Drug interactions
Esketamine intranasal + Isoflurane
Severity: Moderate
Esketamine intranasal and Isoflurane: 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
Esketamine causes sedation, dissociation and blood pressure elevation, and combining it with a general anesthetic may alter hemodynamics and prolong sedation. Anesthetic requirements may also change.
What this interaction means in plain words
Esketamine intranasal and Isoflurane 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.
Why it happens
Additive CNS depression with NMDA antagonism and hemodynamic effects.
What to do
Inform the anesthesia team of recent esketamine dosing and monitor blood pressure, sedation and respiration. Avoid dosing esketamine immediately before anesthesia.
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 Isoflurane
Frequently asked questions
Can I take Esketamine intranasal with Isoflurane?
MediHelp rates the interaction as moderate. Esketamine intranasal and Isoflurane 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 causes sedation, dissociation and blood pressure elevation, and combining it with a general anesthetic may alter hemodynamics and prolong sedation. Anesthetic requirements may also change.
How serious is the interaction between Esketamine intranasal and Isoflurane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Inform the anesthesia team of recent esketamine dosing and monitor blood pressure, sedation and respiration. Avoid dosing esketamine immediately before anesthesia.
What other medicines interact with Isoflurane?
MediHelp also lists interactions of Isoflurane with, for example, Adrenaline-articaine, Amisulpride, Arsenic trioxide. The full list is on the Isoflurane page.
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