Esketamine Nasal Spray

Name: Esketamine Nasal Spray

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using esketamine nasal spray,

  • tell your doctor and pharmacist if you are allergic to esketamine, ketamine, any other medications, or any of the ingredients in esketamine nasal spray. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amphetamines, medications for anxiety, armodafinil (Nuvigil), MAO inhibitors such as phenelzine (Nardil), procarbazine (Matulane), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar); other medications for mental illness, methylphenidate (Aptension, Jornay, Metadate, others), modafanil, opioid (narcotic) medications for pain, medications for seizures, sedatives, sleeping pills, and tranquilizers. Tell your doctor if you have recently taken any of these medications.
  • if you are using a nasal corticosteroid such as ciclesonide (Alvesco, Omnaris, Zetonna) and mometasone (Asmanex) or nasal decongestant such as oxymetazoline (Afrin) and phenylephrine (Neosynephrine), use it at least 1 hour before using esketamine nasal spray.
  • tell your doctor if you have a blood vessel disease in the brain, chest, stomach area, arms or legs; have arteriovenous malformation (an abnormal connection between your veins and arteries); or have a history of bleeding in your brain. Your doctor will probably tell you not to use esketamine nasal spray.
  • tell your doctor if you have ever had a stroke, heart attack, brain injury, or any condition that causes increased brain pressure. Tell your doctor if you see, feel, or hear things that are not there; or believe in things that are not true. Also, tell your doctor if you have or have ever had heart valve disease, heart failure, hypertension (high blood pressure), a slow or irregular heartbeat, shortness of breath, chest pain, or liver or heart disease.
  • tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while using esketamine nasal spray, call your doctor immediately. Esketamine nasal spray may harm the fetus.
  • tell your doctor if you are breast-feeding. You should not breastfeed while using esketamine nasal spray.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are using esketamine nasal spray.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Esketamine nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • frequent, urgent, burning, or painful urination
  • constipation
  • diarrhea
  • dry mouth
  • nausea
  • vomiting
  • difficulty thinking or feeling drunk
  • headache
  • unusual or metallic taste in the mouth
  • nasal discomfort
  • throat irritation
  • increased sweating

Some side effects can be serious. If you experience any of the symptoms listed in the IMPORTANT WARNING, call your doctor immediately or get emergency medical treatment.

Esketamine nasal spray may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( or by phone (1-800-332-1088).

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.