diff --git a/dev-packages/rollup-utils/npmHelpers.mjs b/dev-packages/rollup-utils/npmHelpers.mjs
index 6085a502200f..89921fa7ffc4 100644
--- a/dev-packages/rollup-utils/npmHelpers.mjs
+++ b/dev-packages/rollup-utils/npmHelpers.mjs
@@ -17,6 +17,7 @@ import {
   makeSetSDKSourcePlugin,
   makeSucrasePlugin,
 } from './plugins/index.mjs';
+import { makePackageNodeEsm } from './plugins/make-esm-plugin.mjs';
 import { mergePlugins } from './utils.mjs';
 
 const packageDotJSON = JSON.parse(fs.readFileSync(path.resolve(process.cwd(), './package.json'), { encoding: 'utf8' }));
@@ -120,7 +121,7 @@ export function makeBaseNPMConfig(options = {}) {
 export function makeNPMConfigVariants(baseConfig) {
   const variantSpecificConfigs = [
     { output: { format: 'cjs', dir: path.join(baseConfig.output.dir, 'cjs') } },
-    { output: { format: 'esm', dir: path.join(baseConfig.output.dir, 'esm') } },
+    { output: { format: 'esm', dir: path.join(baseConfig.output.dir, 'esm'), plugins: [makePackageNodeEsm()] } },
   ];
 
   return variantSpecificConfigs.map(variant => deepMerge(baseConfig, variant));
diff --git a/dev-packages/rollup-utils/plugins/make-esm-plugin.mjs b/dev-packages/rollup-utils/plugins/make-esm-plugin.mjs
new file mode 100644
index 000000000000..aa3f272ba2e0
--- /dev/null
+++ b/dev-packages/rollup-utils/plugins/make-esm-plugin.mjs
@@ -0,0 +1,16 @@
+/**
+ * Outputs a package.json file with {type: module} in the root of the output directory so that Node
+ * treats .js files as ESM.
+ */
+export function makePackageNodeEsm() {
+  return {
+    name: 'make-package-node-esm',
+    generateBundle() {
+      this.emitFile({
+        type: 'asset',
+        fileName: 'package.json',
+        source: '{ "type": "module" }',
+      });
+    },
+  };
+}
diff --git a/packages/node-experimental/src/integrations/tracing/prisma.ts b/packages/node-experimental/src/integrations/tracing/prisma.ts
index 1f78262b9a3c..608865fb1de9 100644
--- a/packages/node-experimental/src/integrations/tracing/prisma.ts
+++ b/packages/node-experimental/src/integrations/tracing/prisma.ts
@@ -1,5 +1,6 @@
 import { registerInstrumentations } from '@opentelemetry/instrumentation';
-import { PrismaInstrumentation } from '@prisma/instrumentation';
+// When importing CommonJs modules into an ESM module, we import the named exports directly.
+import * as prismaInstrumentation from '@prisma/instrumentation';
 import { defineIntegration } from '@sentry/core';
 import type { IntegrationFn } from '@sentry/types';
 
@@ -10,7 +11,7 @@ const _prismaIntegration = (() => {
       registerInstrumentations({
         instrumentations: [
           // does not have a hook to adjust spans & add origin
-          new PrismaInstrumentation({}),
+          new prismaInstrumentation.PrismaInstrumentation({}),
         ],
       });
     },
diff --git a/packages/node-experimental/src/sdk/init.ts b/packages/node-experimental/src/sdk/init.ts
index 5e62a01de6cd..712e27d35963 100644
--- a/packages/node-experimental/src/sdk/init.ts
+++ b/packages/node-experimental/src/sdk/init.ts
@@ -39,6 +39,10 @@ import { defaultStackParser, getSentryRelease } from './api';
 import { NodeClient } from './client';
 import { initOtel } from './initOtel';
 
+function getCjsOnlyIntegrations(isCjs = typeof require !== 'undefined'): Integration[] {
+  return isCjs ? [nativeNodeFetchIntegration(), modulesIntegration()] : [];
+}
+
 /** Get the default integrations for the Node Experimental SDK. */
 export function getDefaultIntegrations(options: Options): Integration[] {
   // TODO
@@ -51,7 +55,6 @@ export function getDefaultIntegrations(options: Options): Integration[] {
     // Native Wrappers
     consoleIntegration(),
     httpIntegration(),
-    nativeNodeFetchIntegration(),
     // Global Handlers
     onUncaughtExceptionIntegration(),
     onUnhandledRejectionIntegration(),
@@ -59,9 +62,8 @@ export function getDefaultIntegrations(options: Options): Integration[] {
     contextLinesIntegration(),
     localVariablesIntegration(),
     nodeContextIntegration(),
-    modulesIntegration(),
     httpIntegration(),
-    nativeNodeFetchIntegration(),
+    ...getCjsOnlyIntegrations(),
     ...(hasTracingEnabled(options) ? getAutoPerformanceIntegrations() : []),
   ];
 }