Methoxyacetylfentanyl is metabolized in the liver primarily by CYP450 enzymes, converting it into metabolites excreted through the urine. The exact metabolic pathways are less well-studied compared to fentanyl, but like other fentanyl analogs, it has a relatively short half-life.

Drug-Drug Interactions: 

Methoxyacetylfentanyl interacts dangerously with central nervous system depressants, including alcohol, benzodiazepines, and other opioids. These combinations drastically increase the risk of respiratory depression, unconsciousness, and death. It may also interact with serotonergic drugs, potentially leading to serotonin syndrome, though this is less common.