Drug interactions
Esketamine + Nalbuphine
Severity: Moderate
Esketamine and Nalbuphine: 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
Nalbuphine is a mixed kappa agonist and mu antagonist opioid that causes sedation and can depress respiration. With esketamine it may increase sedation and dysphoric or dissociative effects.
What this interaction means in plain words
Esketamine and Nalbuphine 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; Nalbuphine belongs to Musculoskeletal.
Why it happens
Additive CNS depression from kappa-opioid agonism and esketamine NMDA antagonism.
What to do
Monitor sedation and respiratory status after dosing. Use the lowest effective nalbuphine dose.
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 Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine Major
Frequently asked questions
Can I take Esketamine with Nalbuphine?
MediHelp rates the interaction as moderate. Esketamine and Nalbuphine 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. Nalbuphine is a mixed kappa agonist and mu antagonist opioid that causes sedation and can depress respiration. With esketamine it may increase sedation and dysphoric or dissociative effects.
How serious is the interaction between Esketamine and Nalbuphine?
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 sedation and respiratory status after dosing. Use the lowest effective nalbuphine dose.
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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