Drug interactions
Esketamine + Nicotine intranasal
Severity: Moderate
Esketamine and Nicotine intranasal: 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
Esketamine and nicotine both stimulate the sympathetic system, so using them together may cause a larger increase in blood pressure and heart rate. Intranasal nicotine is absorbed quickly, which may coincide with esketamine's peak hemodynamic effect.
What this interaction means in plain words
Esketamine and Nicotine intranasal 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.
Why it happens
Additive sympathomimetic pressor and chronotropic effects of esketamine and nicotine.
What to do
Monitor blood pressure before and after esketamine administration until it returns to baseline. Avoid nicotine spray use around the dosing session.
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
Frequently asked questions
Can I take Esketamine with Nicotine intranasal?
MediHelp rates the interaction as moderate. Esketamine and Nicotine intranasal 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 and nicotine both stimulate the sympathetic system, so using them together may cause a larger increase in blood pressure and heart rate. Intranasal nicotine is absorbed quickly, which may coincide with esketamine's peak hemodynamic effect.
How serious is the interaction between Esketamine and Nicotine intranasal?
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 before and after esketamine administration until it returns to baseline. Avoid nicotine spray use around the dosing session.
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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