Drug interactions
Esketamine intranasal + Morphine
Severity: Moderate
Esketamine intranasal and Morphine: 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 and morphine both cause sedation and dissociation, and combining them can deepen CNS depression. Label guidance advises monitoring for sedation with concomitant CNS depressants including opioids.
What this interaction means in plain words
Esketamine intranasal and Morphine 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 depressant effects through opioid receptor agonism and NMDA receptor antagonism.
What to do
Monitor sedation level and respiratory status for the post-dose observation period. Reduce the opioid dose if excessive sedation occurs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Esketamine intranasal and Morphine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Morphine
- Alvimopan + Morphine Contraindicated
- Isocarboxazid + Morphine Contraindicated
- Morphine + Olanzapine / samidorphan Contraindicated
- Morphine + Phenelzine Contraindicated
- Morphine + Tranylcypromine Contraindicated
- Alfentanil + Morphine Major
Frequently asked questions
Can I take Esketamine intranasal with Morphine?
MediHelp rates the interaction as moderate. Esketamine intranasal and Morphine 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 and morphine both cause sedation and dissociation, and combining them can deepen CNS depression. Label guidance advises monitoring for sedation with concomitant CNS depressants including opioids.
How serious is the interaction between Esketamine intranasal and Morphine?
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 for the post-dose observation period. Reduce the opioid dose if excessive sedation occurs.
What other medicines interact with Morphine?
MediHelp also lists interactions of Morphine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Morphine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
