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Ketamine Nasal Spray (SpravatoTM) and Intravenous for Mental Health Conditions Prior Authorization Request Form Medical Policy #087 Ketamine Nasal Spray (SpravatoTM) and Intravenous for Mental Health

How to fill out 094 esketamine nasal spray

How to fill out 094 esketamine nasal spray

1. Wash your hands thoroughly before handling the nasal spray.
2. Remove the nasal spray bottle from the packaging.
3. Gently shake the bottle before use.
4. Remove the protective cap from the bottle.
5. Tilt your head slightly back and insert the nasal spray tip into one nostril.
6. Close the other nostril with your finger.
7. While exhaling through your mouth, press down on the pump to release the spray into your nostril.
8. Sniff gently while still pressing down on the pump.
9. Repeat the process for the other nostril, if directed by your healthcare provider.
10. After use, wipe the tip of the nasal spray bottle with a clean tissue and replace the protective cap.
11. Do not blow your nose immediately after using the nasal spray.
12. Follow any additional instructions provided by your healthcare provider.

Who needs 094 esketamine nasal spray?

1. 094 esketamine nasal spray is a prescription medication used for the treatment of treatment-resistant depression.
2. It is primarily indicated for use in adults who have not responded to at least two other antidepressant treatments.
3. Only individuals diagnosed with treatment-resistant depression and under the supervision of a healthcare provider should use 094 esketamine nasal spray.

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What is 094 esketamine nasal spray?

094 esketamine nasal spray is a prescription medication used for the treatment of depression in adults.

Who is required to file 094 esketamine nasal spray?

Medical professionals who prescribe or administer 094 esketamine nasal spray are required to file the necessary documentation.

How to fill out 094 esketamine nasal spray?

Fill out the required information on the form provided by the manufacturer or pharmacy when prescribing or administering 094 esketamine nasal spray.

What is the purpose of 094 esketamine nasal spray?

The purpose of 094 esketamine nasal spray is to provide relief from symptoms of depression in adult patients.

What information must be reported on 094 esketamine nasal spray?

Information such as dosage, frequency of administration, patient's medical history, and any adverse reactions must be reported on 094 esketamine nasal spray.