esketamine + oxymetazoline

Esketamine + oxymetazoline refers to the combination of esketamine, an NMDA receptor antagonist approved for the treatment of treatment-resistant depression and depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior[2][5], and oxymetazoline, a nasal decongestant and alpha-adrenergic agonist. This combination is not an established marketed product but has been investigated as a regimen where oxymetazoline is administered prior to intranasal esketamine, especially in patients with allergic rhinitis, to potentially improve drug absorption through the nasal mucosa[4]. Esketamine acts on the central nervous system by inhibiting the NMDA receptor, while oxymetazoline constricts blood vessels in the nasal passages to reduce congestion. A clinical pharmacokinetic study showed that esketamine administered with oxymetazoline was well tolerated and the pharmacokinetics of esketamine were not meaningfully affected by oxymetazoline pretreatment[4].