Drug interactions
Esketamine intranasal + Sevoflurane
Severity: Moderate
Esketamine intranasal and Sevoflurane: 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 sevoflurane is a potent general anesthetic. Together they produce additive CNS depression and may deepen anesthesia or delay recovery. Cardiovascular effects such as blood pressure changes may also be compounded.
What this interaction means in plain words
Esketamine intranasal and Sevoflurane 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 pharmacodynamic CNS depression from NMDA antagonism combined with GABA-A potentiation and other volatile anesthetic actions.
What to do
Inform the anesthesia team of recent esketamine dosing and titrate sevoflurane to clinical effect with depth-of-anesthesia monitoring. Monitor blood pressure, heart rate and recovery time.
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 Sevoflurane
Frequently asked questions
Can I take Esketamine intranasal with Sevoflurane?
MediHelp rates the interaction as moderate. Esketamine intranasal and Sevoflurane 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 sevoflurane is a potent general anesthetic. Together they produce additive CNS depression and may deepen anesthesia or delay recovery. Cardiovascular effects such as blood pressure changes may also be compounded.
How serious is the interaction between Esketamine intranasal and Sevoflurane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Inform the anesthesia team of recent esketamine dosing and titrate sevoflurane to clinical effect with depth-of-anesthesia monitoring. Monitor blood pressure, heart rate and recovery time.
What other medicines interact with Sevoflurane?
MediHelp also lists interactions of Sevoflurane with, for example, Amiodarone, Amisulpride, Arsenic trioxide. The full list is on the Sevoflurane page.
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