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Inclusion on that list is not drug approval

doi:10.1074/jbc.275.5.3693

Because of the risk of serious adverse outcomes resulting from sedation and dissociation and respiratory depression caused by esketamine nasal spray administration, and the potential for abuse and misuse of the product, it is only available through a restricted distribution system under a Risk Evaluation and Mitigation Strategy (REMS)

If you are traveling for more than a few days, consider whether it makes more sense to bring lyophilized powder and reconstitute at your destination rather than trying to maintain a cold chain for reconstituted solution

Small bubbles from drawing doses are normal and resolve quickly

Its Phase 3 weight-loss figures (in the low-to-mid 20% range) and its late-2025 FDA filing belong to the combination product, not to standalone cagrilintide, which remains at the Phase 2 stage with a peer-reviewed monotherapy result of about 10.8% at 26 weeks