Drug interactions
Esketamine intranasal + Nortriptyline
Severity: Moderate
Esketamine intranasal and Nortriptyline: 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 nortriptyline adds sedation, so combined use may increase drowsiness and impair alertness. Esketamine can also raise blood pressure, which tricyclics may add to.
What this interaction means in plain words
Esketamine intranasal and Nortriptyline 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 and possible additive pressor effects.
What to do
Monitor sedation and blood pressure during and after esketamine administration, and advise against driving until the next day after restful sleep.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Esketamine intranasal with Nortriptyline?
MediHelp rates the interaction as moderate. Esketamine intranasal and Nortriptyline 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 nortriptyline adds sedation, so combined use may increase drowsiness and impair alertness. Esketamine can also raise blood pressure, which tricyclics may add to.
How serious is the interaction between Esketamine intranasal and Nortriptyline?
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 and blood pressure during and after esketamine administration, and advise against driving until the next day after restful sleep.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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