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Special precautions for disposal: Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
Incompatibilities: Not applicable.
Instructions for Use: Nasal Spray Device: Each nasal spray device delivers 28 mg esketamine as two sprays.
Important: This device is intended for administration by the patient, under supervision of a healthcare professional. Read these Instructions for Use in full before training and supervising patient.
Step 1: Get ready.
Before first device only: Instruct patient to blow nose before first device only. Confirm required number of devices (56 mg = 2 devices; 84 mg = 3 devices).
Step 2: Prepare device.
Check expiration date ('EXP'). If expired, get a new device.
Peel blister and remove device.
Do not prime device. This will result in a loss of medicine.
Check that indicator shows 2 green dots. If not, dispose of device and get a new one.
Hand device to patient.
Step 3: Prepare patient.
Instruct the patient to: Hold device with the thumb gently supporting the plunger. Do not press the plunger.
Instruct the patient to: Recline head at about 45 degrees during administration to keep medicine inside the nose.
Step 4: Patient sprays once into each nostril.
Instruct the patient to: Insert tip straight into the first nostril. Nose rest should touch the skin between the nostrils.
Instruct the patient to: Close opposite nostril. Breathe in through nose while pushing plunger all the way up until it stops.
Instruct the patient to: Sniff gently after spraying to keep medicine inside nose.
Instruct the patient to: Switch hands to insert tip into the second nostril. Repeat Step 4 to deliver second spray.
Step 5: Confirm delivery and rest.
Take device from patient.
Check that indicator shows no green dots. If a green dot is seen, have patient spray again into the second nostril.
Check indicator again to confirm device is empty.
Instruct the patient to: Rest in a comfortable position (preferably, semi-reclined) for 5 minutes after each device. If liquid drips out, dab nose with a tissue. Do not blow nose.
Next device (if required): Repeat Steps 2-5 if more than one device is required.
IMPORTANT: Ensure that patient waits 5 minutes after each device to allow medicine to absorb.
Disposal: Dispose of used device(s) in accordance with local requirements.
