Drug interactions
Esketamine + Oxymorphone
Severity: Major
Esketamine and Oxymorphone: 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
Oxymorphone is a potent opioid causing sedation and respiratory depression. With esketamine the CNS depressant effects are additive and may be clinically significant.
What this interaction means in plain words
Esketamine and Oxymorphone 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; Oxymorphone belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression from NMDA antagonism combined with mu-opioid agonism.
What to do
Monitor sedation and breathing carefully after esketamine dosing and keep the opioid dose minimal. Warn patients against additional opioid use around sessions.
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 Oxymorphone
- Alvimopan + Oxymorphone Contraindicated
- Ethanol + Oxymorphone Contraindicated
- Isocarboxazid + Oxymorphone Contraindicated
- Olanzapine / samidorphan + Oxymorphone Contraindicated
- Oxymorphone + Phenelzine Contraindicated
- Oxymorphone + Selegiline transdermal Contraindicated
Frequently asked questions
Can I take Esketamine with Oxymorphone?
MediHelp rates the interaction as major. Esketamine and Oxymorphone 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. Oxymorphone is a potent opioid causing sedation and respiratory depression. With esketamine the CNS depressant effects are additive and may be clinically significant.
How serious is the interaction between Esketamine and Oxymorphone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and breathing carefully after esketamine dosing and keep the opioid dose minimal. Warn patients against additional opioid use around sessions.
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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