac catheterization?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am getting a cardiac catheterization this morning. I am currently on Suboxone 12 mg, once in the morning and once in the evening. When I asked what they would be using to sedate, they said Fentanyl and Versed. I asked for Profol but got no answer. I spoke to a male nurse, not an anesthesiologist.

  1. If the Fentanyl overrides the Suboxone, will I be in withdraw?
  2. Also, are there safety issues when combining these medicines?
  3. Should I cancel this procedure?

Please advise.

Thank you.

Answered by Dr. Padala Balarama Reddy

Hi,

Welcome to icliniq.com.

Usually, for cardiac procedures, anesthesiologists would prefer Fentanyl over Propofol, because Fentanyl is an opioid and will cause good pain relief and sedation. There is a high probability of heart stability, and the chances of losing your breath and consciousness with Fentanyl are very low. But you will be made to sleep and remain pain-free.

Propofol causes deep sleep. You may lose your complete consciousness, you may lose your breathing, and go to mechanical ventilation. So it is always good to go ahead with Fentanyl and Versed. Your medication will not interfere with the drugs, do not worry.

I hope that you get your answer.

Please let me know if you want some help.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

So you are saying Suboxone, which limits any opioid from being effective, is not contraindicated with Fentanyl?

Please guide.

Thank you.

Answered by Dr. Padala Balarama Reddy

Hi,

Welcome back to icliniq.com.

The Suboxone that you are taking morning and night is for pain control, right? It is a combination of Buprenorphine and Naloxone, which are painkillers that act on opioid receptors.

One thing you have to understand is that usually, Naloxone alone will be used to treat opioid-induced side effects like deep sedation or respiratory depression (slow and ineffective breathing) occurring in patients in the hospital setup. So, if you are using Suboxone (Naloxone and Buprenorphine) which has two different actions, they will have an additive effect when used with Fentanyl.

So, definitely, you have to tell the anesthesiologist that you are using this so that he can reduce the dose of Fentanyl during your procedure, and he can give Buprenorphine alone as you are already used to it or some other form of analgesia.

I hope that you get your answer.

Please let me know if you want some help.

Thank you.

Answered byDr. Padala Balarama Reddy

Medically reviewed byDr. Divya Banu M

Published At August 5, 2019
Reviewed AtOctober 17, 2025

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