other by sedation. Use Caution/Monitor.ketamineMonitor Closely (1)esketamine intranasal, ketamine. Either increases toxicity of the other by sedation. Use Caution/Monitor.lamotrigineMonitor Closely (1)esketamine intranasal, lamotrigine. Either increases toxicity of the other by sedation. Use Caution/Monitor.lasmiditanMonitor Closely (1)lasmiditan, esketamine intranasal. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.levetiracetamMonitor Closely (1)esketamine intranasal, levetiracetam. Either increases toxicity of the other by sedation. Use Caution/Monitor.levocetirizineMonitor Closely (1)esketamine intranasal, levocetirizine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.levorphanolMonitor Closely (1)esketamine intranasal, levorphanol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.lisdexamfetamineMonitor Closely (1)esketamine intranasal, lisdexamfetamine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .loratadineMonitor Closely (1)esketamine intranasal, loratadine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.lorazepamMonitor Closely (1)esketamine intranasal, lorazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.loxapineMonitor Closely (1)esketamine intranasal, loxapine. Either increases toxicity of the other by sedation. Use Caution/Monitor.lurasidoneMonitor Closely (1)esketamine intranasal, lurasidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.maprotilineMonitor Closely (1)esketamine intranasal, maprotiline. Either increases toxicity of the other by sedation. Use Caution/Monitor.meclizineMonitor Closely (1)esketamine intranasal, meclizine. Either increases toxicity of the other by sedation. Use Caution/Monitor.meperidineMonitor Closely (1)esketamine intranasal, meperidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.metaxaloneMonitor Closely (1)esketamine intranasal, metaxalone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.methadoneMonitor Closely (1)esketamine intranasal, methadone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.methamphetamineMonitor Closely (1)esketamine intranasal, methamphetamine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .methocarbamolMonitor Closely (1)esketamine intranasal, methocarbamol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.methylphenidateMonitor Closely (1)esketamine intranasal, methylphenidate. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .metoclopramide intranasalSerious - Use Alternative (1)esketamine intranasal, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.midazolamMonitor Closely (1)esketamine intranasal, midazolam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.midazolam intranasalMonitor Closely (1)midazolam intranasal, esketamine intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.modafinilMonitor Closely (1)esketamine intranasal, modafinil. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .morphineMonitor Closely (1)esketamine intranasal, morphine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.nalbuphineMonitor Closely (1)esketamine intranasal, nalbuphine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.nicotine gumMonitor Closely (1)esketamine intranasal, nicotine gum. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .nicotine inhaledMonitor Closely (1)esketamine intranasal, nicotine inhaled. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .nicotine intranasalMonitor Closely (1)esketamine intranasal, nicotine intranasal. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .nicotine lozengeMonitor Closely (1)esketamine intranasal, nicotine lozenge. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .nicotine transdermalMonitor Closely (1)esketamine intranasal, nicotine transdermal. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .nortriptylineMonitor Closely (1)esketamine intranasal, nortriptyline. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.olanzapineMonitor Closely (1)esketamine intranasal, olanzapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.oliceridineMonitor Closely (1)esketamine intranasal, oliceridine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.olopatadine intranasalSerious - Use Alternative (1)esketamine intranasal and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. orphenadrineMonitor Closely (1)esketamine intranasal, orphenadrine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.oxazepamMonitor Closely (1)esketamine intranasal, oxazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.oxycodoneMonitor Closely (1)esketamine intranasal, oxycodone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.oxymorphoneMonitor Closely (1)esketamine intranasal, oxymorphone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.paliperidoneMonitor Closely (1)esketamine intranasal, paliperidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.pentazocineMonitor Closely (1)esketamine intranasal, pentazocine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.pentobarbitalMonitor Closely (1)esketamine intranasal, pentobarbital. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.phendimetrazineMonitor Closely (1)esketamine intranasal, phendimetrazine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .phenelzineMonitor Closely (1)esketamine intranasal, phenelzine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with MAO-Is. .phentermineMonitor Closely (1)esketamine intranasal, phentermine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .phenylephrine POMonitor Closely (1)esketamine intranasal, phenylephrine PO. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .phenytoinMonitor Closely (1)esketamine intranasal, phenytoin. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.pimavanserinMonitor Closely (1)esketamine intranasal, pimavanserin. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.pimozideMonitor Closely (1)esketamine intranasal, pimozide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.pomalidomideMonitor Closely (1)esketamine intranasal, pomalidomide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.pregabalinMonitor Closely (2)esketamine intranasal, pregabalin. