Drug interactions
Esketamine + Ethanol
Severity: Major
Esketamine and Ethanol: major interaction.
Last updated Sources: EMA SmPC
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
Alcohol and esketamine both depress the central nervous system, so drinking around a treatment session increases drowsiness, dizziness, impaired judgment and the risk of respiratory depression. Alcohol also worsens the dissociative and cognitive effects of esketamine.
What this interaction means in plain words
Esketamine and Ethanol 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 depression via GABAergic enhancement and NMDA blockade.
What to do
Advise patients to avoid alcohol before and after esketamine sessions. Delay dosing if the patient appears intoxicated.
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 Esketamine
Frequently asked questions
Can I take Esketamine with Ethanol?
MediHelp rates the interaction as major. Esketamine and Ethanol 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. Alcohol and esketamine both depress the central nervous system, so drinking around a treatment session increases drowsiness, dizziness, impaired judgment and the risk of respiratory depression. Alcohol also worsens the dissociative and cognitive effects of esketamine.
How serious is the interaction between Esketamine and Ethanol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid alcohol before and after esketamine sessions. Delay dosing if the patient appears intoxicated.
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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