Esketamine interactions
Review the current reference classification for Esketamine paired with medications or other agents represented in the Arcametric reference library.
Reference information only. This resource summarizes information from external sources and isn't individualized medical advice or a determination of treatment suitability.
Interactors with a reference entry
Cardiovascular
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Esketamine and Propranolol Monitor Only
Esketamine can transiently increase BP. Propranolol may blunt HR response while BP elevation persists. Risk of hypotension or bradycardia during recovery.
Evidence: FDA label (Spravato) + FDA label (Inderal) + mechanistic
GLP-1/GIP Agonist
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Esketamine and Zepbound (tirzepatide) Monitor Only
Both medications commonly cause nausea/vomiting. Zepbound dehydration warning adds tolerability concern around supervised dosing visits. Intranasal route means no oral absorption delay concern.
Evidence: FDA label (Zepbound 2025) + FDA label (Spravato) + mechanistic
SSRI/SNRI
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Esketamine and Pristiq (desvenlafaxine) Monitor Only
Esketamine (Spravato) is FDA-indicated as monotherapy or with an oral antidepressant — co-use with SNRIs is part of labeled clinical use. Both can raise BP; BP threshold monitoring at each dosing visit is the primary safety gate.
Return to the Drug Interaction Checker to look up a specific pair, or open the Knowledge library.