Drug interactions
Esketamine intranasal + Meperidine
Severity: Moderate
Esketamine intranasal and Meperidine: 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 and dissociation, and meperidine adds CNS and respiratory depression. Together they can increase drowsiness and impair alertness and breathing.
What this interaction means in plain words
Esketamine intranasal and Meperidine 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 through NMDA antagonism and opioid receptor agonism.
What to do
Monitor sedation level and respiratory status during and after esketamine administration. Reduce the opioid dose where appropriate.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Esketamine intranasal with Meperidine?
MediHelp rates the interaction as moderate. Esketamine intranasal and Meperidine 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 and dissociation, and meperidine adds CNS and respiratory depression. Together they can increase drowsiness and impair alertness and breathing.
How serious is the interaction between Esketamine intranasal and Meperidine?
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 sedation level and respiratory status during and after esketamine administration. Reduce the opioid dose where appropriate.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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