Esketamine Nasal Spray

Name: Esketamine Nasal Spray

Why is this medication prescribed?

Esketamine nasal spray is used along with another antidepressant, taken by mouth, to manage treatment-resistant depression (TRD; depression that does not improve with treatment). Esketamine is in a class of medications called NMDA receptor antagonists. It works by changing the activity of certain natural substances in the brain.

How should this medicine be used?

Esketamine comes as a solution (liquid) to spray into the nose. Initially, it is usually sprayed into the nose twice a week during weeks 1–4, once weekly during weeks 5–8, and then once a week or once every 2 weeks during week 9 and beyond. Esketamine must be used in a medical facility.

Do not eat for at least 2 hours or drink liquids for at least 30 minutes before using esketamine nasal spray.

Each nasal spray device provides 2 sprays (one spray for each nostril). Two green dots on the device tells you that the nasal spray is full, one green dot tells you that one spray was used, and no green dots indicates that the full dose of 2 sprays was used.

What should I do if I forget a dose?

If you miss a treatment session contact your doctor right away to schedule an appointment. If you miss a treatment and your depression becomes worse, your doctor may have to change your dose or treatment schedule.

What other information should I know?

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names

  • Spravato®
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