esketamine
Brand names: Spravato
Spravato is a nasal spray medicine used to treat depression. It contains esketamine and affects certain receptors in the brain.
Drug Pricing (NADAC)
Brand Price
$373.45/unit
Generic Available
No
JANSSEN PHARMS
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Spravato is used to treat treatment-resistant depression in adults.
Common side effects
Feeling disconnected from yourself or your surroundings, Dizziness, Nausea
Key warnings
Spravato can cause sleepiness, feeling disconnected, and breathing problems.
How It Works
Spravato is a type of medicine called an NMDA receptor antagonist. It works by affecting certain receptors in the brain. These receptors are involved in regulating mood and emotions.
How to Take It
Spravato is given as a nasal spray by a healthcare provider. You will spray it into your nose. You will be watched for at least 2 hours after each dose. Avoid food for 2 hours and liquids for 30 minutes before taking Spravato. If you use a nasal spray for allergies, use it 1 hour before Spravato.
Pregnancy & Breastfeeding
Spravato may harm an unborn baby. Talk to your doctor about pregnancy planning and birth control. Breastfeeding is not recommended while using Spravato.
Missed Dose
Spravato is given by a healthcare provider, so you are unlikely to miss a dose. If you miss an appointment, call your doctor as soon as possible.
Storage
Store Spravato at room temperature, between 68° to 77°F.
Side Effects (from patient reports)
Based on 12,545 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 15,846 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2015–2025.
Total Reports
15,846
Death-Related Reports
641
Hospitalization Reports
2,714
Top Indication
Depression
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DISSOCIATION | 3,351 |
| 2 | SEDATION | 2,465 |
| 3 | SUICIDAL IDEATION | 1,233 |
| 4 | DRUG INEFFECTIVE | 1,032 |
| 5 | NAUSEA | 876 |
| 6 | DEPRESSION | 808 |
| 7 | PRODUCT DOSE OMISSION ISSUE | 709 |
| 8 | HOSPITALISATION | 702 |
| 9 | HYPERTENSION | 688 |
| 10 | ANXIETY | 681 |
| 11 | VOMITING | 643 |
| 12 | DIZZINESS | 597 |
| 13 | BLOOD PRESSURE INCREASED | 518 |
| 14 | FEELING ABNORMAL | 455 |
| 15 | OFF LABEL USE | 365 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Spravato can cause sleepiness, feeling disconnected, and breathing problems. You will be monitored for these side effects. Spravato has the potential for abuse and misuse. Spravato may increase suicidal thoughts and behaviors in young adults. Spravato is only available through a special program.
Known Drug Interactions
7.2 Psychostimulants Concomitant use with psychostimulants (e.g., amphetamines, methylphenidate, modafinil, armodafinil) may increase blood pressure [see Warnings and Precautions (5.7) ] .
Mechanism: Taking these two medicines together can cause your blood pressure to go up higher than usual.
What to do: Your healthcare provider should check your blood pressure regularly while you are using both medications.
Common Questions
Can Spravato prevent suicide?
Can I drive after taking Spravato?
What if my blood pressure is high?
Is Spravato safe for children?
What should I avoid before taking Spravato?
Can I take other medicines with Spravato?
How long will I be monitored after taking Spravato?
What if I feel sleepy after taking Spravato?
How is Spravato supplied?
What does Spravato contain?
What are the common side effects of esketamine?
Does esketamine interact with other medications?
What drug class is esketamine?
Is esketamine safe during pregnancy?
Related Medications in NMDA Receptor Antagonist (Nasal Spray)
Other drugs grouped near esketamine — same-class peers and common alternatives.
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alprazolam
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amitriptyline
Elavil
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amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
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aripiprazole
Abilify
Aripiprazole (Abilify) is a medicine used to treat certain mental disorders and mood problems.
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What the FDA Data Shows for esketamine
The FDA label for esketamine (sold under brand names such as Spravato) classifies it as a prescription-only medication in the NMDA Receptor Antagonist (Nasal Spray) class. Spravato is used to treat treatment-resistant depression in adults. Official labeling lists 12 commonly reported side effects, including Feeling disconnected from yourself or your surroundings, Dizziness, Nausea.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 12,545 voluntary reports. The database also lists 1 documented drug interaction derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: August 26, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages