ketamine

Pronunciation

Generic Name: ketamine (KET a meen)
Brand Name: Ketalar

What is ketamine?

Ketamine is an anesthetic medication.

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.

What is the most important information I should know about ketamine?

You should not receive ketamine if you have untreated or uncontrolled hypertension (high blood pressure).

Do not use ketamine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

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Tell your caregivers at once if you have any of these serious side effects within 24 hours after you receive ketamine: severe confusion, hallucinations, unusual thoughts, or extreme fear.

What should I discuss with my health care provider before receiving ketamine?

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

Do not use ketamine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure ketamine is safe for you, tell your doctor if you have:

  • heart disease;

  • high blood pressure;

  • a history of alcoholism; or

  • if you recently drank large amounts of alcohol.

Ketamine may be habit forming and should be used only by the person for whom it was prescribed.

Ketamine may be harmful to an unborn baby. Before you receive ketamine, tell your doctor if you are pregnant.

It is not known whether ketamine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is ketamine given?

Ketamine is injected into a muscle, or into a vein through an IV. You will receive this injection in a clinic or hospital setting.

Your breathing, blood pressure, heart function, and other vital signs will be watched closely while you are receiving ketamine.

You may feel strange or slightly confused when you first come out of anesthesia. Tell your caregivers if these feelings are severe or unpleasant.

You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Since ketamine is usually given for anesthesia, you are not likely to be on a dosing schedule.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur. Your vital signs will be closely watched while you are under anesthesia to make sure the medication is not causing any harmful effects.

What should I avoid after receiving ketamine?

This medicine may impair your thinking or reactions. You will probably not be allowed to drive yourself home after your surgery or medical procedure. Avoid driving or operating machinery for at least 24 hours after you have received ketamine.

Follow your doctor's instructions about any restrictions on food, beverages, or activity after you recover from anesthesia.

Ketamine side effects

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

Tell your caregivers at once if you have any of these serious side effects within 24 hours after you receive ketamine: severe confusion, hallucinations, unusual thoughts, or extreme fear.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • slow heart rate, weak or shallow breathing;

  • pain or burning when you urinate; or

  • jerky muscle movements that may look like convulsions.

Common side effects may include:

  • dream-like feeling;

  • blurred vision, double vision;

  • mild dizziness, drowsiness;

  • nausea, vomiting, loss of appetite; or

  • sleep problems (insomnia).

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.

See also: Side effects (in more detail)

Ketamine dosing information

Usual Adult Dose for Anesthesia:

Parenteral:

Intravenous:

Induction: 1 to 4.5 mg/kg; alternatively, 1 to 2 mg/kg at a rate of 0.5 mg/kg/min may be used. (2 mg/kg dose provides 5 to 10 minutes of surgical anesthesia within 30 seconds following injection).

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.

Intramuscular:

Induction: 6.5 to 13 mg/kg; (9 to 13 mg/kg dose provides 12 to 25 minutes of surgical anesthesia within 3 to 4 minutes following injection).

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.

What other drugs will affect ketamine?

If you are using any drugs that make you sleepy or slow your breathing, it may take you longer to recover from anesthesia with ketamine. This includes a sedative or sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with ketamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about ketamine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03. Revision Date: 2014-03-13, 12:03:31 PM.

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