Mixing Fentanyl (fent) and Xylazine (tranq)
Dangerous
This is tranq dope: breathing can come back after naloxone while the person stays unconscious.
Do not combine. If someone won't wake, give naloxone anyway, then rescue breaths, put them on their side, and stay.
What to do
- Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
- Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
- Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
- Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
- Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
- Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.
What “Dangerous” means
High risk of death or life-changing injury. Do not combine.
How the ratings workThe longer explanation
This is what 'tranq dope' is. In animal studies, xylazine made fentanyl's effect on breathing and brain oxygen worse and longer-lasting, and a naloxone dose that fully reversed fentanyl alone did not rescue the mixture. In a person that can look like breathing that comes back after naloxone while they stay unconscious. Give naloxone anyway, give rescue breaths, put them on their side and stay. In Philadelphia the sedative in the supply is now mostly medetomidine, which is far stronger, with a withdrawal severe enough that nine in ten people hospitalised for it there went to intensive care.
Sources (6)
- Choi S, Irwin MR, Kiyatkin EA. Xylazine effects on opioid-induced brain hypoxia. Psychopharmacology. 2023link.springer.com
- Watkins JM et al. Xylazine exacerbates fentanyl-induced respiratory depression and prevents rescue by naloxone in mice. Psychopharmacology. 2026pmc.ncbi.nlm.nih.gov
- What You Should Know About Xylazine. CDCcdc.gov
- Friedman J et al. Xylazine spreads across the US. Drug Alcohol Depend. 2022pubmed.ncbi.nlm.nih.gov
- Notes from the Field: Suspected Medetomidine Withdrawal Syndrome Among Fentanyl-Exposed Patients — Philadelphia, Pennsylvania, September 2024–January 2025. MMWR. 2025pmc.ncbi.nlm.nih.gov
- Notes from the Field: Severe Medetomidine Withdrawal Syndrome in Patients Using Illegally Manufactured Opioids — Pittsburgh, Pennsylvania, October 2024–March 2025. MMWR. 2025pmc.ncbi.nlm.nih.gov
Think this is wrong, or know a better source? Send it.
Other names
- Fentanyl
- fent, fentanil, carfentanil, nitazene, nitazenes, duragesic
- Synthetic — potent by micrograms, unevenly mixed
- Xylazine
- tranq, tranq dope, zombie drug, anestesia de caballo, rompun, medetomidine
- Animal sedative cut into fentanyl, as is its stronger cousin medetomidine — naloxone reverses neither
Related combinations
- KetamineDangerous
- MXEDangerous
- AlcoholDangerous
- BenzodiazepinesDangerous
- ZolpidemDangerous
- GHB / GBLDangerous
Can you mix Fentanyl (fent) and Xylazine (tranq)?
MixSafe rates mixing Fentanyl and Xylazine as "Dangerous" — high risk of death or life-changing injury. Do not combine. Source: MixSafe research. Educational information, not medical advice.