Hydrocortisone Injection and Esketamine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Esketamine
Hydrocortisone Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased hydrocortisone exposure and an increased risk of hydrocortisone-related adverse reactions
Interaction Deep Dive
Concomitant use of hydrocortisone and CYP3A4 inhibitors may increase hydrocortisone exposure, which may also increase hydrocortisone-related adverse reactions and thus concomitant use may require reduction in hydrocortisone dose1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of hydrocortisone
Common questions
Can I take Hydrocortisone Injection and Esketamine together?
Increased hydrocortisone exposure and an increased risk of hydrocortisone-related adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Hydrocortisone Injection and Esketamine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Hydrocortisone Injection or Esketamine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: KHINDIVI(R) oral solution, hydrocortisone oral solution. Eton Pharmaceuticals (per Manufacturer), Cranbury, NJ, 2025. DailyMed
Keep reading about Esketamine
Keep reading about Hydrocortisone Injection
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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