TABLE 1.
Relevant doses and plasma concentrations of ketamine for its clinical use and side effects in humans
| Clinical Uses and Side Effects | Route of Administration | Ketamine Dose | Plasma Cmax | References |
|---|---|---|---|---|
| Clinical effects | ||||
| General anesthesia | Intravenous | 1.0–2 mg/kg | 1200–2400 ng/ml; 5–10 μM | Sussman (1974), Clements et al. (1982), Idvall et al. (1983), Malaquin (1984), Malinovsky et al. (1996), Dachs and Innes (1997), Yanagihara et al. (2003), Weber et al. (2004), Craven (2007), Gao et al. (2016) |
| Intramuscular | 4–11 mg/kg | |||
| Rectal | 8–10.6 mg/kg | |||
| Oral | 500 mg (max)—sedation | |||
| Intranasal | For (S)-ketamine: 3–9 mg/kg | N/R | Weber et al. (2004), Huge et al. (2010), Reid et al. (2011) | |
| Analgesia | Intravenous | 0.15 mg/kg | 70–160 ng/ml; 0.29–0.67 μM | Grant et al. (1981), Clements et al. (1982), Hirlinger and Dick (1984), Weksler et al. (1993), Eide et al. (1995), Malinovsky et al. (1996), Stubhaug et al. (1997), Lauretti et al. (1999), Azevedo et al. (2000), Flood and Krasowski (2000), Tanaka et al. (2000), Carr et al. (2004), Marchetti et al. (2015) |
| Intramuscular | 0.5–1 mg/kg | |||
| Intranasal | 2 × 10–50 mg | |||
| Transdermal | 25 mg released throughout a 24-hour period | |||
| Subcutaneous | 0.05–0.15 mg/kg per hour for 7 days | |||
| Rectal | 10 mg/kg | |||
| Oral | 2 mg/kg | |||
| 0.5 mg/kg | 45 ± 10 ng/ml; 0.19 ± 0.04 μM | Grant et al. (1981) | ||
| Anti-inflammation | Intravenous | 0.15–0.25 mg/kg | N/R | Roytblat et al. (1998), Beilin et al. (2007), Russabrov et al. (2008) |
| Antidepressant | Intravenous | 0.5 mg/kg; 40-min infusion | 185 ng/ml; 0.78 μM | Zarate et al. (2006) |
| Side effects | ||||
| Dissociation | Intravenous | 0.5 mg/kg; 40-min infusion | 100–250 ng/ml; 0.42–1.1 μM | Krystal et al. (1994) |
| Psychotomimetic effects in subjects with schizophrenia | Intravenous | 0.3 mg/kg bolus | 120 ng/ml; 0.5 μM | Lahti et al. (2001) |
| 0.12 mg/kg bolus followed by a 60-min infusion of 0.65 mg/kg (total dose 0.77 mg/kg) | N/R | Malhotra et al. (1997) | ||
| Cognitive and memory impairment | Intravenous | 40- to 120-min infusion of 0.4–0.8 mg/kg | N/R | Malhotra et al. (1996), Newcomer et al. (1999), Morgan et al. (2004), Mathew et al. (2010) |
| 0.5 mg/kg bolus | 350 ng/ml; 1.5 μM | Pfenninger et al. (2002) | ||
| infusion over length of testing (total dose variable) | N/R | Harris et al. (1975), Driesen et al. (2013) | ||
| Intramuscular | 0.25–0.5 mg/kg bolus | N/R | Ghoneim et al. (1985) | |
| Abuse (recreational use) | Intravenous | 1–2 mg/kg | N/R | Siegel (1978), Dalgarno and Shewan (1996), Jansen (2000), Arditti et al. (2002), Wolff and Winstock (2006), Bokor and Anderson (2014) |
| Intramuscular | 50–150 mg | |||
| Oral | 100–500 mg | |||
| Intranasal | 30–400 mg |
N/R, not reported.