Drug & supplement interaction

Pao Pereira + Esketamine

Esketamine brand name: Spravato.

No Known Interaction
Medically reviewed by · Updated June 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Pao Pereira and Esketamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Pao Pereira and Esketamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Esketamine and Pao Pereira in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Pao Pereira at all — not against Esketamine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Pao Pereira safety at a glance

Pao Pereira overall Use caution Human safety data are limited, so use with care and professional guidance.
Pregnancy Avoid Not enough safety data; avoid during pregnancy.
Breastfeeding Avoid Not enough safety data; avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Esketamine and Pao Pereira? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Esketamine’s Own FDA Label Lists

This is not an interaction — none of it involves Pao Pereira. These are the most notable effects listed in the ADVERSE REACTIONS section of Esketamine’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 4 of them are worth acting on rather than waiting out — marked below.

  • Thoughts of self-harm Worth acting on mentioned in 7.6% of FDA reports for Esketamine
  • Memory problems Worth acting on
  • Low mood Worth acting on mentioned in 4.9% of FDA reports for Esketamine
  • Raised blood pressure Worth acting on mentioned in 4.8% of FDA reports for Esketamine
  • Drowsiness mentioned in 15.3% of FDA reports for Esketamine
  • Anxiety or restlessness
  • Tiredness
  • Dizziness
  • Nausea mentioned in 5.4% of FDA reports for Esketamine
  • Vomiting

Showing the 10 most notable of 11 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Esketamine. Read the label on DailyMed › Where a percentage is shown, it is the share of 17,728 voluntary FDA FAERS reports for Esketamine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Pao Pereira’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Pao Pereira side to compare — that is a limit of the record, not a statement that Pao Pereira has no side effects.

Everything else you take

See Every Supplement That Interacts With Esketamine

This page covers Pao Pereira only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esketamine page lists 11 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Scopolia (major), Cowhage (moderate), Dhea (moderate), Griffonia Simplicifolia (moderate) and Indian Snakeroot (moderate).

By severity: 1 major · 6 moderate · 4 minor.

From our pharmacist’s overview on the Esketamine page

“Esketamine (Spravato) is the nasal spray for depression that hasn't responded to standard treatment, and its supplement list deserves genuine respect. Scopolia carries the only major rating and is the entry to understand before any other; pairing it with the medication can raise the risk of anticholinergic effects, meaning dry mouth, b…”

Reviewed by 2 · Jul 18, 2026

Open the Esketamine interaction page

One more smart check

Taking Pao Pereira as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1 real supplement products containing Pao Pereira, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Pao Pereira. Even though Pao Pereira itself has no known interaction with Esketamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Pao Pereira and Esketamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Pao Pereira
Steady interest

#974 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Esketamine
Steady interest

#2,357 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions. Pao Pereira is not yet covered by that licensed database, so its write-up cites publicly available medical sources directly (see the references below).
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Pao Pereira reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Pao Pereira and Esketamine records this page draws on were last updated June 22, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Pao Pereira

What is Pao Pereira?

  • Immune support
  • Cancer support (complementary use)
  • Antimalarial/fever (traditional)
  • Digestive complaints (traditional)
  • General tonic

Pao Pereira is a bark extract from a South American tree that is marketed mainly as a complementary cancer and immune-support supplement. Human evidence is very limited, and most research comes from laboratory and animal studies, so it should not be used in place of proven medical care. Talk with your pharmacist or doctor before trying it, especially if you have a serious health condition.

Geissospermum laeve · Apocynaceae · Bark (and bark extract) · Capsules, tinctures, liquid extracts, powdered bark

An interaction check asks whether these two react with each other — it does not ask whether Pao Pereira is a good idea for someone in your situation. Here is what our Pao Pereira record says about it on its own.

Pao Pereira: dosing

There is no established or standardized dose for Pao Pereira. Different products contain different amounts and strengths of bark extract.If you choose to use it, follow the directions on the product label and do not exceed the recommended amount.

From our Pao Pereira monograph — the full record covers uses, side effects and every documented interaction.

Read the full Pao Pereira monograph & all interactions
Medication

About Esketamine Nasal Spray

What Is Esketamine Nasal Spray Used For?

Brand name: Spravato

Spravato nasal spray is approved for two uses in adults. First, it treats treatment-resistant depression (TRD) — depression that has not responded to other antidepressants — either on its own or alongside an oral antidepressant. Second, it treats depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior, always used together with an oral antidepressant in this case.

Important limits: Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behavior on its own. It is not a replacement for hospitalization if that is clinically needed, and it is not approved as an anesthetic.

Most-Reported Side Effects for Esketamine

From FAERS, the FDA’s public side-effect reporting system (17,728 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dissociation 3,733 reports
Sedation 2,706 reports
Suicidal ideation 1,351 reports
Nausea 957 reports
Depression 873 reports
See full Esketamine Nasal Spray drug information
Keep checking

Other Drugs & Pao Pereira

Browse every other medication we’ve checked against Pao Pereira — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Pao Pereira against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Pao Pereira list.

See the full Pao Pereira interactions page
See every supplement checked against Esketamine, ranked by severity
Evidence & sources

Pao Pereira References

The 4 sources that drive our Pao Pereira monograph — publicly available pages from reputable medical and government organizations. Every link was verified to work before publishing. Pao Pereira is not covered by the licensed Natural Medicines interaction database, so its page cites these public sources directly.

  1. About Herbs, Botanicals & Other Products — Memorial Sloan Kettering Cancer Center Source
  2. Using Dietary Supplements Wisely — NIH NCCIH Source
  3. Dietary Supplements: What You Need to Know — NIH Office of Dietary Supplements Source
  4. Herbs at a Glance — NIH NCCIH Source

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Pao Pereira and Esketamine Together: Common Questions

Is it safe to take Pao Pereira with Esketamine?
We do not list a known interaction between Pao Pereira and Esketamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Does Esketamine interact with any supplements?
Yes. Esketamine has documented interactions with 11 supplements in our database — Pao Pereira is not one of them. The Esketamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Pao Pereira monograph Uses, safety profile, and every drug interaction in one place Esketamine Nasal Spray drug information The full plain-English guide to this medication Esketamine supplement interactions Every supplement checked against Esketamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 4 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esketamine and Pao Pereira?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.