Drug interactions
Esketamine + Sodium oxybate
Severity: Major
Esketamine and Sodium oxybate: major interaction.
Last updated Sources: US FDA label
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
Sodium oxybate is a potent CNS depressant, and with esketamine there is a risk of profound sedation, respiratory depression and coma. Sodium oxybate is itself restricted for use with other CNS depressants.
What this interaction means in plain words
Esketamine and Sodium oxybate 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; Sodium oxybate belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression from GABA-B and GHB receptor activity combined with NMDA antagonism.
What to do
Avoid combining where possible. If unavoidable, reduce doses and monitor sedation and respiratory function closely, and do not schedule esketamine near bedtime oxybate doses.
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 Sodium oxybate
- Alprazolam + Sodium oxybate Contraindicated
- Amobarbital + Sodium oxybate Contraindicated
- Butorphanol + Sodium oxybate Contraindicated
- Chloral hydrate + Sodium oxybate Contraindicated
- Clonazepam + Sodium oxybate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Esketamine with Sodium oxybate?
MediHelp rates the interaction as major. Esketamine and Sodium oxybate 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. Sodium oxybate is a potent CNS depressant, and with esketamine there is a risk of profound sedation, respiratory depression and coma. Sodium oxybate is itself restricted for use with other CNS depressants.
How serious is the interaction between Esketamine and Sodium oxybate?
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 unavoidable, reduce doses and monitor sedation and respiratory function closely, and do not schedule esketamine near bedtime oxybate doses.
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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