Yes, Spravato (esketamine) is an intranasal spray
Spravato is specifically formulated as a nasal spray device for intranasal administration only. 1
Formulation and Administration
Spravato contains esketamine hydrochloride delivered through a nasal spray device. Each device delivers two sprays containing a total of 28 mg of esketamine in 0.2 mL of solution. 1
Key administration details:
- For nasal use only - this is explicitly stated in the FDA labeling 1
- The device should not be primed before use to prevent medication loss 1
- Dosing requires 2 devices (56 mg) or 3 devices (84 mg) with a 5-minute rest between each device 1
- Achieves approximately 48% bioavailability via intranasal route 1
- Peak plasma concentrations occur 20-40 minutes after the last spray 1
Clinical Context
The intranasal formulation is FDA-approved for:
- Treatment-resistant depression (TRD) as monotherapy or with oral antidepressants 1, 2
- Major depressive disorder with acute suicidal ideation or behavior (in conjunction with oral antidepressants) 1
Important distinction: While ketamine (the racemic mixture) can be administered intravenously or intranasally 3, Spravato (esketamine, the S-enantiomer) is specifically manufactured and approved only as an intranasal spray formulation. 1, 4
The intranasal delivery provides targeted administration with rapid onset of antidepressant effects, often within hours, distinguishing it from traditional oral antidepressants that require weeks. 4, 2