Nasal Spray Bottle
Nasal spray bottles tend to work well for the duration of the prescription. Occasionally the medication can crystallize in the spray tube if not used regularly. The nasal spray bottle is normally included in the cost of the ketamine prescription. Oftentimes if the nasal spray bottle is put on its side medication will leak out.
Spray nebulizers atomize particles in the saline solution. Spray nebulizers are primarily used for different types of sinusitis. Based on observation data from our clinic nebulizers are marginally better at delivering medication to the nasal passage with less likelihood of irritation. The average cost for an nebulizer is $65 one time purchase. They are normally battery operated.
The most common side effect of ketamine sprays is irritated nasal passages. Moisturizing the nostrils plays a big role in reducing irritation of the nasal passage. We recommend the use of a topical cream acetyl glutathione 5% to help patients who suffer from irritation. The topical creams come in three different scents, spearmint, menthol and lavender. We recommend spearmint and menthol during the day. Lavender during the night. We partner with University Pharmacy who uses several different bases for these creams. The most common base to these creams is cocoa butter followed by combinations involving cocoa butter. One tube will last most people 2-3 months. Below is a description of what glutathione is and how it helps.Glutathione is naturally produced in the body. It is important to the immune system and helps remove pollutants from the body. Normal cellular function results in some buildup of free radicals that must be removed with the help of glutathione molecules. In some cases however the number of free radicals becomes greater than the body’s ability to remove them. This can be due to some factor increasing the amount of toxins in the body or to a decrease in levels of GSH.
Ketamine spray dosing. The greater the strength the more likely it will cause irritation to the nasal passage. The strengths that are the most likely to cause irritation are between 125 and 175 mg per ml. Going much over 175 mg per ml will cause the ketamine to fall out of suspension.
The most effective way to increase the absorption of ketamine if to pump 1 spray per nostril then massage the nostril so the mucus membrane absorbs the ketamine and then do the other nostril the same way. Only sniff up if the medication starts leaking out of the nose. Wait seven minutes between the two sprays and do a total number of sprays based on the recommendation of the medical provider.
Bioavailability of Ketamine depending on route of administration
Infusion IV Drip | Intramuscular approx 90%
Intranasal Sprays approx 70%
Oral | Troches via the stomach approx 30%