Spravato administration details: Formulation, potencies, ingestion methods, and additional insights

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Spravato administration details: Formulation, potencies, ingestion methods, and additional insights

Spravato, a brand name drug, is authorized by the Food and Drug Administration (FDA) for specific kinds of depression in grown-ups. It's available as a liquid nasal spray that's administered in a healthcare facility. The dose can differ depending on the condition it's being used to treat.

The FDA approves Spravato for:

  • Resistant depression to treatment (TRD), this type of depression hasn't responded to two or more antidepressants.
  • Symptoms of depression in major depressive disorder (MDD) that include suicidal thoughts or behaviors.

Spravato falls under a category of medications named N-methyl-D-aspartate receptor antagonists. It's not offered in a generic version.

Read ahead for specific details about Spravato's dosage, including strengths and administration. For a comprehensive understanding of Spravato, see this article. Remember, always follow the dosage your doctor prescribes when taking Spravato. You'll take your Spravato doses with the help of a healthcare professional at a healthcare facility.

* Spravato is approved for these uses when it is given in combination with an oral antidepressant.

Spravato dosage

The following table summarizes Spravato's dosage. Doctors prescribe Spravato in combination with an oral antidepressant. All doses are listed in milligrams (mg). Your doctor will determine the best dosage for you.

| | | | || --- | --- | --- | --- || Use for Spravato | Dosage for weeks 1–4 | Maintenance dosage for weeks 5–8 | Maintenance dosage for week 9 and later || treatment-resistant depression (TRD) | first dose of 56 mg followed by either 56 mg or 84 mg twice per week | 56 mg or 84 mg once per week | 56 mg or 84 mg once every 2 weeks or once per week || major depressive disorder (MDD)* | 84 mg twice per week for 4 weeks; may be reduced to 56 mg twice per week if needed | talk with your doctor† | talk with your doctor† |

Use for Spravato

* For MDD, Spravato is not typically given for more than 4 weeks.† The manufacturer of Spravato recommends determining whether Spravato is working for you before you continue with the treatment. You will need to discuss the risks and benefits of Spravato with your doctor before you continue the treatment.

Check below for details about Spravato's dosages for its approved uses.

Dosage for weeks 1–4

Spravato form

Spravato is available as a nasal spray.

Maintenance dosage for weeks 5–8

Spravato strength

Each Spravato spray contains 14 milligrams (mg) of the medication. There are two sprays in each device, making a total of 28 mg per device.

Maintenance dosage for week 9 and later

Typical dosages

The following information describes Spravato nasal spray dosages that are commonly taken or recommended. However, be sure to take the dosage that your doctor prescribes for you. Your doctor will determine the best dosing frequency to fit your needs.

Dosage for treatment-resistant depression (TRD)

The first dose of Spravato for TRD is 56 mg. For weeks 1–4 of treatment, you’ll receive 56 mg or 84 mg of Spravato twice per week.

treatment-resistant depression (TRD)

At the start of week 5, you’ll receive 56 mg or 84 mg of Spravato once per week. This dosage will be the same for weeks 6–8. During week 9, you’ll receive 56 mg or 84 mg of Spravato once every 2 weeks or once per week.

Your doctor will determine how long you will need to receive Spravato.

first dose of 56 mg followed by either 56 mg or 84 mg twice per week

Dosage for depressive symptoms of major depressive disorder (MDD)

The dosage of Spravato for MDD is 84 mg twice per week for a total of 4 weeks. Your doctor may reduce this amount to 56 mg two times per week if you have side effects that bother you.

56 mg or 84 mg once per week

Spravato treatment that lasts longer than 4 weeks has not been studied in people with MDD. You and your doctor will decide if you need to continue the treatment beyond 4 weeks.

Long-term treatment

56 mg or 84 mg once every 2 weeks or once per week

Your doctor may recommend that you take Spravato in the long term if it’s safe, effective, and necessary for you. Talk with your doctor about whether Spravato is right for you as a long-term treatment.

For MDD, your doctor will typically not prescribe Spravato for longer than 4 weeks.

Your healthcare provider will guide you in utilizing the nasal spray device. If your Spravato dosage is 56 milligrams (mg), you'll need two devices, administering a total of 4 sprays. If your Spravato dosage is 84 mg, you'll require three devices, resulting in a total of 6 sprays. Post administration, a healthcare professional will observe you for 2 hours to detect any side effects. They'll watch out for symptoms such as elevated blood pressure and respiratory changes, including alterations in blood oxygen levels. Due to the potential side effects of Spravato, it's mandatory to have someone drive you home following your treatment.

Here are more specific guidelines on using Spravato:

major depressive disorder (MDD)*

  • Clear your nasal passages before using the device.
  • Your physician will determine the appropriate dose. They'll inspect the device prior to your use.
  • Keep the device in hand and lean back after spraying to maintain the medication in your nose.
  • Administer one spray in each nostril. Gently inhale after each spray to retain the medication in your nose.
  • Return the device to your physician. They'll ensure it's empty.
    • If you're using the 56-mg dose pack, wait 5 minutes and repeat the above steps with a new device.
    • If you're using the 84-mg dose pack, repeat the steps above twice, resting 5 minutes after emptying each device.

A video demonstrating how to take Spravato is accessible from the manufacturer.

84 mg twice per week for 4 weeks; may be reduced to 56 mg twice per week if needed

Easily readable prescription labels and containers If you're having difficulty reading your prescription label, consult your doctor or pharmacist. Certain pharmacies provide labels with large print, braille, or a code that can be scanned with a smartphone to convert text into speech. If your local pharmacy does not offer these options, your doctor or pharmacist might recommend a pharmacy that does.

Missed dose

talk with your doctor†

If you miss an appointment to receive your Spravato dosage, contact your doctor immediately. They will reschedule your appointment. They may also adjust your dosage and treatment plan. This can help ensure the safety of the treatment.

To decrease the chance of missing an appointment, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

talk with your doctor†

Spravato and misuse

Spravato carries a boxed warning about the risk of misuse. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Misuse refers to the use of a drug in a manner other than prescribed by your doctor. Given the potential for misuse, inform your doctor if you've misused any drug in the past.

Spravato is only supplied through a program called Spravato REMS. This means that you can only take it in a healthcare setting certified by the Spravato REMS program.

Takeaway and helpful resources

The dosages mentioned in this article are the typical ones provided by the drug's manufacturer. If your doctor recommends Spravato for you, they will prescribe the dosage that's right for you.

If you have questions about the appropriate dosage of Spravato for you, consult your doctor.

Besides learning about dosages, you may want other information about Spravato. These additional articles might be helpful to you:

  • More about Spravato. For information about other aspects of Spravato, refer to this article.
  • Side effects. To learn about side effects of Spravato, see this article. You can also review the Spravato prescribing information.
  • Drug comparison. To find out how Spravato compares with similar drugs, see the “Spravato vs. other drugs” section in this article.
  • Details about depression. For more information about your condition, see our mental health hub and this list of related articles.

Disclaimer: Medical News Today has made every effort to ensure that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

  1. It's important to note that Spravato, a medication used to treat certain types of depression, is only available through a program called Spravato REMS due to its potential for misuse.
  2. For individuals with resistant depression to treatment (TRD), Spravato is often prescribed in combination with an oral antidepressant, with a starting dose of 56 mg, followed by either 56 mg or 84 mg twice a week, and potentially a maintenance dose of 56 mg or 84 mg once every 2 weeks or once per week.
  3. Mental health and physical health are closely intertwined, and Spravato, while being primarily used for depression, can have impacts on overall mental health. It's crucial to discuss these potential effects with a healthcare professional.

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