Dosing

Dosing for ketamine varies greatly depending on the route of administration and the specific goals of treatment. However, it is essential to note that a qualified healthcare professional should always determine your dosages based on your needs and medical history. The dose that produces the best response for each patient can only be determined by titrating the patient from lower to higher doses and observing the response.

Never vary your doses without consulting your provider and modifying your treatment plan.

Note that doses are intertwined with bioavailability, as the amount of ketamine introduced to the body ultimately results in the risk present to the bladder. Lower doses of ketamine are more bioavailable depending on their delivery means. Lower doses mean less ketamine and its metabolites reach the bladder, reducing the risk of harm. Here are some general guidelines for low, medium, and high doses of ketamine for various routes of administration:

Intravenous (IV):

• Low: 0.1-0.45 mg/kg
• Medium: 0.45-0.7 mg/kg
• High: 0.7-1.0 mg/kg

Intramuscular (IM):

• Low: 0.12-0.6 mg/kg
• Medium: 0.6-0.85 mg/kg
• High: 0.85-1.4 mg/kg

Subcutaneous:

• Low: 0.5-1 mg/kg
• Medium: 1-3 mg/kg
• High: 3-5 mg/kg

Nasal spray: (varies depending on the concentration of the solution)

• Low: 2-3 sprays (approximately 20-30 mg)
• Medium: 4-6 sprays (about 40-60 mg)
• High: 7-9 sprays (about 70-90 mg)

Troche:

• Low: 50-75 mg
• Medium: 100-150 mg
• High: 200-300 mg

Rapid dissolve tablets:

• Low: 50-75 mg
• Medium: 100-150 mg
• High: 200-300 mg

Suppository:

• Low: 50-75 mg
• Medium: 100-150 mg
• High: 200-300 mg

Transdermal:

• Low: 25-50 mg
• Medium: 50-100 mg
• High: 100-200 mg

Nebulization:

• Low: 25-50 mg
• Medium: 50-100 mg
• High: 100-200 mg

Please note that these are general guidelines, and individual dosing will vary. A patient new to ketamine will respond more strongly to lower doses than a patient undergoing some length of the treatment period. A qualified healthcare professional should always determine and administer the exact dosages based on a patient’s needs and medical history.

Williams, N. R., Heifets, B. D., Blasey, C., Sudheimer, K., Pannu, J., Pankow, H., … & Schatzberg, A. F. (2018). Attenuation of antidepressant effects of ketamine by opioid receptor antagonism. American Journal of Psychiatry, 175(12), 1205-1215. Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2018.18020138

Domino, E. F., Chodoff, P., & Corssen, G. (1965). Pharmacologic Effects of CI-581,a New Dissociative Anesthetic, in Man. Clinical Pharmacology & Therapeutics, 6(3), 279-291. Retrieved from https://pubmed.ncbi.nlm.nih.gov/14293576/