Drug interactions
Esketamine + Olanzapine / samidorphan
Severity: Moderate
Esketamine and Olanzapine / samidorphan: 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 causes sedation, dissociation and blood pressure changes, while olanzapine is sedating and can cause orthostatic hypotension. Combined use may increase drowsiness, dizziness and impaired psychomotor performance.
What this interaction means in plain words
Esketamine and Olanzapine / samidorphan 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 central nervous system depressant effects and hemodynamic effects of both drugs.
What to do
Monitor for excessive sedation and orthostatic hypotension during and after esketamine sessions. Counsel patients not to drive or operate machinery until the next day after a restful sleep.
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 Olanzapine / samidorphan?
MediHelp rates the interaction as moderate. Esketamine and Olanzapine / samidorphan 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 causes sedation, dissociation and blood pressure changes, while olanzapine is sedating and can cause orthostatic hypotension. Combined use may increase drowsiness, dizziness and impaired psychomotor performance.
How serious is the interaction between Esketamine and Olanzapine / samidorphan?
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 for excessive sedation and orthostatic hypotension during and after esketamine sessions. Counsel patients not to drive or operate machinery until the next day after a restful sleep.
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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