Drug interactions
Esketamine intranasal + Tranylcypromine
Severity: Major
Esketamine intranasal and Tranylcypromine: 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 raises blood pressure and heart rate, and MAO inhibitors can cause hypertensive effects through increased catecholamine availability. The combination may therefore lead to additive or marked blood pressure elevation.
What this interaction means in plain words
Esketamine intranasal and Tranylcypromine 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 sympathetic stimulation with MAO inhibition increasing catecholamine availability.
What to do
Monitor blood pressure closely before and after each esketamine dose. Consider an alternative antidepressant strategy if blood pressure is difficult to control.
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 Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Esketamine intranasal with Tranylcypromine?
MediHelp rates the interaction as major. Esketamine intranasal and Tranylcypromine 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 raises blood pressure and heart rate, and MAO inhibitors can cause hypertensive effects through increased catecholamine availability. The combination may therefore lead to additive or marked blood pressure elevation.
How serious is the interaction between Esketamine intranasal and Tranylcypromine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure closely before and after each esketamine dose. Consider an alternative antidepressant strategy if blood pressure is difficult to control.
What other medicines interact with Tranylcypromine?
MediHelp also lists interactions of Tranylcypromine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Tranylcypromine page.
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