Drug interactions
Codeine + Esketamine intranasal
Severity: Moderate
Codeine and Esketamine intranasal: 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
Esketamine causes sedation and dissociation, and with opioids the sedative and respiratory depressant effects are additive.
What this interaction means in plain words
Codeine and Esketamine intranasal 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.
Why it happens
Additive CNS and respiratory depression from combined pharmacodynamic effects.
What to do
Monitor sedation level and respiratory status during and after esketamine dosing. Reduce the opioid dose where clinically feasible.
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 Codeine
- Alvimopan + Codeine Contraindicated
- Codeine + Isocarboxazid Contraindicated
- Codeine + Olanzapine / samidorphan Contraindicated
- Codeine + Phenelzine Contraindicated
- Codeine + Tranylcypromine Contraindicated
- Alfentanil + Codeine Major
Frequently asked questions
Can I take Codeine with Esketamine intranasal?
MediHelp rates the interaction as moderate. Codeine and Esketamine intranasal 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. Esketamine causes sedation and dissociation, and with opioids the sedative and respiratory depressant effects are additive.
How serious is the interaction between Codeine and Esketamine intranasal?
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 level and respiratory status during and after esketamine dosing. Reduce the opioid dose where clinically feasible.
What other medicines interact with Codeine?
MediHelp also lists interactions of Codeine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Codeine page.
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