Ketamine

Generic name: ketamine (KET a meen)
Brand name: Ketalar
Dosage forms: injectable solution (10 mg/mL; 10 mg/mL-NaCl 0.9%; 100 mg/mL; 50 mg/5 mL-NaCl 0.9%; 50 mg/mL); intravenous solution (1 mg/mL-NaCl 0.9%; 10 mg/mL-NaCl 0.9%; 100 mg/10 mL-NaCl 0.9%; 50 mg/mL)
Drug class: General anesthetics

Ketamine is used to put you to sleep for surgery and to prevent pain and discomfort during certain medical tests or procedures.

Ketamine may also be used for purposes not listed in this medication guide.

Warnings

Tell your caregivers if you have hallucinations or unusual thoughts while waking up from anesthesia.

Before taking this medicine

You should not be treated with ketamine if you are allergic to it, or if you have untreated or uncontrolled hypertension (high blood pressure).

Tell your doctor if you have ever had:

  • heart disease;
  • high blood pressure;
  • liver disease;
  • alcoholism; or
  • if you drink large amounts of alcohol.

Tell your doctor if you are pregnant or breastfeeding.

Anesthesia may affect brain development in a young child or unborn baby (when used in the mother), leading to learning or behavior problems later in life. Long surgeries or repeated procedures pose the highest risks.

Anesthesia may still be necessary for a life-threatening condition, medical emergency, or surgery to correct a birth defect. Your doctor can give inform you about all medicines given during a surgery or procedure.

Ask a doctor if it is safe to breastfeed shortly after you receive ketamine.

How is ketamine given?

Ketamine is injected into a muscle or a vein. A healthcare provider will give you this injection.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely.

You may feel strange or confused when you awake from anesthesia. Tell your caregivers if these feelings are severe or unpleasant.

What happens if I miss a dose?

Ketamine is used as a single dose and does not have a daily dosing schedule.

What happens if I overdose?

In a medical setting an overdose would be treated quickly.

What should I avoid after receiving ketamine?

ketamine may impair your thinking or reactions for several hours. Avoid driving or operating machinery for at least 24 hours after you receive ketamine.

Ketamine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers if you have hallucinations or unusual thoughts while waking up from anesthesia.

Call your doctor at once if you have:

  • painful or difficult urination, increased urination, loss of bladder control, blood in your urine;
  • a light-headed feeling, like you might pass out;
  • slow heart rate, weak or shallow breathing; or
  • jerky muscle movements that may look like convulsions.

Common side effects may include:

  • confusion; or
  • dream-like feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ketamine dosing information

Usual Adult Dose for Anesthesia:

IV:
-Induction: 1 to 4.5 mg/kg IV; alternatively, 1 to 2 mg/kg IV at a rate of 0.5 mg/kg/min; (2 mg/kg dose provides 5 to 10 minutes of surgical anesthesia within 30 seconds)
-Maintenance: The maintenance dose should be adjusted according to the patient's anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.

IM:
-Induction: 6.5 to 13 mg/kg IM; (9 to 13 mg/kg IM provides 12 to 25 minutes of surgical anesthesia)
-Maintenance: The maintenance dose should be adjusted according to the patient's anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.

Comments:
-This drug should be administered slowly over a period of 60 seconds (more rapid administration may result in respiratory depression and enhanced pressor response).
-The larger the total dose, the longer will be complete recovery.
-Because of rapid induction following the initial IV injection, the patient should be in a supported position during administration.

Usual Pediatric Dose for Anesthesia:

16 years and older: See adult dosing

What other drugs will affect ketamine?

It may take you longer to recover from anesthesia if you use other drugs that make you sleepy or slow your breathing. This includes opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Other drugs may affect ketamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.