Esketamine Hydrochloride and Oxymetazoline Hydrochloride

• Generic Name: esketamine
• Dosage Forms: n.a.
• Other Brand Names: Spravato

Used intranasally for treatment (in combination with an oral antidepressant) of treatment-resistant depression. Although there are various definitions of treatment-resistant depression, the condition is often defined as the failure of ≥2 trials of first-line antidepressants given in an adequate dosage for an adequate duration of therapy.

Intranasal esketamine substantially improved depressive symptoms as measured by the Montgomery-Asberg Depression Rating Scale (MADRS) within 24 hours of administration in a short-term clinical trial and prolonged time to relapse in a longer-term maintenance trial.

Esketamine is the S-enantiomer of racemic ketamine, which is an anesthetic agent. However, esketamine is not labeled for use as an anesthetic agent; efficacy and safety not established.

• Generic Name: oxymetazoline ophthalmic
• Dosage Forms: n.a.
• Other Brand Names: Visine LR, Visine Long Lasting, Ocuclear

Self-medication for temporary relief of nasal congestion associated with the common cold, hay fever, or other upper respiratory allergies.

As effective as other topical vasoconstrictors.

Labeled and has been used for self-medication for temporary relief of nasal congestion associated with sinusitis; however, efficacy data are lacking and/or controversial. In October 2005, FDA issued final rule to remove this indication from labeling of OTC nasal decongestants. Compliance date for preparations with annual sales <$25,000 is October 11, 2007; compliance date for all other preparations is April 11, 2007.

Self-medication for temporary relief of ocular redness due to minor irritation.

Has been used for self-medication for symptomatic prevention of otitic barotrauma (aerotitis [barotitis] media); however, no more effective than placebo.