Drug interactions
Esketamine intranasal + Pimavanserin
Severity: Moderate
Esketamine intranasal and Pimavanserin: 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 pimavanserin may add to somnolence. Combined use may increase sedation and impair alertness.
What this interaction means in plain words
Esketamine intranasal and Pimavanserin 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.
What to do
Observe patients for sedation during and after each esketamine session, as required by the esketamine monitoring program. Counsel against driving until the next day after a 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 Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Esketamine intranasal with Pimavanserin?
MediHelp rates the interaction as moderate. Esketamine intranasal and Pimavanserin 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 pimavanserin may add to somnolence. Combined use may increase sedation and impair alertness.
How serious is the interaction between Esketamine intranasal and Pimavanserin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Observe patients for sedation during and after each esketamine session, as required by the esketamine monitoring program. Counsel against driving until the next day after a restful sleep.
What other medicines interact with Pimavanserin?
MediHelp also lists interactions of Pimavanserin with, for example, Lefamulin, Pimozide, Vandetanib. The full list is on the Pimavanserin page.
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