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Can you take Esketamine with Propiomazine?

1 drug interaction and 14 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

propiomazine esketamine

Applies to: propiomazine and esketamine

Using esketamine together with propiomazine may increase side effects such as:

  • drowsiness
  • confusion
  • difficulty concentrating
  • impairment in thinking, judgment, reaction speed, and motor coordination

After receiving treatment with esketamine, you should avoid driving or operating hazardous machinery until the next day after a restful sleep.

Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

esketamine Food/Lifestyle

Applies to: esketamine

Using esketamine together with alcohol may increase side effects such as:

  • drowsiness
  • confusion
  • difficulty concentrating
  • impairment in thinking, judgment, reaction speed, and motor coordination

You should avoid or limit the use of alcohol while being treated with esketamine.

Nausea and vomiting may occur following the nasal application of esketamine.

To help prevent nausea and vomiting, you should avoid eating for at least 2 hours before using esketamine and avoid drinking liquids for at least 30 minutes before using esketamine.

Moderate:

propiomazine Alcohol (Ethanol)

Applies to: propiomazine

Ask your doctor before using propiomazine together with ethanol (alcohol).

This can cause:

  • uncontrollable movements
  • agitation
  • seizures
  • severe dizziness or fainting
  • coma
  • very deep sleep
  • irregular heartbeats
  • high or low body temperature

Use caution when driving, operating machinery, or performing other hazardous activities, these medicaions may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Disease interactions

12 potential interactions Applies to: 11 conditions, including High Blood Pressure, Depression, Allergies, Psychosis, and Urinary Retention.

Allergies

Major:

esketamine

Esketamine has a major potential interaction with Allergies.

Esketamine causes an increase in systolic and/or diastolic blood pressure at all recommended doses. The increase peaks approximately 40 minutes after administration of esketamine, and lasts for about 4 hours. Blood pressure should be monitored prior and after administration. If baseline blood pressure is elevated before administering (e.g., >140 mmHg systolic, >90 mmHg diastolic), consider the risks of short term increases in blood pressure and benefit of treatment in patients with treatment- resistant depression (TRD). Do not administer esketamine if an increase in blood pressure or intracranial pressure poses a serious risk. Esketamine is contraindicated in patients with aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels), arteriovenous malformations, or a history of intracerebral hemorrhage.

Aortic Aneurysm

Major:

esketamine

Esketamine has a major potential interaction with Aortic Aneurysm.

Esketamine causes an increase in systolic and/or diastolic blood pressure at all recommended doses. The increase peaks approximately 40 minutes after administration of esketamine, and lasts for about 4 hours. Blood pressure should be monitored prior and after administration. If baseline blood pressure is elevated before administering (e.g., >140 mmHg systolic, >90 mmHg diastolic), consider the risks of short term increases in blood pressure and benefit of treatment in patients with treatment- resistant depression (TRD). Do not administer esketamine if an increase in blood pressure or intracranial pressure poses a serious risk. Esketamine is contraindicated in patients with aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels), arteriovenous malformations, or a history of intracerebral hemorrhage.

Cerebral Vascular Disorder

Major:

esketamine

Esketamine has a major potential interaction with Cerebral Vascular Disorder.

Esketamine causes an increase in systolic and/or diastolic blood pressure at all recommended doses. The increase peaks approximately 40 minutes after administration of esketamine, and lasts for about 4 hours. Blood pressure should be monitored prior and after administration. If baseline blood pressure is elevated before administering (e.g., >140 mmHg systolic, >90 mmHg diastolic), consider the risks of short term increases in blood pressure and benefit of treatment in patients with treatment- resistant depression (TRD). Do not administer esketamine if an increase in blood pressure or intracranial pressure poses a serious risk. Esketamine is contraindicated in patients with aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels), arteriovenous malformations, or a history of intracerebral hemorrhage.

Depression

Major:

propiomazine

Propiomazine has a major potential interaction with Depression.

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Drug Dependence

Major:

esketamine

Esketamine has a major potential interaction with Drug Dependence.

Esketamine, is a Schedule III controlled substance (CIII), and may be subject to abuse and diversion. Assess each patient's risk for abuse or misuse prior to prescribing esketamine and monitor all patients receiving treatment for the development of these behaviors or conditions, including drug- seeking behavior, while on therapy. Individuals with a history of drug abuse or dependence are at greater risk; therefore, use careful consideration prior to treatment of individuals with a history of substance use disorder and monitor for signs of abuse or dependence.

Glaucoma/Intraocular Hypertension

Moderate:

propiomazine

Propiomazine has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

High Blood Pressure

Major:

esketamine

Esketamine has a major potential interaction with High Blood Pressure.

Esketamine causes an increase in systolic and/or diastolic blood pressure at all recommended doses. The increase peaks approximately 40 minutes after administration of esketamine, and lasts for about 4 hours. Blood pressure should be monitored prior and after administration. If baseline blood pressure is elevated before administering (e.g., >140 mmHg systolic, >90 mmHg diastolic), consider the risks of short term increases in blood pressure and benefit of treatment in patients with treatment- resistant depression (TRD). Do not administer esketamine if an increase in blood pressure or intracranial pressure poses a serious risk. Esketamine is contraindicated in patients with aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels), arteriovenous malformations, or a history of intracerebral hemorrhage.

History - Cerebrovascular Disease

Major:

esketamine

Esketamine has a major potential interaction with History - Cerebrovascular Disease.

Esketamine causes an increase in systolic and/or diastolic blood pressure at all recommended doses. The increase peaks approximately 40 minutes after administration of esketamine, and lasts for about 4 hours. Blood pressure should be monitored prior and after administration. If baseline blood pressure is elevated before administering (e.g., >140 mmHg systolic, >90 mmHg diastolic), consider the risks of short term increases in blood pressure and benefit of treatment in patients with treatment- resistant depression (TRD). Do not administer esketamine if an increase in blood pressure or intracranial pressure poses a serious risk. Esketamine is contraindicated in patients with aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels), arteriovenous malformations, or a history of intracerebral hemorrhage.

Liver Disease

Moderate:

esketamine

Esketamine has a moderate potential interaction with Liver Disease.

Esketamine has not been studied in patients with severe hepatic impairment (Child-Pugh class C). Use in this population is not recommended. Additionally, the mean esketamine AUC and t1/2 values were higher in patients with moderate hepatic impairment compared to those with normal hepatic function. Patients with moderate hepatic impairment may need to be monitored for adverse reactions for a longer period of time.

Moderate:

propiomazine

Propiomazine has a moderate potential interaction with Liver Disease.

In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

Psychosis

Major:

esketamine

Esketamine has a major potential interaction with Psychosis.

Esketamine can cause dissociative or perceptual changes (including distortion of time, space and illusions), derealization and depersonalization. Patients with psychosis must be carefully assessed before administering esketamine, and treatment should be initiated only if the benefit outweighs the risk. Patients must be monitored by a healthcare provider for at least 2 hours at each treatment session, followed by an assessment to determine when the patient is considered clinically stable and ready to leave the healthcare setting.

Urinary Retention

Moderate:

propiomazine

Propiomazine has a moderate potential interaction with Urinary Retention.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

More resources

esketamine

A total of 302 drugs are known to interact with esketamine.

propiomazine

A total of 522 drugs are known to interact with propiomazine.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.