Drug interactions
Esketamine + Promethazine
Severity: Moderate
Esketamine and Promethazine: 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
Promethazine is a sedating phenothiazine antihistamine and adds to the sedation and dissociation caused by esketamine. This can increase impairment of alertness and, at higher doses, breathing.
What this interaction means in plain words
Esketamine and Promethazine 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; Promethazine belongs to Respiratory.
Why it happens
Additive CNS depression from H1-antagonist/phenothiazine sedative effects and NMDA-antagonist effects.
What to do
Monitor sedation and respiratory status throughout the esketamine observation period and use the lowest promethazine dose needed. Avoid additional sedatives where possible.
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 Promethazine
- Cabergoline + Promethazine Contraindicated
- Dopamine + Promethazine Contraindicated
- Ibutilide + Promethazine Contraindicated
- Pimozide + Promethazine Contraindicated
- Promethazine + Thioridazine Contraindicated
- Alfentanil + Promethazine Major
Frequently asked questions
Can I take Esketamine with Promethazine?
MediHelp rates the interaction as moderate. Esketamine and Promethazine 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. Promethazine is a sedating phenothiazine antihistamine and adds to the sedation and dissociation caused by esketamine. This can increase impairment of alertness and, at higher doses, breathing.
How serious is the interaction between Esketamine and Promethazine?
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 throughout the esketamine observation period and use the lowest promethazine dose needed. Avoid additional sedatives where possible.
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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