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. pregabalin, esketamine intranasal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primidoneMonitor Closely (1)esketamine intranasal, primidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.promethazineMonitor Closely (1)esketamine intranasal, promethazine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.propofolMonitor Closely (1)esketamine intranasal, propofol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.protriptylineMonitor Closely (1)esketamine intranasal, protriptyline. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.pseudoephedrineMonitor Closely (1)esketamine intranasal, pseudoephedrine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .quazepamMonitor Closely (1)esketamine intranasal, quazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.quetiapineMonitor Closely (1)esketamine intranasal, quetiapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.ramelteonMonitor Closely (1)esketamine intranasal, ramelteon. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.remifentanilMonitor Closely (1)esketamine intranasal, remifentanil. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.remimazolamMonitor Closely (1)remimazolam, esketamine intranasal. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.reserpineMonitor Closely (1)esketamine intranasal, reserpine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.risperidoneMonitor Closely (1)esketamine intranasal, risperidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.rufinamideMonitor Closely (1)esketamine intranasal, rufinamide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.scopolamineMonitor Closely (1)esketamine intranasal, scopolamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.secobarbitalMonitor Closely (1)esketamine intranasal, secobarbital. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.serdexmethylphenidate/dexmethylphenidateMonitor Closely (1)esketamine intranasal, serdexmethylphenidate/dexmethylphenidate. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .sevofluraneMonitor Closely (1)esketamine intranasal, sevoflurane. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.sodium oxybateMonitor Closely (1)esketamine intranasal, sodium oxybate. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.stiripentolMonitor Closely (1)esketamine intranasal, stiripentol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.sufentanilMonitor Closely (1)esketamine intranasal, sufentanil. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.sufentanil SLMonitor Closely (1)esketamine intranasal, sufentanil SL. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.sulpirideMonitor Closely (1)esketamine intranasal, sulpiride. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.suvorexantMonitor Closely (1)esketamine intranasal, suvorexant. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.tapentadolMonitor Closely (1)esketamine intranasal, tapentadol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.tasimelteonMonitor Closely (1)esketamine intranasal, tasimelteon. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.temazepamMonitor Closely (1)esketamine intranasal, temazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.tetrabenazineMonitor Closely (1)esketamine intranasal, tetrabenazine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.thalidomideMonitor Closely (1)esketamine intranasal, thalidomide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.thioridazineMonitor Closely (1)esketamine intranasal, thioridazine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.thiothixeneMonitor Closely (1)esketamine intranasal, thiothixene. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.tiagabineMonitor Closely (1)esketamine intranasal, tiagabine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.tizanidineMonitor Closely (1)esketamine intranasal, tizanidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.topiramateMonitor Closely (1)esketamine intranasal, topiramate. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)esketamine intranasal, tramadol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.tranylcypromineMonitor Closely (1)esketamine intranasal, tranylcypromine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with MAO-Is. .triazolamMonitor Closely (1)esketamine intranasal, triazolam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.trifluoperazineMonitor Closely (1)esketamine intranasal, trifluoperazine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.trimipramineMonitor Closely (1)esketamine intranasal, trimipramine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.triprolidineMonitor Closely (1)esketamine intranasal, triprolidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.valerianMonitor Closely (1)esketamine intranasal, valerian. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.valproic acidMonitor Closely (1)esketamine intranasal, valproic acid. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.vigabatrinMonitor Closely (1)esketamine intranasal, vigabatrin. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.zaleplonMonitor Closely (1)esketamine intranasal, zaleplon. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.ziconotideMonitor Closely (1)esketamine intranasal, ziconotide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.ziprasidoneMonitor Closely (1)esketamine intranasal, ziprasidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.zolpidemMonitor Closely (1)esketamine intranasal, zolpidem. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.zonisamideMonitor Closely (1)esketamine intranasal, zonisamide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. >10% (TRD) Dissociation (41%) Dizziness (29%) Nausea (28%) Vertigo (23%) Sedation (23%) Headache (20%) Dysgeusia (19%) Hypoesthesia (18%) Anxiety (13%) Lethargy (11%) Sedation Aged <65 yr, 84 mg (61%) Aged <65 yr, 56 mg (50%) Aged ≥65 yr, 28-84 mg (49%) Dissociation or perceptual changes Aged ≥65 yr, 28-84 mg (75%) Aged <65 yr, 84 mg (69%) Aged <65 yr, 56