Drug & supplement interaction

Pu-erh Tea + Esketamine

Esketamine brand name: Spravato.

Minor Interaction
The bottom line Minor

Pu-erh Tea has a minor interaction with Esketamine. Theoretically, TCAs might bind with pu-erh tea constituents when taken at the same time.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Pu-erh Tea and Esketamine

Here is the interaction we found between these two, with the evidence behind it.

Minor

TRICYCLIC ANTIDEPRESSANTS (TCAs)

Why this applies to Esketamine

Esketamine falls under TRICYCLIC ANTIDEPRESSANTS (TCAs) — the group Pu-erh Tea interacts with.

Theoretically, TCAs might bind with pu-erh tea constituents when taken at the same time.
In vitro research suggests that the tannins in pu-erh tea might cause precipitation of TCAs. However, this effect has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the honest picture for Spravato (esketamine): the interaction we have on file is really about swallowed tablets, where the tannins in pu-erh tea can grab onto a medication in your stomach and keep some of it from being absorbed. Esketamine isn't a pill you swallow though, it's a nasal spray that goes straight into your bloodstream through the lining of your nose. So a cup of tea in your stomach isn't going to bump into it the same way.

On top of that, this concern comes only from lab dish studies, never from real people, and it's rated as minor. I wouldn't lose sleep over enjoying pu-erh tea. Just keep in mind it has caffeine, which can add to jitteriness. As always, run your full routine by your doctor or pharmacist.

References
  1. Lasswell WL Jr, Weber SS, Wilkins JM. In vitro interaction of neuroleptics and tricylic antidepressants with coffee, tea, and gallotannic acid. J Pharm Sci 1984;73:1056-8. PubMed
  2. Kulhanek F, Linde OK, Meisenberg G. Precipitation of antipsychotic drugs in interaction with coffee or tea. Lancet 1979;2:1130.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Pu-erh Tea Also Interacts With Other Medications

Pu-erh Tea has 9 major, 448 moderate, 209 minor known drug interactions in our database — the Esketamine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Pu-erh Tea

Covers the 2,830 medications we’ve checked against Pu-erh Tea. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Esketamine

This page covers Pu-erh Tea 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

How much people look this up

Where Pu-erh Tea 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 Pu-erh Tea
Steady interest

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

29 days ago today
Medication Esketamine
Steady interest

#2,708 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.

Supplement

About Pu-erh Tea

What is Pu-erh Tea?

  • Weight management
  • Cholesterol and heart health
  • Digestion after meals
  • Mental alertness
  • General antioxidant support

Pu-erh tea is a fermented, aged form of tea made from the same plant as green and black tea. It is enjoyed worldwide as a beverage and is sometimes promoted for weight loss, cholesterol, and digestion, but human evidence for these uses is limited. As a normal drink it is generally well tolerated, though it does contain caffeine.

Read the full Pu-erh Tea 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.

See full Esketamine Nasal Spray drug information
Keep checking

Other Drugs & Pu-erh Tea

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

9Major
448Moderate
209Minor
2,163No known interaction
Major

9 interactions

Moderate

448 interactions

Showing 60 of 448 moderate interactions — see all 448 on the Pu-erh Tea page.

Minor

209 interactions

Showing 60 of 209 minor interactions — see all 209 on the Pu-erh Tea page.

No interaction 2,163 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Pu-erh Tea and Esketamine Together: Common Questions

Can you take Pu-erh Tea with Esketamine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Pu-erh Tea and Esketamine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

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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.