Drug interactions
Esketamine intranasal + Phenelzine
Severity: Major
Esketamine intranasal and Phenelzine: major 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 transiently raises blood pressure and heart rate, and MAO inhibitors can potentiate sympathomimetic effects. Combined use may produce larger or more prolonged blood pressure elevations.
What this interaction means in plain words
Esketamine intranasal and Phenelzine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive sympathomimetic and pressor effects from NMDA antagonism-related catecholamine release and MAO inhibition.
What to do
Measure blood pressure before dosing and for at least 1 to 2 hours afterwards, and withhold esketamine if baseline pressure is elevated. Consider an alternative to the MAO inhibitor when cardiovascular risk is high.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Phenelzine
- 5-HTP + Phenelzine Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amoxapine + Phenelzine Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Benzphetamine + Phenelzine Contraindicated
- Brimonidine + Phenelzine Contraindicated
Frequently asked questions
Can I take Esketamine intranasal with Phenelzine?
MediHelp rates the interaction as major. Esketamine intranasal and Phenelzine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Esketamine transiently raises blood pressure and heart rate, and MAO inhibitors can potentiate sympathomimetic effects. Combined use may produce larger or more prolonged blood pressure elevations.
How serious is the interaction between Esketamine intranasal and Phenelzine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure blood pressure before dosing and for at least 1 to 2 hours afterwards, and withhold esketamine if baseline pressure is elevated. Consider an alternative to the MAO inhibitor when cardiovascular risk is high.
What other medicines interact with Phenelzine?
MediHelp also lists interactions of Phenelzine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Phenelzine page.
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