Individual generic drug information

ketamine

Reference monograph

Part of registered formulation

KETAMINE

Reference record: Ketamine
Source: BNF 80 (2020–2021)
Printed source pages: 1437, 1438
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Ketamine only.

Indications And Dose

Induction and maintenance of anaesthesia for short procedures ▶BY INTRAMUSCULAR INJECTION ▶Adult: Initially 6.5–13 mg/kg, adjusted according to response, a dose of 10 mg/kg usually produces 12–25 minutes of surgical anaesthesia ▶BY INTRAVENOUS INJECTION ▶Adult: Initially 1–4.5 mg/kg, adjusted according to response, to be administered over at least 60 seconds, a dose of 2 mg/kg usually produces 5–10 minutes of surgical anaesthesia Diagnostic manoeuvres and procedures not involving intense pain ▶BY INTRAMUSCULAR INJECTION ▶Adult: Initially 4 mg/kg Induction and maintenance of anaesthesia for long procedures ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 0.5–2 mg/kg, using an infusion solution containing 1 mg/ml; maintenance 10–45 micrograms/kg/minute, adjusted according to response

Source page 1437

Contra Indications

Acute porphyrias p. 1120. eclampsia. head trauma. hypertension. pre-eclampsia. raised intracranial pressure. severe cardiac disease. stroke

Source page 1437

Cautions

Acute circulatory failure (shock). cardiovascular disease. dehydration. elderly. ﬁxed cardiac output. hallucinations. head injury. hypertension. hypovolaemia. increased cerebrospinal ﬂuid pressure. intracranial mass lesions. nightmares. predisposition to seizures. psychotic disorders. raised intra-ocular pressure . respiratory tract infection. thyroid dysfunction

Source pages 1437, 1438

Safety

Extracted information for Ketamine only.

Important Safety Information

Ketamine should only be administered by, or under the direct supervision of, personnel experienced in its use, with adequate training in anaesthesia and airway management, and when resuscitation equipment is available.

Source page 1437

Interactions

→Appendix 1: ketamine

Source page 1438

Side Effects

▶Common or very common Anxiety. behaviour abnormal. confusion. diplopia. hallucination. muscle tone increased . nausea. nystagmus. skin reactions. sleep disorders. tonic clonic movements. vomiting ▶Uncommon Appetite decreased. arrhythmias. hypotension . respiratory disorders ▶Rare or very rare Apnoea. cystitis. cystitis haemorrhagic. delirium. dysphoria. ﬂashback. hypersalivation ▶Frequency not known Drug-induced liver injury SIDE-EFFECTS, FURTHER INFORMATION Incidence of hallucinations can be reduced by premedicaton with a benzodiazepine (such as midazolam).

Source page 1438

Pregnancy

May depress neonatal respiration if used during delivery.

Source page 1438

Breast Feeding

Avoid for at least 12 hours after last Anaesthesia dose.

Source page 1438

Hepatic Impairment

Manufacturer advises caution (risk of prolonged duration of action). Dose adjustments Manufacturer advises consider dose reduction.

Source page 1438

Dose and formulations

Extracted information for Ketamine only.

Directions For Administration

For continuous intravenous infusion, dilute to a concentration of 1 mg/mL with Glucose 5% or Sodium Chloride 0.9%; use microdrip infusion for maintenance of anaesthesia. For intravenous injection, dilute 100 mg/mL strength to a concentration of not more than 50 mg/mL with Glucose 5% or Sodium Chloride 0.9% or Water for Injections.

Source page 1438

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: solution for injection Solution for injection ▶Ketamine (Non-proprietary) Ketamine (as Ketamine hydrochloride) 10 mg per 1 ml Ketamin 10 Curamed 50mg/5ml solution for injection ampoules | 10 ampoule P s b Ketamine (as Ketamine hydrochloride) 50 mg per 1 ml Ketamine 500mg/10ml solution for injection vials | 10 vial P £70.00 b | 10 vial P £70.00 (Hospital only) b Ketamin 100mg/2ml solution for injection ampoules | 10 ampoule P s b Ketamine 500mg/10ml solution for injection ampoules | 10 ampoule P £70.00 b ▶Ketalar (Pfizer Ltd) Ketamine (as Ketamine hydrochloride) 10 mg per 1 ml Ketalar 200mg/20ml solution for injection vials | 1 vial P £5.06 DT = £5.06 b Ketamine (as Ketamine hydrochloride) 50 mg per 1 ml Ketalar 500mg/10ml solution for injection vials | 1 vial P £8.77 DT = £8.77 b HYPNOTICS, SEDATIVES AND ANXIOLYTICS › NON-BENZODIAZEPINE HYPNOTICS AND SEDATIVES

Source page 1438

Clinical care

Extracted information for Ketamine only.

Patient And Carer Advice

Driving and skilled tasks Patients given sedatives and analgesics during minor outpatient procedures should be very carefully warned about the risk of driving or undertaking skilled tasks afterwards. For a short general anaesthetic the risk extends to at least 24 hours after administration. Responsible persons should be available to take patients home. The dangers of taking alcohol should also be emphasised. For information on 2015 legislation regarding driving whilst taking certain controlled drugs, including ketamine, see Drugs and driving under Guidance on prescribing p. 1.

Source page 1438

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

Initially 6.5–13 mg/kg, adjusted according to

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Adults

First line only; read the complete Indications and dose section above.

Initially 1–4.5 mg/kg, adjusted according to

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Adults

First line only; read the complete Indications and dose section above.

Initially 4 mg/kg

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Adults

First line only; read the complete Indications and dose section above.

Initially 0.5–2 mg/kg, using an infusion solution

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.

Individual generic drug information

ketamine

Reference monograph

Part of registered formulation

KETAMINE

Reference record: Ketamine
Source: BNF 80 (2020–2021)
Printed source pages: 1437, 1438
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Ketamine only.

Indications And Dose

Source page 1437

Contra Indications

Acute porphyrias p. 1120. eclampsia. head trauma. hypertension. pre-eclampsia. raised intracranial pressure. severe cardiac disease. stroke

Source page 1437

Cautions

Source pages 1437, 1438

Safety

Extracted information for Ketamine only.

Important Safety Information

Source page 1437

Interactions

→Appendix 1: ketamine

Source page 1438

Side Effects

Source page 1438

Pregnancy

May depress neonatal respiration if used during delivery.

Source page 1438

Breast Feeding

Avoid for at least 12 hours after last Anaesthesia dose.

Source page 1438

Hepatic Impairment

Manufacturer advises caution (risk of prolonged duration of action). Dose adjustments Manufacturer advises consider dose reduction.

Source page 1438

Dose and formulations

Extracted information for Ketamine only.

Directions For Administration

Source page 1438

Medicinal Forms

Source page 1438

Clinical care

Extracted information for Ketamine only.

Patient And Carer Advice

Source page 1438

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

Initially 6.5–13 mg/kg, adjusted according to

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Adults

First line only; read the complete Indications and dose section above.

Initially 1–4.5 mg/kg, adjusted according to

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Adults

First line only; read the complete Indications and dose section above.

Initially 4 mg/kg

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Adults

First line only; read the complete Indications and dose section above.

Initially 0.5–2 mg/kg, using an infusion solution

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 1437

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.