Drug interactions
Esketamine intranasal + Tizanidine
Severity: Moderate
Esketamine intranasal and Tizanidine: 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 drugs cause sedation and dizziness. Used together they can produce excessive drowsiness, impaired psychomotor performance and a higher risk of falls. Esketamine can also raise blood pressure while tizanidine lowers it, which makes hemodynamic effects less predictable.
What this interaction means in plain words
Esketamine intranasal and Tizanidine 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 central nervous system depression from alpha-2 agonism (tizanidine) and NMDA antagonism (esketamine).
What to do
Monitor for sedation and blood pressure during and after esketamine dosing, and consider lowering the tizanidine dose around treatment sessions. Advise the patient not to drive until the next day after rest.
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 Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Pipemidic acid + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
Frequently asked questions
Can I take Esketamine intranasal with Tizanidine?
MediHelp rates the interaction as moderate. Esketamine intranasal and Tizanidine 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 drugs cause sedation and dizziness. Used together they can produce excessive drowsiness, impaired psychomotor performance and a higher risk of falls. Esketamine can also raise blood pressure while tizanidine lowers it, which makes hemodynamic effects less predictable.
How serious is the interaction between Esketamine intranasal and Tizanidine?
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 for sedation and blood pressure during and after esketamine dosing, and consider lowering the tizanidine dose around treatment sessions. Advise the patient not to drive until the next day after rest.
What other medicines interact with Tizanidine?
MediHelp also lists interactions of Tizanidine with, for example, Ciprofloxacin, Fluvoxamine, Pefloxacin. The full list is on the Tizanidine page.
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