What is Spravato (84 MG Dose): Uses, Warnings & Interactions

You must first enroll in the Risk Evaluation and Mitigation Strategies (REMS) program set up for this medication.

Spravato is only administered in a monitored and certified clinical setting with a healthcare professional in attendance. The entire process may take two hours or longer.

Keep all appointments.

Follow all the instructions given by the clinic’s healthcare providers before, during, and after treatment.

A healthcare professional will instruct you on how to administer doses and supervise the administration of the drug. Follow these instructions. 

You are released only after an assessment. The clinic may make you stay longer for continued monitoring.

You must arrange for transportation following treatment. The clinic may not release you until a ride has arrived.

Do not miss treatment sessions.

If a treatment session is missed:

• The therapist usually resumes treatment if depression symptoms haven’t worsened.

• The therapist may restart treatment from day one if depression symptoms have worsened.

This medicine is not right for everyone. 

A doctor or other healthcare professional will not use it in people with:

• Known allergies to esketamine or ketamine

• A history of aneurysms

• Abnormal connections between arteries and veins

• A history of bleeding in the brain

Patients must enroll in a Risk Evaluation and Mitigation Strategies program before Spravato can be administered. Fill this form out honestly. It will ask for information vital to ensuring your safety.

A healthcare provider must assess your health before and after each treatment. Regular visits are required to monitor the effectiveness of therapy and spot any potential side effects. Keep all appointments.

Tell the prescribing doctor if you are pregnant, breastfeeding, or have:

• A history of bleeding in the brain

• Blood vessel problems

• High blood pressure

• A history of heart attack

• Heart valve disease

• Slow heartbeats

• A history of stroke

• A history of brain injury

• Liver problems

• Any past incidents of psychosis (hallucinations or delusions)

• Any history of drug or alcohol abuse

Esketamine can cause serious problems, including:

• Prolonged sedation and impairment

• Respiratory depression (slow or inadequate breathing)

• Increased risk of suicidal thoughts or actions

• Dissociation (feeling separated from yourself or the world)

• Hallucinations

• Fear and anxiety

• Temporary cognitive impairment

• Increased blood pressure

It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine.

Do not breastfeed during treatment with this medicine.

This medicine may make you drowsy, confused, or have problems with thinking clearly. Do not drive or do any potentially hazardous activities until the next day after a restful sleep. You will need someone to drive you home after treatment with this medicine.

Esketamine has a high potential for addiction and abuse. An overdose can be fatal. Talk to the prescribing healthcare professional if you develop cravings for the drug or the treatment. 

Make sure the healthcare professional treating you knows about all the prescription drugs, over-the-counter medications, supplements, and off-label drugs that you are using, particularly:

• Drugs that make you sleepy such as narcotic pain medications, benzodiazepines, sleeping pills, alcohol, marijuana products, and similar drugs

• Stimulants such as amphetamines, wakefulness agents, and ADHD medications

• Monoamine oxidase inhibitors (find a list of MAO inhibitors here)

• Illicit drugs

If you need to take a nasal steroid or decongestant, take your dose at least one hour before your Spravato treatment session.