Drug interactions
Dextromoramide + Ketamine
Severity: Major
Dextromoramide and Ketamine: major interaction.
Last updated Sources: US FDA label
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
Dextromoramide is a potent opioid analgesic, and combining it with ketamine can increase sedation and respiratory depression. Although ketamine is used as an opioid-sparing adjunct, the combination requires careful dosing.
What this interaction means in plain words
Dextromoramide and Ketamine 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 via opioid receptor agonism and NMDA antagonism.
What to do
Start with reduced opioid and ketamine doses and monitor respiratory rate, oxygen saturation and sedation continuously. Have naloxone and airway support available.
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 Ketamine
Frequently asked questions
Can I take Dextromoramide with Ketamine?
MediHelp rates the interaction as major. Dextromoramide and Ketamine 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. Dextromoramide is a potent opioid analgesic, and combining it with ketamine can increase sedation and respiratory depression. Although ketamine is used as an opioid-sparing adjunct, the combination requires careful dosing.
How serious is the interaction between Dextromoramide and Ketamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with reduced opioid and ketamine doses and monitor respiratory rate, oxygen saturation and sedation continuously. Have naloxone and airway support available.
What other medicines interact with Ketamine?
MediHelp also lists interactions of Ketamine with, for example, Benzhydrocodone / acetaminophen, Brexanolone, Buprenorphine buccal. The full list is on the Ketamine page.
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