Drug interactions
Esketamine + Secobarbital
Severity: Major
Esketamine and Secobarbital: major interaction.
Last updated Sources: UK SmPC
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
Barbiturates are strong CNS depressants, and combining secobarbital with esketamine can cause profound sedation and respiratory depression. Barbiturate enzyme induction may also lower exposure to some co-medications.
What this interaction means in plain words
Esketamine and Secobarbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Esketamine belongs to Central Nervous System; Secobarbital belongs to Central Nervous System.
Why it happens
Additive CNS depression via GABA-A potentiation by barbiturates plus NMDA receptor antagonism.
What to do
Avoid combining where possible; if necessary, use the lowest doses and monitor respiratory status and sedation closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Esketamine
Other interactions of Secobarbital
- Calcium / magnesium / potassium / sodium oxybates + Secobarbital Contraindicated
- Doravirine + Secobarbital Contraindicated
- Elbasvir / grazoprevir + Secobarbital Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Secobarbital Contraindicated
- Isavuconazonium + Secobarbital Contraindicated
- Lonafarnib + Secobarbital Contraindicated
Frequently asked questions
Can I take Esketamine with Secobarbital?
MediHelp rates the interaction as major. Esketamine and Secobarbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Barbiturates are strong CNS depressants, and combining secobarbital with esketamine can cause profound sedation and respiratory depression. Barbiturate enzyme induction may also lower exposure to some co-medications.
How serious is the interaction between Esketamine and Secobarbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible; if necessary, use the lowest doses and monitor respiratory status and sedation closely.
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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