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Drug interactions

Esketamine intranasal + Promethazine

Severity: Moderate

Esketamine intranasal and Promethazine: 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

Both agents cause sedation, and combined use may deepen sedation and impair alertness. Esketamine also causes dissociation and blood pressure elevation, adding to monitoring needs.

What this interaction means in plain words

Esketamine intranasal and Promethazine 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.

Evidence level: Moderate

Why it happens

Additive CNS depressant effects.

What to do

Monitor sedation level and vital signs during and after esketamine administration, and counsel the patient not to drive after sessions.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Esketamine intranasal with Promethazine?

MediHelp rates the interaction as moderate. Esketamine intranasal and Promethazine 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. Both agents cause sedation, and combined use may deepen sedation and impair alertness. Esketamine also causes dissociation and blood pressure elevation, adding to monitoring needs.

How serious is the interaction between Esketamine intranasal and Promethazine?

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 vital signs during and after esketamine administration, and counsel the patient not to drive after sessions.

What other medicines interact with Promethazine?

MediHelp also lists interactions of Promethazine with, for example, Cabergoline, Dopamine, Ibutilide. The full list is on the Promethazine page.

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