Drug interactions
Esketamine + Protriptyline
Severity: Moderate
Esketamine and Protriptyline: 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
Protriptyline is a tricyclic antidepressant that is less sedating than most but can still add to dizziness and cognitive impairment with esketamine. Both drugs can raise heart rate and blood pressure, so cardiovascular effects may be additive.
What this interaction means in plain words
Esketamine and Protriptyline 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.
Why it happens
Additive CNS and sympathomimetic cardiovascular effects through monoamine reuptake inhibition and NMDA antagonism.
What to do
Monitor blood pressure, heart rate and sedation before and after dosing. Use caution in patients with cardiovascular disease.
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
Frequently asked questions
Can I take Esketamine with Protriptyline?
MediHelp rates the interaction as moderate. Esketamine and Protriptyline 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. Protriptyline is a tricyclic antidepressant that is less sedating than most but can still add to dizziness and cognitive impairment with esketamine. Both drugs can raise heart rate and blood pressure, so cardiovascular effects may be additive.
How serious is the interaction between Esketamine and Protriptyline?
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 blood pressure, heart rate and sedation before and after dosing. Use caution in patients with cardiovascular disease.
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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