Drug interactions
Esketamine + Thioridazine
Severity: Major
Esketamine and Thioridazine: 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
Thioridazine is strongly sedating and causes dose-related QT prolongation. With esketamine it can increase sedation and hypotension, and esketamine-related blood pressure and heart rate changes add cardiovascular stress.
What this interaction means in plain words
Esketamine and Thioridazine 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; Thioridazine belongs to Central Nervous System.
Why it happens
Additive CNS depression plus cardiovascular effects; thioridazine prolongs QT via hERG blockade.
What to do
Avoid if possible; if used, monitor sedation, blood pressure and ECG, and correct electrolytes.
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
- Esketamine 25 mg/ml solution for injection/infusion - SmPC sections 4.3/4.5 (class statement: antipsychotics; "In combination with hypnotics, benzodiazepines or antipsychotics, there is a reduction in adverse effects but also a prolongation of the duration of effect of e") — electronic medicines compendium (UK SmPC)
Other interactions of Esketamine
Other interactions of Thioridazine
- Abiraterone + Thioridazine Contraindicated
- Adagrasib + Thioridazine Contraindicated
- Amiodarone + Thioridazine Contraindicated
- Amisulpride + Thioridazine Contraindicated
- Amitriptyline + Thioridazine Contraindicated
- Amoxapine + Thioridazine Contraindicated
Frequently asked questions
Can I take Esketamine with Thioridazine?
MediHelp rates the interaction as major. Esketamine and Thioridazine 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. Thioridazine is strongly sedating and causes dose-related QT prolongation. With esketamine it can increase sedation and hypotension, and esketamine-related blood pressure and heart rate changes add cardiovascular stress.
How serious is the interaction between Esketamine and Thioridazine?
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 if possible; if used, monitor sedation, blood pressure and ECG, and correct electrolytes.
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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