Drug interactions
Esketamine + Nortriptyline
Severity: Moderate
Esketamine and Nortriptyline: 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
Nortriptyline is a tricyclic antidepressant with sedative and anticholinergic properties, and esketamine can raise blood pressure and cause sedation. Combined use may increase drowsiness and cardiovascular effects.
What this interaction means in plain words
Esketamine and Nortriptyline 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; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive CNS depression, plus possible additive cardiovascular stimulation.
What to do
Monitor sedation and blood pressure before and after esketamine doses. Consider adjusting the tricyclic dose if oversedation occurs.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Esketamine with Nortriptyline?
MediHelp rates the interaction as moderate. Esketamine and Nortriptyline 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. Nortriptyline is a tricyclic antidepressant with sedative and anticholinergic properties, and esketamine can raise blood pressure and cause sedation. Combined use may increase drowsiness and cardiovascular effects.
How serious is the interaction between Esketamine and Nortriptyline?
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 blood pressure before and after esketamine doses. Consider adjusting the tricyclic dose if oversedation occurs.
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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