Ketamine (Injection route)
The 100 mg/mL concentration of ketamine hydrochloride injection should not be injected intravenously without proper dilution. It is recommended the drug be diluted with an equal volume of either sterile water for injection, USP, sodium chloride (0.9%) injection, or 5% dextrose in water .
Uses of This Medicine:
Ketamine injection is used alone or together with other medicines to produce loss of consciousness before and during surgery or a medical procedure. It belongs to the group of medicines called general anesthetics.
Ketamine is given only by or under the immediate supervision of a medical doctor trained to use it. If you will be receiving ketamine during surgery, your doctor or anesthesiologist will give you the medicine and closely follow your progress.
Before Using This Medicine:
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of ketamine injection in children younger than 16 years of age. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ketamine injection in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving ketamine injection.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Morphine Sulfate Liposome
- St John's Wort
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems—
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Alcohol, excessive use or
- Brain disease or
- Drug abuse or dependence, history of or
- Heart disease or
- Hypertension (high blood pressure) or
- Respiratory depression (very slow breathing)—Use with caution. May make these conditions worse.
Proper Use of This Medicine:
A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given as a shot into a muscle or into a vein.
Precautions While Using This Medicine:
It is very important that your doctor check your progress very closely while you are receiving this medicine to see if it is working properly and to allow for a change in the dose. Your doctor will monitor your heart function, blood pressure, and breathing after receiving this medicine.
This medicine may make you dizzy, drowsy, or confused for several hours. It may also cause problems with your ability to think. If you have had outpatient surgery, you will need someone to drive you home.
This medicine may make you have unusual thoughts or behaviors after the surgery. You might feel confused or excited, or you might see or hear things that are not really there. You might feel as if you are dreaming while you are awake. Call your doctor if these thoughts or behaviors are severe or last longer than 24 hours.
Wait at least 24 hours after you receive this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are barbiturates or medicine for seizures or other anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are receiving this medicine.
Side Effects of This Medicine:
- Incidence not known
- Bloody or cloudy urine
- bluish lips or skin
- blurred vision
- chest pain or discomfort
- confusion as to time, place, or person
- difficult or troubled breathing
- difficult, burning, or painful urination
- difficulty with swallowing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fast, slow, or irregular heartbeat
- frequent urge to urinate
- holding false beliefs that cannot be changed by fact
- irregular, fast or slow, or shallow breathing
- not breathing
- pale or blue lips, fingernails, or skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- seeing, hearing, or feeling things that are not there
- shortness of breath
- skin rash
- tightness in the chest
- unusual excitement, nervousness, or restlessness
- unusual tiredness or weakness
- Incidence not known
- Double vision
- dream-like state
- flushing or redness of the skin
- loss of appetite
- pain at the injection site
- seeing double
- uncontrolled eye movements
- unusually warm skin
- weight loss
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Last Updated: 11/4/2014