Ketamine interactions
Review the current reference classification for Ketamine 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
Benzodiazepine
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Ketamine and Alprazolam (Xanax) Strong Caution
Sedation, coma, and respiratory depression risk from synergistic CNS depression at GABA and opioid receptors.
Evidence: FDA Label, REMS
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Ketamine and Diazepam (Valium) Clinician Review
Additive CNS depression. Respiratory monitoring recommended. May attenuate antidepressant ketamine response.
Evidence: Anesthesia & Analgesia guidelines.
Cardiovascular
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Ketamine and Propranolol Monitor Only
Ketamine has variable hemodynamic effects. Propranolol lowers HR and can cause bradycardia and hypotension. No direct pairing studies found.
Evidence: FDA label (Ketalar) + FDA label (Inderal) + mechanistic
GLP-1/GIP Agonist
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Ketamine and Zepbound (tirzepatide) Monitor Only
No direct pharmacokinetic interaction for IV/IM ketamine. Main concern is additive nausea/vomiting burden and dehydration. Ketamine label highlights hemodynamic instability; dehydration can worsen post-dose hypotension.
Evidence: FDA label (Zepbound 2025) + FDA label (Ketalar) + mechanistic
Other Somatic
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Ketamine and Levothyroxine Clinician Review
Hypertension and tachycardia risk from unknown sympathetic synergy. Hyperthyroid patients at elevated cardiovascular risk.
Evidence: Case report
SSRI/SNRI
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Ketamine and Pristiq (desvenlafaxine) Clinician Review
No direct DDI evidence. Pristiq raises BP and has seizure caution. Ketamine can also raise BP. Combined BP elevation risk requires screening.
Evidence: FDA label (Pristiq 2017) + FDA label (Ketalar) + mechanistic
Stimulant
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Ketamine and Amphetamine salts (Adderall) Strong Caution
Severe hypertension and tachycardia risk from additive sympathomimetic effects.
Evidence: FDA Label
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