Drug interactions
Esketamine + Guanfacine
Severity: Moderate
Esketamine and Guanfacine: 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
Guanfacine is sedating and lowers blood pressure, while esketamine causes sedation and transient blood pressure elevation. The combination may produce excess sedation and variable blood pressure.
What this interaction means in plain words
Esketamine and Guanfacine 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.
Esketamine belongs to Central Nervous System; Guanfacine belongs to Cardiovascular.
Why it happens
Additive CNS depression from alpha-2 agonism and NMDA antagonism, with opposing hemodynamic effects.
What to do
Monitor blood pressure, heart rate and sedation before and after esketamine dosing. Counsel patients about drowsiness and orthostatic dizziness.
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 Guanfacine
- Clonidine + Guanfacine Major
- Guanfacine + Lofexidine Major
- Aldesleukin + Guanfacine Moderate
- Amiodarone + Guanfacine Moderate
- Amisulpride + Guanfacine Moderate
- Amitriptyline + Guanfacine Moderate
Frequently asked questions
Can I take Esketamine with Guanfacine?
MediHelp rates the interaction as moderate. Esketamine and Guanfacine 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. Guanfacine is sedating and lowers blood pressure, while esketamine causes sedation and transient blood pressure elevation. The combination may produce excess sedation and variable blood pressure.
How serious is the interaction between Esketamine and Guanfacine?
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 blood pressure, heart rate and sedation before and after esketamine dosing. Counsel patients about drowsiness and orthostatic dizziness.
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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