Drug interactions
Esketamine + Ziconotide
Severity: Moderate
Esketamine and Ziconotide: 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
Intrathecal ziconotide causes dizziness, confusion and decreased alertness and can cause psychiatric and neurological adverse effects. Esketamine, which causes sedation and dissociation, may add to these CNS effects.
What this interaction means in plain words
Esketamine and Ziconotide 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; Ziconotide belongs to Central Nervous System.
Why it happens
Additive CNS and cognitive impairment; ziconotide blocks N-type calcium channels while esketamine antagonizes NMDA receptors.
What to do
Monitor for sedation, confusion and psychiatric symptoms. Reduce or stop one agent if cognitive or psychiatric adverse effects emerge.
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 Ziconotide
- Clozapine + Ziconotide Major
- Alprazolam + Ziconotide Moderate
- Amitriptyline + Ziconotide Moderate
- Amobarbital + Ziconotide Moderate
- Aripiprazole + Ziconotide Moderate
- Armodafinil + Ziconotide Moderate
Frequently asked questions
Can I take Esketamine with Ziconotide?
MediHelp rates the interaction as moderate. Esketamine and Ziconotide 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. Intrathecal ziconotide causes dizziness, confusion and decreased alertness and can cause psychiatric and neurological adverse effects. Esketamine, which causes sedation and dissociation, may add to these CNS effects.
How serious is the interaction between Esketamine and Ziconotide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, confusion and psychiatric symptoms. Reduce or stop one agent if cognitive or psychiatric adverse effects emerge.
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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