Drug interactions
Butabarbital + Esketamine
Severity: Major
Butabarbital and Esketamine: major interaction.
Last updated Sources: UK SmPC
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
Barbiturates are strong CNS depressants and with esketamine may cause marked sedation and respiratory depression. Barbiturates also induce liver enzymes, which may modestly lower exposure to some drugs.
What this interaction means in plain words
Butabarbital 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 depression; barbiturate enzyme induction may also alter esketamine clearance.
What to do
Avoid the combination if possible. If both are needed, monitor sedation and respiratory function closely after esketamine dosing.
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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References
Other interactions of Esketamine
Frequently asked questions
Can I take Butabarbital with Esketamine?
MediHelp rates the interaction as major. Butabarbital 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. Barbiturates are strong CNS depressants and with esketamine may cause marked sedation and respiratory depression. Barbiturates also induce liver enzymes, which may modestly lower exposure to some drugs.
How serious is the interaction between Butabarbital 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: Avoid the combination if possible. If both are needed, monitor sedation and respiratory function closely after esketamine dosing.
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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