Drug interactions
Esketamine + Fentanyl iontophoretic transdermal system
Severity: Major
Esketamine and Fentanyl iontophoretic transdermal system: 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
Both agents cause sedation, and combining a potent opioid with esketamine may increase respiratory depression. The effect is most relevant after esketamine dosing.
What this interaction means in plain words
Esketamine and Fentanyl iontophoretic transdermal system 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.
What to do
Monitor sedation and respiratory status closely during esketamine sessions, and prefer a non-opioid analgesic if feasible.
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 Fentanyl iontophoretic transdermal system?
MediHelp rates the interaction as major. Esketamine and Fentanyl iontophoretic transdermal system 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. Both agents cause sedation, and combining a potent opioid with esketamine may increase respiratory depression. The effect is most relevant after esketamine dosing.
How serious is the interaction between Esketamine and Fentanyl iontophoretic transdermal system?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and respiratory status closely during esketamine sessions, and prefer a non-opioid analgesic if feasible.
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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