Spravato and Alcohol/Food Interactions

Esketamine can cause transient but significant increases in blood pressure, and using it with caffeine may increase the risk. Let your doctor know if you have been using caffeine prior to getting treatment with esketamine. You may need a dose adjustment or more frequent monitoring of your blood pressure 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.

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Using esketamine together with ethanol may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with esketamine. Do not use more than the recommended dose of esketamine, and avoid driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until you know how the medication affects you. Talk to your doctor if you have any questions or concerns. 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.

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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.

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esketamine - 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.