How long does Spravato stay in your system?
Spravato's active ingredient, esketamine, has a half-life of about 7 to 12 hours, so most of a dose has left your body within a couple of days. The effects you feel are shorter still: they ease within the two hours you rest with us, and you can drive again the next day after a night's sleep.
What is the half-life of Spravato?
The half-life of Spravato is about 7 to 12 hours, meaning the amount of esketamine in your blood halves in that time after the first sharp drop (Spravato Prescribing Information). Levels peak 20 to 40 minutes after the spray and fall quickly from there.
| Time after your dose | What's happening |
|---|---|
| 20 to 40 minutes | Blood levels peak. This is when you feel the effects most. |
| About 2 hours | Levels have dropped a long way. Most people feel close to themselves and go home. |
| 7 to 12 hours | The terminal half-life: half of what remains is cleared. |
| About 2 to 3 days | Most of the dose has been cleared from your body. |
Pharmacokinetics from the SPRAVATO® (esketamine) Prescribing Information. Clearance varies from person to person.
What affects how fast Spravato leaves your body?
Your liver does most of the work: it breaks esketamine down into a by-product called noresketamine, which clears a little more slowly, and very little leaves your body unchanged (Spravato Prescribing Information). A few things shift the timing:
- Liver health. With moderate liver disease, esketamine stays in the blood longer, so we may watch you for longer after each dose. Spravato isn't recommended with severe liver disease.
- Age. Blood levels run higher in older adults, which is one reason we watch everyone for the full two hours.
- The dose. An 84 mg dose leaves more to clear than 56 mg. Spravato dosage.
Does Spravato show up on a drug test?
Spravato usually doesn't show up on a standard workplace drug test, because most standard panels don't look for ketamine. A test designed to detect ketamine can pick up esketamine for a few days after a dose. If you're tested, tell the tester you're prescribed Spravato. If you need it, we'll give you a letter confirming your treatment for a drug test or your employer.
A positive result for a prescribed medicine isn't a failed test.
Spravato is an FDA-approved prescription given in a certified office, with every dose recorded. That record is what a medical review officer looks for.
Which drug tests can detect Spravato?
- Standard workplace panels: usually not. Ketamine typically isn't part of a standard drug screen.
- Expanded panels that include ketamine: yes, for a few days after a dose, because esketamine is a form of ketamine.
- Confirmation tests: a lab can confirm what was found, and your prescription explains it.
The manufacturer reports no published cases of Spravato causing a false positive for a different drug (J&J Medical Information, urine drug screen response).
What should you tell the tester?
Tell the tester, or the medical review officer who reads the result, that you're prescribed Spravato (esketamine), and give them our office's name and number, (908) 450-7002. You don't have to explain your diagnosis to your employer. If you're having surgery or a procedure, tell that team about your treatment schedule too.
When can you drive after Spravato?
You can drive after Spravato the next day, after a night's sleep. That rule is stricter than the clearance numbers alone suggest, because alertness takes a little longer to return than the blood levels do. Driving and getting home.
Can you work or drink after Spravato?
After your first treatment or two, most of our patients find they don't need much rest and go back to their usual day, apart from driving. Take it easy on your first treatment days. Skip alcohol on treatment days, since it adds to the sleepiness, and tell us about any other medicines you take. Spravato and your other medications.
Why short-lived effects are the point.
Spravato's side effects are temporary: they stay inside the two hours you rest with us, then most people go home feeling like themselves. A daily antidepressant stays in your system around the clock, and so can its side effects. With Spravato, the benefit builds across the course of treatment while each dose clears within days.
30 doses
Every day.
Side effectsEvery single day: sedation, dry mouth, sexual side effects, weight gain.
8 visits
Twice a week.
4 visits
Down to once a week.
2–4 visits a month
Down to once a week or every other week. Dashed: weeks you may or may not need.
Side effectsMostly gone by the end of each visit.
Ask us about tests, work or travel.
Call us with your situation and a member of our team will walk you through it.
Name, date of birth and insurer. We check your plan and call you back. No commitment.
Check my coverageRegister once, and our team starts your insurance check and reaches out to schedule your evaluation.
Request an evaluationWhat people ask about Spravato and their system.
How long does Spravato stay in your system?
Most of a Spravato dose is cleared within about two to three days. The half-life of esketamine is about 7 to 12 hours.
Will Spravato make me fail a drug test?
Usually not on a standard panel, which doesn't test for ketamine. A ketamine-specific test can detect it for a few days. Tell the tester it's prescribed.
How long do Spravato's effects last?
The effects you feel ease within the two hours you rest in our office. Some people feel tired afterward in their first sessions; after that, most people get on with their day.
How long is Spravato detectable in urine?
Usually a few days after a dose, and only on a test that looks for ketamine. Most standard workplace panels don't.
Can you give me a letter for my employer or a drug test?
Yes. On request, we provide a letter confirming you're being treated with Spravato.
Does Spravato show up as ketamine on a drug test?
On a test designed to find ketamine, yes, because esketamine is a form of ketamine. Your prescription accounts for the result.
Does Spravato build up in your body?
No. Each dose is cleared within days, which is why the schedule is twice a week to start and then less often.