Drug interactions
Escitalopram + Remifentanil
Severity: Moderate
Escitalopram and Remifentanil: 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
Opioid and SSRI co-therapy can increase the risk of serotonin syndrome. Cases with remifentanil are uncommon, but the combination is flagged because the syndrome can be severe.
What this interaction means in plain words
Escitalopram and Remifentanil 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.
Escitalopram belongs to Central Nervous System; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and opioid serotonergic activity.
What to do
Monitor for signs of serotonin toxicity during and after anaesthesia or dose changes. Stop serotonergic drugs and provide supportive care if toxicity occurs.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Remifentanil?
MediHelp rates the interaction as moderate. Escitalopram and Remifentanil 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. Opioid and SSRI co-therapy can increase the risk of serotonin syndrome. Cases with remifentanil are uncommon, but the combination is flagged because the syndrome can be severe.
How serious is the interaction between Escitalopram and Remifentanil?
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 for signs of serotonin toxicity during and after anaesthesia or dose changes. Stop serotonergic drugs and provide supportive care if toxicity occurs.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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