Drug interactions
Esketamine + Isocarboxazid
Severity: Major
Esketamine and Isocarboxazid: 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
MAO inhibitors potentiate sympathomimetic effects and can cause hypertensive reactions, and esketamine itself increases blood pressure. Combined use may result in marked blood pressure elevation.
What this interaction means in plain words
Esketamine and Isocarboxazid 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.
Esketamine belongs to Central Nervous System; Isocarboxazid belongs to Central Nervous System.
Why it happens
Additive pressor effects, with MAO inhibition increasing monoamine availability.
What to do
Measure blood pressure before and after each esketamine dose and avoid treatment if baseline pressure is elevated. Consider alternatives if blood pressure control is difficult.
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
Other interactions of Isocarboxazid
- 5-HTP + Isocarboxazid Contraindicated
- Amitriptyline + Isocarboxazid Contraindicated
- Amobarbital + Isocarboxazid Contraindicated
- Amoxapine + Isocarboxazid Contraindicated
- Apraclonidine + Isocarboxazid Contraindicated
- Atomoxetine + Isocarboxazid Contraindicated
Frequently asked questions
Can I take Esketamine with Isocarboxazid?
MediHelp rates the interaction as major. Esketamine and Isocarboxazid 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. MAO inhibitors potentiate sympathomimetic effects and can cause hypertensive reactions, and esketamine itself increases blood pressure. Combined use may result in marked blood pressure elevation.
How serious is the interaction between Esketamine and Isocarboxazid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure blood pressure before and after each esketamine dose and avoid treatment if baseline pressure is elevated. Consider alternatives if blood pressure control is difficult.
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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