Drug interactions
Esketamine + Primidone
Severity: Moderate
Esketamine and Primidone: 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
Primidone is metabolized partly to phenobarbital and has sedative effects that add to esketamine's CNS depression. Primidone is also an enzyme inducer, which could modestly lower exposure to drugs metabolized by CYP enzymes.
What this interaction means in plain words
Esketamine and Primidone 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; Primidone belongs to Central Nervous System.
Why it happens
Additive CNS depression from barbiturate-type GABAergic action and NMDA antagonism.
What to do
Monitor sedation and respiratory status after esketamine dosing, and watch for reduced antidepressant response if enzyme induction is suspected.
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 Primidone
- Lorlatinib + Primidone Contraindicated
- Lurasidone + Primidone Contraindicated
- Primidone + Ranolazine Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Voriconazole Contraindicated
- Abiraterone + Primidone Major
Frequently asked questions
Can I take Esketamine with Primidone?
MediHelp rates the interaction as moderate. Esketamine and Primidone 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. Primidone is metabolized partly to phenobarbital and has sedative effects that add to esketamine's CNS depression. Primidone is also an enzyme inducer, which could modestly lower exposure to drugs metabolized by CYP enzymes.
How serious is the interaction between Esketamine and Primidone?
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 respiratory status after esketamine dosing, and watch for reduced antidepressant response if enzyme induction is suspected.
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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