Drug interactions
Buprenorphine long-acting + Esketamine
Severity: Major
Buprenorphine long-acting and Esketamine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Esketamine and opioids can each cause sedation and dissociation, and together they may increase CNS and respiratory depression. Long-acting buprenorphine provides continuous exposure, so effects can overlap with each esketamine session.
What this interaction means in plain words
Buprenorphine long-acting and Esketamine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression.
What to do
Monitor sedation, oxygen saturation, and breathing throughout the post-dose observation period. Use only when alternatives are inadequate.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Esketamine
Frequently asked questions
Can I take Buprenorphine long-acting with Esketamine?
MediHelp rates the interaction as major. Buprenorphine long-acting and Esketamine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Esketamine and opioids can each cause sedation and dissociation, and together they may increase CNS and respiratory depression. Long-acting buprenorphine provides continuous exposure, so effects can overlap with each esketamine session.
How serious is the interaction between Buprenorphine long-acting and Esketamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation, oxygen saturation, and breathing throughout the post-dose observation period. Use only when alternatives are inadequate.
What other medicines interact with Esketamine?
MediHelp also lists interactions of Esketamine with, for example, Alfentanil, Amobarbital, Belladonna and opium. The full list is on the Esketamine page.
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