Drug interactions
Esketamine + Pentazocine
Severity: Major
Esketamine and Pentazocine: major interaction.
Last updated Sources: US FDA label
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
Pentazocine is a mixed agonist-antagonist opioid that causes sedation, respiratory depression and sometimes psychotomimetic effects. With esketamine it may increase sedation and dissociative or dysphoric symptoms.
What this interaction means in plain words
Esketamine and Pentazocine 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; Pentazocine belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression from opioid receptor activity and NMDA antagonism.
What to do
Monitor sedation, respiratory rate and psychiatric symptoms after dosing. Consider an alternative analgesic if marked sedation or dysphoria occurs.
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 Pentazocine
- Calcium / magnesium / potassium / sodium oxybates + Pentazocine Contraindicated
- Olanzapine / samidorphan + Pentazocine Contraindicated
- Pentazocine + Phenelzine Contraindicated
- Pentazocine + Tranylcypromine Contraindicated
- Alfentanil + Pentazocine Major
- Alprazolam + Pentazocine Major
Frequently asked questions
Can I take Esketamine with Pentazocine?
MediHelp rates the interaction as major. Esketamine and Pentazocine 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. Pentazocine is a mixed agonist-antagonist opioid that causes sedation, respiratory depression and sometimes psychotomimetic effects. With esketamine it may increase sedation and dissociative or dysphoric symptoms.
How serious is the interaction between Esketamine and Pentazocine?
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, respiratory rate and psychiatric symptoms after dosing. Consider an alternative analgesic if marked sedation or dysphoria 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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