Drug interactions
Esketamine + Phenelzine
Severity: Major
Esketamine and Phenelzine: 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
Phenelzine is a nonselective MAO inhibitor that potentiates sympathetic activity, and esketamine raises blood pressure on its own. Combined use may lead to significant hypertensive responses. The MAOI also increases the potential for other adverse neuropsychiatric effects.
What this interaction means in plain words
Esketamine and Phenelzine 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; Phenelzine belongs to Central Nervous System.
Why it happens
Additive pressor effects: esketamine sympathetic stimulation with MAO inhibition that increases catecholamine availability.
What to do
Monitor blood pressure closely before and after each esketamine dose and avoid treatment if baseline hypertension is uncontrolled. Consider an alternative approach where pressure cannot be reliably controlled.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Esketamine and Phenelzine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Esketamine
Other interactions of Phenelzine
- 5-HTP + Phenelzine Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amoxapine + Phenelzine Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Benzphetamine + Phenelzine Contraindicated
- Brimonidine + Phenelzine Contraindicated
Frequently asked questions
Can I take Esketamine with Phenelzine?
MediHelp rates the interaction as major. Esketamine and Phenelzine 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. Phenelzine is a nonselective MAO inhibitor that potentiates sympathetic activity, and esketamine raises blood pressure on its own. Combined use may lead to significant hypertensive responses. The MAOI also increases the potential for other adverse neuropsychiatric effects.
How serious is the interaction between Esketamine and Phenelzine?
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 blood pressure closely before and after each esketamine dose and avoid treatment if baseline hypertension is uncontrolled. Consider an alternative approach where pressure cannot be reliably controlled.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
