Ketamine Hydrochloride 50 mg/mL (Ketamine Hydrochloride INJECTION, SOLUTION, CONCENTRATE) 50 mg/mL

Ketamine Hydrochloride 50 mg/mL is a general anesthetic that acts on the NMDA receptor pathway.

• Anesthesia: Induces and maintains general anesthesia for diagnostic and surgical procedures.
• Procedural Sedation: Used for procedural sedation where respiratory depression must be minimized.
• Analgesia: Provides analgesia during procedures.
• Treatment-Resistant Depression (Off-Label): Used off-label for treatment-resistant depression in clinical settings.

• Ketamine Hydrochloride 50 mg/mL works by antagonizing the NMDA (N-methyl-D-aspartate) receptor in the central nervous system. This action produces dissociative anesthesia and analgesia, characterized by a state of sedation, amnesia, and pain relief without significant respiratory depression. The drug also inhibits central and peripheral catecholamine reuptake, leading to cardiovascular stimulation.

Ketamine Hydrochloride 50 mg/mL can cause various side effects, ranging from common to serious.

Common Side Effects

• Confusion or a dream-like feeling.
• Drowsiness.
• Agitation or restlessness.
• Anxiety or nervousness.
• Increased blood pressure.
• Nausea or vomiting.
• Dizziness.
• Blurred vision.

Serious or Rare Side Effects

• Allergic reactions, such as skin rash, itching, hives, or swelling of the face, lips, tongue, or throat.
• CNS depression, including slow or shallow breathing, shortness of breath, or trouble staying awake.
• Hallucinations.
• Increased blood pressure.
• Liver injury, indicated by right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, or unusual weakness or fatigue.

Ketamine Hydrochloride 50 mg/mL should be used with caution and under medical supervision.

• Administration: Should be administered slowly over a period of 60 seconds to avoid respiratory depression and enhanced pressor response.
• Monitoring: Patients should be closely monitored for adverse reactions, especially during and after administration.
• Contraindications: Avoid use in patients with a history of psychosis, severe hypertension, or known hypersensitivity to ketamine.
• Pregnancy: Use during pregnancy should be carefully considered, as safety has not been established.
• Breastfeeding: Use with caution in breastfeeding women, as the effects on the infant are not well understood.
• Storage: Store at 20°C to 25°C (68°F to 77°F): Keep in the original packaging, protect from light, and do not freeze.

Ketamine Hydrochloride 50 mg/mL can interact with other medications, potentially altering its effects or increasing the risk of side effects.

Major Interactions (Avoid)

• Monoamine Oxidase Inhibitors (MAOIs): Can increase the risk of hypertensive crisis.
• Psychostimulants: Can enhance the stimulant effects of ketamine, leading to increased heart rate and blood pressure.
• Anticholinergics: Can increase the risk of CNS depression and anticholinergic effects.

Moderate Interactions (Monitor Closely)

• Benzodiazepines: Can enhance the sedative effects of ketamine.
• Opioids: Can increase the risk of respiratory depression.
• Antidepressants: Can increase the risk of serotonin syndrome.
• Antipsychotics: Can enhance the sedative and hypotensive effects of ketamine.