How to Use SPRAVATO® Nasal Spray

Instructions for Use
You will administer SPRAVATO® nasal spray yourself under the supervision of a healthcare provider at a certified SPRAVATO® treatment center. Your healthcare provider will show you how to use the SPRAVATO® nasal spray device.
Watch the video to learn more about using the nasal spray.
Super: Welcome
Speaker: Welcome to SPRAVATO® (esketamine) nasal spray CIII.
SUPER: How to use
Speaker: In this video, you’ll learn how to use SPRAVATO®.
SUPER: Treatment-resistant depression
SUPER: Depressive symptoms in adults with major depressive disorder with suicidal thoughts or actions
Speaker/SUPER: SPRAVATO® is a prescription medicine, taken along with an oral antidepressant, for adults with treatment-resistant depression; and for depressive symptoms in adults with major depressive disorder with suicidal thoughts or actions.
SPRAVATO® is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO® is safe or effective as an anesthetic medicine. It is not known if SPRAVATO® is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. SPRAVATO® is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of SPRAVATO®. It is not known if SPRAVATO® is safe and effective in children.
Speaker: SPRAVATO® can cause serious side effects, including sedation and dissociation. There is a risk for abuse and misuse with SPRAVATO®. Be sure to tell your healthcare provider about your complete medical history, including if you have any history of abusing prescription or street drugs, or a problem with alcohol. Because of these risks, SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program. There is an increased risk of suicidal thoughts and behavior with SPRAVATO®. Call your healthcare provider right away if you have new or sudden changes in mood, behavior, thoughts or feelings.
You'll administer SPRAVATO® yourself at a certified SPRAVATO® treatment center under the supervision of a healthcare provider who will show you how to use the nasal spray.
SUPER: MPORTANT SAFETY INFORMATION:SPRAVATO® may cause sleepiness (sedation), fainting, dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts, feelings and things around you (dissociation). There is a risk for abuse and physical and psychological dependence with SPRAVATO® treatment. Tell your healthcare provider if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs. Because of the risks for sedation, dissociation, and abuse and misuse, SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program. SPRAVATO® may cause worsening of depression and suicidal thoughts and behaviors. Pay close attention to any changes, especially sudden changes, in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions. Tell your healthcare provider right away if any such changes occur. Please see the Important Safety Information in this video, and full Prescribing Information, including Boxed WARNINGS, on SPRAVATO.com.
SUPER: A look at the SPRAVATO® Nasal Spray
SUPER: What to expect on treatment days
Speaker: Let's review the instructions for using SPRAVATO® now.
SUPER: TopNose restIndicatorFinger restPlunger
Speaker: Looking at the nasal spray, you'll see the top, nose rest, indicator, finger rest and plunger.
SUPER: Contains two sprays
Speaker: Each nasal spray contains two sprays inside, one spray for each nostril.
SUPER: Indicator
Speaker: Now, let's look at the indicator window.
SUPER: Full
Speaker: Two green dots mean the nasal spray is full.
SUPER: One spray delivered
Speaker: One green dot indicates that one spray was delivered.
SUPER: Empty
Speaker: If there are no green dots, the nasal spray container is empty.
SUPER: Before your first device only
Speaker: Before administering your first device only, blow your nose to clear your nostrils.
SUPER: Hold like this
Speaker: Now, hold the nasal spray as shown with your thumb gently supporting the plunger. Be careful not to press the plunger just yet.
SUPER: Tilt head about 45 degrees
Speaker: Tilt your head back at about 45 degrees throughout the administration. This will keep the medication inside your nose.
SUPER: Insert top into first nostril
Speaker: Next, insert the top into your first nostril, like this. The nose rest should touch the skin between the nostrils as shown.
SUPER: Close opposite nostril
Speaker: Before you spray, use your finger to close the opposite nostril.
SUPER: You’re ready to spray
Speaker: Now, breathe in through your nose while pushing the plunger all the way up until it stops.
SUPER: Sniff gently
Speaker: Sniff gently after spraying to keep the medication inside your nose.
SUPER: Repeat in the second nostril
Speaker: Now, repeat the same steps to administer SPRAVATO® into your second nostril. Keep your head tilted back at a 45-degree angle, switch hands and insert the top of the nasal spray into your second nostril, making sure the nose rest is touching the skin between the nostrils.
SUPER: You’re ready to spray
Speaker: Use your finger to close the opposite nostril, then breathe in through your nose while pushing the plunger all the way up until it stops.
SUPER: Sniff gently
Speaker: Sniff gently to keep the medication inside your nose.
After administering SPRAVATO®, your healthcare provider will check the indicator window to ensure there are no green dots, confirming that all the medication has been administered.
SUPER: 5 min rest between devices
Speaker: It's important that you rest in a comfortable position, preferably semi-reclined, for five minutes between devices to allow the medication to absorb.
SUPER: Do not blow your nose
Speaker: Do not blow your nose. If liquid drips out, dab your nose with a tissue.
SUPER: Observation period
Speaker: After you get your full dose of SPRAVATO®, you will be monitored for at least two hours. You may want to listen to music, read or just relax while a healthcare provider monitors your blood pressure and checks for possible side effects. Other serious side effects may include problems with thinking clearly and bladder problems.
SUPER: SPRAVATO® can cause a temporary increase in your blood pressure that may last for about four hours – so you will have your blood pressure measured before administration and periodically for at least two hours. Tell your healthcare provider if you experience any side effects while taking SPRAVATO®. Please see the Important Safety Information in this video, and full Prescribing Information, including Boxed WARNINGS, on SPRAVATO.com.
Speaker: After the observation period, when your healthcare provider gives you the okay, you'll be ready to leave. Keep in mind you won't be able to drive, operate machinery or do anything where you need to be completely alert after taking SPRAVATO® until the next day, following a restful sleep, so you will need to plan for rides on treatment days.
Please listen to the following Important Safety Information in this video.
SUPER: Please listen to the following Important Safety Information in this video and read the Prescribing Information, including Boxed WARNINGS, and Medication Guide available on SPRAVATO.com.
Speaker/SUPER:
IMPORTANT SAFETY INFORMATION
What is the most important information I should know about SPRAVATO®?
SPRAVATO® can cause serious side effects, including:
SPRAVATO® is not for use in children
Do not take SPRAVATO® if you:
If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking SPRAVATO®.
Before you take SPRAVATO®, tell your healthcare provider about all of your medical conditions, including if you:
Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO® with certain medicine may cause side effects.
Especially tell your healthcare provider if you take central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicines. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.
How will I take SPRAVATO®?
What should I avoid while taking SPRAVATO®?
Do not drive, operate machinery, or do anything where you need to be completely alert after taking SPRAVATO®. Do not take part in these activities until the next day following a restful sleep. See “What is the most important information I should know about SPRAVATO®?”
What are the possible side effects of SPRAVATO®?
SPRAVATO® may cause serious side effects including:
The most common side effects of SPRAVATO® when used along with an antidepressant taken by mouth include:
If these common side effects occur, they usually happen right after taking SPRAVATO® and go away the same day.
These are not all the possible side effects of SPRAVATO®.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for SPRAVATO® at SPRAVATO.com and discuss any questions you may have with your healthcare provider.
SUPER:
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SUPER:
© Janssen Pharmaceuticals, Inc. 2022. All rights reserved. 01/22 cp-153444v3
After you and your healthcare provider have decided SPRAVATO® is right for you —
and you understand the benefits and risks — you can start planning for treatment.
If two or more antidepressants haven’t worked for you, you may have treatment-resistant depression (TRD). It’s time to talk to your doctor about a different treatment approach.