Drug interactions
Diphenoxylate + Esketamine
Severity: Moderate
Diphenoxylate 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
Diphenoxylate is an opioid with central effects, particularly at higher doses or with overdose, and may add to the sedation caused by esketamine. This can result in excessive drowsiness and, rarely, respiratory depression.
What this interaction means in plain words
Diphenoxylate 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.
Diphenoxylate belongs to Gastrointestinal Tract; Esketamine belongs to Central Nervous System.
Why it happens
Additive CNS depression between an NMDA antagonist and an opioid agonist.
What to do
Use diphenoxylate at the lowest effective dose and monitor sedation and respiratory status during and after esketamine administration. Consider delaying the antidiarrheal dose until after the session is complete.
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 Diphenoxylate
Frequently asked questions
Can I take Diphenoxylate with Esketamine?
MediHelp rates the interaction as moderate. Diphenoxylate 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. Diphenoxylate is an opioid with central effects, particularly at higher doses or with overdose, and may add to the sedation caused by esketamine. This can result in excessive drowsiness and, rarely, respiratory depression.
How serious is the interaction between Diphenoxylate 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: Use diphenoxylate at the lowest effective dose and monitor sedation and respiratory status during and after esketamine administration. Consider delaying the antidiarrheal dose until after the session is complete.
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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