Compounded Ketamine Nasal Spray in Florida
A non-oral formulation of compounded racemic ketamine, considered when a provider determines a nasal route is clinically appropriate for an eligible patient.
If you are in crisis or having thoughts of suicide, this is an emergency. Call or text 988 (Suicide & Crisis Lifeline) or call 911. Bravely Balanced is not an emergency service, and the candidate assessment is not a crisis intervention.
Compounded ketamine nasal spray is one formulation a provider may consider when an oral route is less appropriate. Like all compounded ketamine used for psychiatric purposes, it is prescribed off-label and is not an FDA-approved product.
Formulation and route
A metered nasal spray delivers compounded racemic ketamine through the nasal mucosa. Because it is compounded, it is prepared for individual patients by a licensed compounding pharmacy — not manufactured as an FDA-approved finished product.
Not the same as esketamine (Spravato)
This is a common point of confusion. Compounded racemic ketamine nasal spray is different from FDA-approved esketamine (Spravato), which is a branded product administered under a specific risk-management program. The two are not interchangeable, and compounded ketamine nasal spray is prescribed off-label.
General patient experience
Nasal administration is absorbed relatively quickly. During and after a session you may experience relaxation, mild dissociation, or changes in perception. These effects are typically temporary. Experiences vary, and your provider will discuss what to expect before treatment.
Preparation and administration
Preparation mirrors the general at-home safety framework: a calm, private environment, no alcohol or recreational substances, a support person available, and no driving afterward. Administration follows your provider's specific instructions for your prescribed strength and frequency.
Safety considerations
- Use only the strength and frequency your provider prescribes.
- Report unexpected or concerning effects through the secure portal rather than adjusting dose.
- Maintain a support person and a safe environment.
- Complete required follow-up so your provider can assess response and safety.
Pharmacy dispensing
Your prescription is sent to an independent licensed compounding pharmacy, which prepares and ships the medication and bills you directly. Bravely Balanced does not operate a pharmacy or mark up medication.
Provider monitoring
Your provider reviews your session logs and symptom tracking at follow-up and decides whether to continue, adjust, or discontinue treatment. Formulation, strength, and frequency are clinical decisions — patients do not self-dose.
Important context about ketamine. Ketamine is FDA-approved as an anesthetic. The use of compounded racemic ketamine for psychiatric conditions is off-label, and compounded medications are not FDA-approved products. Compounded ketamine nasal spray is not the same as FDA-approved esketamine (Spravato®).
Treatment is not appropriate for everyone. A licensed clinician independently determines whether prescribing is appropriate. No prescription is guaranteed, and completing an assessment does not equal clinical eligibility.
About this page
- Written by:
- Bravely Balanced Clinical Education Team
- Medical review:
- Pending — this content has not yet been reviewed by a licensed clinician.
- Last updated:
- 2026-08-27
This page is educational and is not a substitute for personalized medical advice. All treatment decisions are made by a licensed provider based on your individual evaluation.