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Ketamine

Dissociativeintranasal (insufflated) · inferred

NMDA receptor antagonist and dissociative anesthetic. Rapidly metabolized by CYP3A4/CYP2B6 to norketamine (active, ~1/3 potency). Also approved as esketamine nasal spray for treatment-resistant depression. Effects last 45-90 min (IM/IV). Oral bioavailability ~17%.

Projected serum levels — 50 mg, as needed (shown daily)

Ketamine
Ketamine modeled serum levels, 50 mg as needed (shown daily) over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 5 10 15 20 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1

Maintenance schedule: 50 mg as needed (shown daily) (intranasal (insufflated)).

Modeled steady state after ~1 days: peak ≈ 19.9 mg, trough ≈ 0.32 mg body load. Population-based estimate over 15 days for a 50 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Dissociative
Route modeled
Intranasal (insufflated)
Model confidence
inferred
Half-life
2.5 h
Common dose
50 mg
Reference dose range
25–100 mg (single dose)
Suggested cadence
as needed (shown daily)

Documented interactions

  • danger
    1,4-BDO (1,4-Butanediol) + Ketamine Contraindicated

    1,4-BDO converts to GHB. Stacked with ketamine's dissociation and CNS depression, increases risk of respiratory depression, vomiting, and aspiration during unconsciousness.

  • danger
    Carbamazepine (Tegretol) + Ketamine CYP induction

    Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Ketamine AUC by ~0.43x

  • danger
    Cocaine + Ketamine Stacked effects

    Cocaine and Ketamine both push the DAT, NET, and sigma 1 in the same direction.

  • danger
    Dextromethorphan (DXM) + Ketamine Stacked effects

    Dextromethorphan (DXM) and Ketamine both push the mu opioid, nmda, and sigma 1 in the same direction.

  • danger
    Efavirenz (Sustiva) + Ketamine CYP induction

    Efavirenz (Sustiva) inducer of CYP3A4 predicted to change Ketamine AUC by ~0.30x

  • danger
    Esketamine (Spravato) + Ketamine Stacked effects

    Esketamine (Spravato) and Ketamine both push the mu opioid, nmda, and sigma 1 in the same direction.

Serum checks 126 modeled interaction pairings for ketamine across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Pharmacokinetics of Ketamine and Its Major Metabolites Norketamine, Hydroxynorketamine, and Dehydronorketamine: A Model-Based Analysis Kamp J et al. · British Journal of Anaesthesia, 2020 DOI

    Population PK model of ketamine and metabolites after IV administration, characterizing norketamine formation via CYP3A4/CYP2B6 and subsequent hydroxylation pathways.

  2. Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) Mion G, Villevieille T · CNS Neuroscience & Therapeutics, 2013 DOI

    Comprehensive review of ketamine pharmacology including 2-3 hour elimination half-life, high clearance of 1000-1600 mL/min, and norketamine as the primary active metabolite.

  3. Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Zanos P et al. · Pharmacological Reviews, 2018 DOI

    Landmark review establishing that hydroxynorketamine metabolites may mediate antidepressant effects independently of NMDA receptor blockade, reframing ketamine therapeutic mechanism.

3 published studies referenced in the app, each with a plain-language summary.