Drug interactions
Esketamine + Pimavanserin
Severity: Moderate
Esketamine and Pimavanserin: 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
Pimavanserin is a serotonin 5-HT2A inverse agonist that may cause somnolence and prolong the QT interval. Combined with esketamine, additive sedation is possible, though evidence is limited.
What this interaction means in plain words
Esketamine and Pimavanserin 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; Pimavanserin belongs to Central Nervous System.
Why it happens
Possible additive CNS depression; no established pharmacokinetic interaction.
What to do
Monitor sedation and blood pressure during post-dose observation. Check the QT interval if other QT-prolonging drugs are present.
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 Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Esketamine with Pimavanserin?
MediHelp rates the interaction as moderate. Esketamine and Pimavanserin 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. Pimavanserin is a serotonin 5-HT2A inverse agonist that may cause somnolence and prolong the QT interval. Combined with esketamine, additive sedation is possible, though evidence is limited.
How serious is the interaction between Esketamine and Pimavanserin?
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 during post-dose observation. Check the QT interval if other QT-prolonging drugs are present.
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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