Drug interactions
Esketamine + Pseudoephedrine
Severity: Moderate
Esketamine and Pseudoephedrine: 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
Pseudoephedrine is a sympathomimetic decongestant that raises blood pressure and heart rate. Esketamine has similar transient effects, so the combination may cause a greater pressor response. Nasal congestion may also affect intranasal esketamine absorption.
What this interaction means in plain words
Esketamine and Pseudoephedrine 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; Pseudoephedrine belongs to Respiratory.
Why it happens
Additive sympathomimetic pressor effects.
What to do
Check blood pressure before and after esketamine dosing and defer if baseline pressure is elevated. Avoid using decongestant nasal products shortly before intranasal dosing.
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 Pseudoephedrine
- Isocarboxazid + Pseudoephedrine Contraindicated
- Phenelzine + Pseudoephedrine Contraindicated
- Pseudoephedrine + Rasagiline Contraindicated
- Pseudoephedrine + Selegiline Contraindicated
- Pseudoephedrine + Selegiline transdermal Contraindicated
- Pseudoephedrine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Esketamine with Pseudoephedrine?
MediHelp rates the interaction as moderate. Esketamine and Pseudoephedrine 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. Pseudoephedrine is a sympathomimetic decongestant that raises blood pressure and heart rate. Esketamine has similar transient effects, so the combination may cause a greater pressor response. Nasal congestion may also affect intranasal esketamine absorption.
How serious is the interaction between Esketamine and Pseudoephedrine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check blood pressure before and after esketamine dosing and defer if baseline pressure is elevated. Avoid using decongestant nasal products shortly before intranasal dosing.
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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