Ketamine Dosage

Generic name: ketamine
Brand name: Ketalar
Drug class: General anesthetics

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  INJ

General anesthesia induction

[IV route]

Dose: 1-4.5 mg/kg/dose IV x1; Info: onset 30sec, duration 5-10min for 2 mg/kg dose; give adjuvant antisialagogue and benzodiazepine

[IM route]

Dose: 6.5-13 mg/kg/dose IM x1; Info: onset 3-4min, duration 12-25min for 10 mg/kg dose; give adjuvant antisialagogue and benzodiazepine

General anesthesia maintenance

[0.1-0.5 mg/min IV]

Alt: 0.5-4.5 mg/kg/dose IV prn; 3.25-13 mg/kg/dose IM prn; Info: give adjuvant benzodiazepine prn

Pain, mod-severe acute

[IV route]

Dose: 0.1-0.35 mg/kg/dose IV x1; Alt: 0.1-1 mg/kg/h IV prn; Info: refer to institution protocols

[intranasal route]

Dose: 0.5-1 mg/kg/dose intranasally x1, may repeat 0.25-0.5 mg/kg/dose intranasally x1 after 10-15min if no response; Info: refer to institution protocols; use injectable form w/ mucosal atomization device; divide dose and give as 1 spray in each nostril

Pain, mod-severe chronic

[IV route]

Dose: 0.5-2 mg/kg/h IV; Alt: 0.1-0.35 mg/kg/dose IV x1; Info: duration, frequency varies, refer to institution protocols; consider test dose 80 mg IV x1 over 2h

[intranasal route]

Dose: 10 mg intranasally q90sec prn up to 50 mg total dose; Alt: 25 mg intranasally q6h prn; Info: refer to institution protocols; use injectable form w/ mucosal atomization device; divide dose and give as 1 spray in each nostril

Renal dosing

renal impairment: no adjustment

HD/PD: not defined

Hepatic dosing

[not defined]

hepatic impairment: caution advised

Recommended Peds Dosing

Dosage forms:  INJ

General anesthesia induction

[*IV route, 3 mo-15 yo]

Dose: 1-3 mg/kg/dose IV x1

[IV route, 16 yo and older]

Dose: 1-4.5 mg/kg/dose IV x1; Info: onset 30sec, duration 5-10min for 2 mg/kg dose; give adjuvant antisialagogue and benzodiazepine

[*IM route, 3 mo-15 yo]

Dose: 5-10 mg/kg/dose IM x1

[IM route, 16 yo and older]

Dose: 6.5-13 mg/kg/dose IM x1; Info: onset 3-4min, duration 12-25min for 10 mg/kg dose; give adjuvant antisialagogue and benzodiazepine

general anesthesia maintenance

[*3 mo-15 yo]

Dose: 0.5-3 mg/kg/dose IV prn; Alt: 1-5 mg/kg/h IV

[16 yo and older]

Dose: 0.1-0.5 mg/min IV; Alt: 0.5-4.5 mg/kg/dose IV prn; 3.25-13 mg/kg/dose IM prn; Info: give adjuvant benzodiazepine prn

*Sedation, procedural

[IV route, 3 mo and older]

Dose: 1.5-2 mg/kg/dose IV x1; Info: onset 0.5-2min, duration 5-60min; may give 0.5-1 mg/kg/dose IV prn q5-15min after initial dose; consider adjuvant antisialagogue and benzodiazepine

[IM route, 3 mo and older]

Dose: 4-5 mg/kg/dose IM x1; Info: onset 3-10min, duration 15-90min; may give 2-4 mg/kg/dose IM x1 10min after initial dose; consider adjuvant antisialagogue and benzodiazepine; IV route preferred

[intranasal route, 3 mo and older]

Dose: 3-6 mg/kg/dose intranasally x1; Start: 5-20min before procedure; Info: use injectable form w/ mucosal atomization device; divide dose and give as 1 spray in each nostril

[PO route, 3 mo and older]

Dose: 5-6 mg/kg/dose PO x1; Info: mix injectable form in beverage; onset 15-45min, duration 30-120min; consider adjuvant antisialagogue and benzodiazepine; IV route preferred

Renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

Hepatic dosing

[not defined]

hepatic impairment: caution advised

SRC: NLM .