NRx Pharmaceuticals Refiles ANDA for KETAFREE™, a Preservative-Free IV Ketamine Formulation Amid Drug Shortage

• KETAFREE™ to provide innovative, preservative-free IV ketamine formulation, eliminating toxic preservatives, in keeping with current HHS priorities to eliminate toxic preservatives from foods and drugs
• Filing is based on FDA interaction and approval of Suitability Petition for NRx’s proposed strength of preservative-free ketamine
• This presentation of ketamine represents a reshoring of a strategically important drug to the US, in keeping with the Presidential Executive Order signed on May 5, 2025. Ketamine faces a current US drug shortage not expected to abate in the near future ¹
• Current ketamine market estimated at $750 million and projected to reach $3.35 billion globally in 2034. ² NRx anticipates marketing KETAFREE™ for currently approved ketamine indications
• The Company has filed a citizen’s petition with the FDA to remove benzethonium chloride, a known neurotoxic and cytotoxic substance, from all presentations of ketamine intended for intravenous use
• This formulation of ketamine is distinct from the formulation used in the ongoing NDA submission for NRX-100 in suicidal ideation in depressed patients, including bipolar depression, which was recently granted Fast Track designation by the FDA

WILMINGTON, Del., Sept. 29, 2025 (GLOBE NEWSWIRE) -- NRx Pharmaceuticals, Inc. (Nasdaq: NRXP), a clinical-stage biopharmaceutical company, today announced the re-filing of its Abbreviated New Drug Application (ANDA) to the U.S. Food and Drug Administration (FDA) for KETAFREE™, its preservative-free IV ketamine formulation, for use in all existing approved indications. The filing follows FDA grant of approval of its Suitability Petition for NRx’s proposed strength of preservative-free ketamine.

The current annual ketamine market is estimated at $750 million, with global demand for ketamine projected to grow to $3.35 billion by 2034. This does not include the widespread use of compounded ketamine by clinics unable to obtain manufactured drug. NRx aims to capture a significant share of the current market. According to a 2021 survey, an estimated 5.1 million Americans had received ketamine for medical uses in their lifetime ³ , a number that continues to grow with increased clinical focus on this important medication. Ketamine currently faces a severe drug shortage according to the American Society of Hospital Pharmacists. Accordingly, NRx is seeking priority review from FDA.

The Company previously filed a citizen’s petition with the FDA to remove benzethonium chloride (BZT), a known neurotoxic and cytotoxic substance, from presentations of ketamine intended for intravenous use. The FDA has previously disallowed the use of BZT in hand cleansers and topical antiseptics. A related preservative, benzalkonium chloride has demonstrated corneal and conjunctival toxicity in artificial tears and glaucoma medications, leading to use of preservative-free alternatives. NRx has filed expert testimony from accredited toxicologists regarding the toxicity of BZT, which is not generally recognized as safe (GRAS) by the FDA. Removal of potentially harmful preservatives from foods is a stated priority in the MAHA report and HHS leadership has additionally targeted preservatives in vaccines. BZT was originally added to ketamine when it was first formulated in the 1970s to maintain stability and sterility using the container closure systems then available. NRx has demonstrated long term stability and sterility with a patented preservative-free formulation using modern manufacturing methods.

Return of strategic drugs to US manufacture (Reshoring) is a current US priority as stated in a Presidential executive order issued on May 5, 2025. This initiative particularly applies to drugs that are critical for inpatient care, such as ketamine. The NRx product is manufactured in partnership with Nephron Pharmaceuticals of West Columbia, SC.

The formulation filed under the ANDA is distinct from that used in the New Drug Application (NDA), for which the Company has received Fast Track Designation for Treatment of Suicidal Ideation in Depression, including Bipolar Depression. The Company anticipates submitting clinical trial data from more than 1,000 patients and real-world data from more than 180,000 patients in which ketamine demonstrated superiority to placebo and active placebo, with noninferiority to electroconvulsive therapy. Should both the ANDA and the NDA be approved, the resulting commercial products would have different, non-substitutable product numbers and different commercial paths.

“We appreciate FDA’s rapid response to our suitability petition and look forward to advancing our preservative-free ketamine presentation to market,” said Jonathan Javitt, MD, MPH, Chairman and CEO of NRx Pharmaceuticals. “KETAFREE™ is designed to replace older formulations that rely on potentially neurotoxic and cytotoxic preservatives for stability and sterility, and to reshore the manufacture of a strategically-important drug to the US. We have filed a US patent on our novel, preservative-free formulation, which anticipates three years of room-temperature shelf stability.”

About NRx Pharmaceuticals, Inc.

NRx Pharmaceuticals, Inc. (www.nrxpharma.com), is a clinical-stage biopharmaceutical company developing therapeutics based on its NMDA platform for the treatment of central nervous system disorders, specifically suicidal depression, chronic pain, and PTSD. The Company is developing NRX-100 (preservative-free intravenous ketamine) and NRX-101 (oral D-cycloserine/lurasidone). NRX-100 has been awarded Fast Track Designation for the treatment of Suicidal ideation in Depression, including Bipolar Depression. NRX-101 has been awarded Breakthrough Therapy Designation for the treatment of suicidal bipolar depression. NRx has recently had a Suitability Petition granted, allowing re-filing of an Abbreviated New Drug Application (ANDA), and initiated a New Drug Application filing for NRX-100 with an application for the Commissioner’s National Priority Voucher Program for the treatment of suicidal depression.

About HOPE Therapeutics, Inc.

HOPE Therapeutics, Inc. ( www.hopetherapeutics.com ), a subsidiary of NRx Pharmaceuticals, is a Healthcare delivery company that is building a best-in-class network of interventional psychiatry clinics to offer ketamine, transcranial magnetics stimulation (TMS), and other lifesaving therapies to patients with suicidal depression and related disorders, together with a digital therapeutic-enabled platform designed to augment and preserve the clinical benefit of NMDA-targeted drug therapy.

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¹ https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=391
² https://www.factmr.com/report/injectable-ketamine-market
³ https://www.radars.org/system/publications/NMURx%20Ketamine%20Use%20Poster_fin2.pdf