Drug interactions
Carbamazepine + Esketamine
Severity: Moderate
Carbamazepine and Esketamine: moderate 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
Carbamazepine causes drowsiness and dizziness, which may add to esketamine's sedation. Carbamazepine is also a strong CYP3A4 inducer and may lower exposure to esketamine, reducing its effect.
What this interaction means in plain words
Carbamazepine and Esketamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbamazepine belongs to Central Nervous System; Esketamine belongs to Central Nervous System.
Why it happens
Additive CNS depression, plus possible CYP3A4/CYP2B6 induction increasing esketamine metabolism.
What to do
Monitor sedation and antidepressant response, and consider whether the combination is necessary.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Esketamine
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Esketamine?
MediHelp rates the interaction as moderate. Carbamazepine and Esketamine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Carbamazepine causes drowsiness and dizziness, which may add to esketamine's sedation. Carbamazepine is also a strong CYP3A4 inducer and may lower exposure to esketamine, reducing its effect.
How serious is the interaction between Carbamazepine and Esketamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and antidepressant response, and consider whether the combination is necessary.
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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