Drug interactions
Esketamine + Tranylcypromine
Severity: Major
Esketamine and Tranylcypromine: major interaction.
Last updated Sources: EMA 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
Tranylcypromine is a nonselective MAO inhibitor with notable pressor potential, and esketamine also increases blood pressure. The combination may produce marked hypertension and tachycardia.
What this interaction means in plain words
Esketamine and Tranylcypromine 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; Tranylcypromine belongs to Central Nervous System.
Why it happens
Additive pressor effects from esketamine sympathetic stimulation and MAO inhibition raising catecholamine levels.
What to do
Monitor blood pressure before and after each esketamine dose and do not treat if pressure is uncontrolled. Consider alternatives if repeated significant elevations occur.
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 Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Esketamine with Tranylcypromine?
MediHelp rates the interaction as major. Esketamine and Tranylcypromine 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. Tranylcypromine is a nonselective MAO inhibitor with notable pressor potential, and esketamine also increases blood pressure. The combination may produce marked hypertension and tachycardia.
How serious is the interaction between Esketamine and Tranylcypromine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure before and after each esketamine dose and do not treat if pressure is uncontrolled. Consider alternatives if repeated significant elevations occur.
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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