Drug interactions
Esketamine intranasal + Zonisamide
Severity: Moderate
Esketamine intranasal and Zonisamide: 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 can cause sedation, drowsiness and impaired psychomotor performance. Taken together, their central nervous system effects may add up, which matters particularly because esketamine is given in supervised sessions and patients may drive afterwards.
What this interaction means in plain words
Esketamine intranasal and Zonisamide 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.
What to do
Monitor sedation level during and after esketamine sessions and advise patients not to drive until the next day after a restful sleep. Extend observation if excessive drowsiness occurs.
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 Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Esketamine intranasal with Zonisamide?
MediHelp rates the interaction as moderate. Esketamine intranasal and Zonisamide 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 can cause sedation, drowsiness and impaired psychomotor performance. Taken together, their central nervous system effects may add up, which matters particularly because esketamine is given in supervised sessions and patients may drive afterwards.
How serious is the interaction between Esketamine intranasal and Zonisamide?
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 during and after esketamine sessions and advise patients not to drive until the next day after a restful sleep. Extend observation if excessive drowsiness occurs.
What other medicines interact with Zonisamide?
MediHelp also lists interactions of Zonisamide with, for example, Zuranolone, Acetazolamide, Amisulpride. The full list is on the Zonisamide page.
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