Esketamine (intranasal): Patient drug information

Warning

This drug may make you feel sleepy or dizzy, pass out, or cause anxiety. This drug may also cause a spinning feeling or an out-of-body feeling (like you are separated from your thoughts, feelings, surroundings, yourself, or time). These effects happened on the day of treatment and have gone away. Tell your doctor right away if you feel like you cannot stay awake or if you feel like passing out.
This drug may cause deadly breathing problems. Rarely, these problems were severe. Call your doctor right away if you have slow, shallow, or trouble breathing.
You will be watched closely while you receive this drug and for some time after your dose. Talk with your doctor.
Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.
This drug has a risk of abuse and misuse. Use this drug only as you were told by your doctor. Tell your doctor if you have ever abused or been addicted to any drugs or alcohol.

What is this drug used for?

It is used to treat depression.

What do I need to tell my doctor BEFORE I take this drug?

If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
If you have any of these health problems: A certain type of blood vessel disease (aneurysm) in the brain, chest, abdomen, arms, or legs; arteriovenous malformation; high blood pressure; or liver problems.
If you have ever had bleeding in the brain.
If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.
If you are breast-feeding. Do not breast-feed while you take this drug.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
Avoid driving and doing other tasks or actions that call for you to be alert after a dose. Do not do these things until the next day after you have gotten enough sleep. Someone else will need to drive you home after each dose of this drug.
This drug may cause high blood pressure.
Your doctor will be watching your blood pressure closely.
Talk with your doctor before you use alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
If you need to stop treatment with this drug, you will need to watch for signs of withdrawal. Tell your doctor if you have any bad effects. If you have questions, talk with your doctor.
If you are able to get pregnant, talk with your doctor about ways to prevent pregnancy while taking this drug.
This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
Chest pain.
Shortness of breath.
Seizures.
Feeling confused.
Memory problems or loss.
Anxiety.
Feeling the need to pass urine often or right away, pain when passing urine, or passing urine more often at night.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
Feeling dizzy or sleepy.
Feeling sluggish, drunk, or out of sorts.
Feeling very happy or excited.
Upset stomach or throwing up.
Change in taste.
Headache.
Numbness or tingling in the mouth.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
For the nose only.
This drug will be given in a healthcare setting where you will be watched closely. Follow how to use this drug as you have been told.
Blow your nose before use.
Do not eat food for at least 2 hours before using this drug. Do not drink liquids for at least 30 minutes before using this drug.
If you use other drugs in your nose on the same day you use this drug, use them at least 1 hour before using this drug.

What do I do if I miss a dose?

Call your doctor to find out what to do.

How do I store and/or throw out this drug?

If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.

General drug facts

If your symptoms or health problems do not get better or if they become worse, call your doctor.
Do not share your drugs with others and do not take anyone else's drugs.
Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

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Esketamine (intranasal): Patient drug information