ketamine Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |
| Stem definition | Drug id | CAS RN |
|---|---|---|
| 1523 | 6740-88-1 |
Description:
| Molecule | Description |
|---|---|
|
Synonyms:
|
A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.
Legend: OFP - off patent OFM - off market ONP - on patent |
Drug dosage:
None
ADMET properties:
| Property | Value | Reference |
|---|---|---|
| BDDCS (Biopharmaceutical Drug Disposition Classification System) | 1 | Benet LZ, Broccatelli F, Oprea TI |
| S (Water solubility) | 200 mg/mL | Benet LZ, Broccatelli F, Oprea TI |
| EoM (Fraction excreted unchanged in urine) | 4 % | Benet LZ, Broccatelli F, Oprea TI |
| MRTD (Maximum Recommended Therapeutic Daily Dose) | 8.41 µM/kg/day | Contrera JF, Matthews EJ, Kruhlak NL, Benz RD |
| BA (Bioavailability) | 20 % | Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H |
| Vd (Volume of distribution) | 2.90 L/kg | Lombardo F, Berellini G, Obach RS |
| CL (Clearance) | 19 mL/min/kg | Lombardo F, Berellini G, Obach RS |
| fu (Fraction unbound in plasma) | 0.47 % | Lombardo F, Berellini G, Obach RS |
| t_half (Half-life) | 2.80 hours | Lombardo F, Berellini G, Obach RS |
Approvals:
| Date | Agency | Company | Orphan |
|---|---|---|---|
| Feb. 19, 1970 | FDA | PAR STERILE PRODUCTS |
FDA Adverse Event Reporting System (Female)
| MedDRA adverse event term | Likelihood ratio | Likelihood ratio threshold | Patients taking drug having adverse event | Patients taking drug not having adverse event | Patients not taking drug having adverse event | Patients not taking drug not having adverse event |
|---|---|---|---|---|---|---|
| Drug abuse | 274.43 | 70.45 | 73 | 861 | 11953 | 2345198 |
| Dilatation intrahepatic duct acquired | 268.02 | 70.45 | 34 | 900 | 54 | 2357097 |
| Hydronephrosis | 241.14 | 70.45 | 44 | 890 | 1223 | 2355928 |
| Anaphylactic shock | 230.67 | 70.45 | 52 | 882 | 4234 | 2352917 |
| Haematuria | 187.35 | 70.45 | 44 | 890 | 4274 | 2352877 |
| Hypercapnia | 163.80 | 70.45 | 28 | 906 | 524 | 2356627 |
| Hepatotoxicity | 148.39 | 70.45 | 35 | 899 | 3446 | 2353705 |
| Bronchospasm | 147.91 | 70.45 | 34 | 900 | 2990 | 2354161 |
| Hypotension | 147.85 | 70.45 | 58 | 876 | 32378 | 2324773 |
| Cardiac arrest | 121.32 | 70.45 | 41 | 893 | 14889 | 2342262 |
| Venoocclusive liver disease | 121.21 | 70.45 | 22 | 912 | 586 | 2356565 |
| Biliary dilatation | 118.96 | 70.45 | 20 | 914 | 336 | 2356815 |
| Drug ineffective | 117.88 | 70.45 | 71 | 863 | 101553 | 2255598 |
| Acute kidney injury | 106.14 | 70.45 | 44 | 890 | 28078 | 2329073 |
| Sterile pyuria | 103.18 | 70.45 | 12 | 922 | 3 | 2357148 |
| Respiratory acidosis | 102.27 | 70.45 | 20 | 914 | 801 | 2356350 |
| Lung hyperinflation | 100.67 | 70.45 | 15 | 919 | 109 | 2357042 |
| Respiratory depression | 98.57 | 70.45 | 23 | 911 | 2147 | 2355004 |
| Blood lactic acid increased | 95.49 | 70.45 | 19 | 915 | 832 | 2356319 |
| Blood pH decreased | 92.87 | 70.45 | 17 | 917 | 474 | 2356677 |
| Reduced bladder capacity | 92.25 | 70.45 | 11 | 923 | 6 | 2357145 |
| Airway peak pressure increased | 90.55 | 70.45 | 12 | 922 | 31 | 2357120 |
| Bladder disorder | 90.27 | 70.45 | 19 | 915 | 1102 | 2356049 |
| Foetal growth restriction | 89.95 | 70.45 | 19 | 915 | 1121 | 2356030 |
| PCO2 increased | 87.32 | 70.45 | 14 | 920 | 172 | 2356979 |
| Oliguria | 86.65 | 70.45 | 19 | 915 | 1338 | 2355813 |
| Hepatocellular injury | 84.29 | 70.45 | 23 | 911 | 4032 | 2353119 |
| Bladder hypertrophy | 83.99 | 70.45 | 11 | 923 | 25 | 2357126 |
| Cardio-respiratory arrest | 81.61 | 70.45 | 27 | 907 | 9119 | 2348032 |
| PO2 decreased | 79.73 | 70.45 | 14 | 920 | 306 | 2356845 |
| Blood bicarbonate decreased | 79.69 | 70.45 | 15 | 919 | 488 | 2356663 |
| Intra-abdominal pressure increased | 76.89 | 70.45 | 10 | 924 | 21 | 2357130 |
| Pollakiuria | 76.64 | 70.45 | 21 | 913 | 3735 | 2353416 |
| Off label use | 76.12 | 70.45 | 48 | 886 | 73550 | 2283601 |
| Venoocclusive disease | 75.37 | 70.45 | 13 | 921 | 255 | 2356896 |
| Liver function test abnormal | 74.44 | 70.45 | 24 | 910 | 7466 | 2349685 |
| Pneumatosis | 74.29 | 70.45 | 11 | 923 | 76 | 2357075 |
| Respiratory rate increased | 73.71 | 70.45 | 17 | 917 | 1503 | 2355648 |
| Lower urinary tract symptoms | 72.66 | 70.45 | 9 | 925 | 10 | 2357141 |
| Cystitis | 72.46 | 70.45 | 22 | 912 | 5620 | 2351531 |
| Propofol infusion syndrome | 71.32 | 70.45 | 11 | 923 | 103 | 2357048 |
| Unwanted awareness during anaesthesia | 70.63 | 70.45 | 10 | 924 | 48 | 2357103 |
FDA Adverse Event Reporting System (Male)
| MedDRA adverse event term | Likelihood ratio | Likelihood ratio threshold | Patients taking drug having adverse event | Patients taking drug not having adverse event | Patients not taking drug having adverse event | Patients not taking drug not having adverse event |
|---|---|---|---|---|---|---|
| Drug abuse | 442.65 | 64.05 | 121 | 815 | 13568 | 1732277 |
| Hydronephrosis | 234.26 | 64.05 | 47 | 889 | 1298 | 1744547 |
| Toxicity to various agents | 185.04 | 64.05 | 76 | 860 | 29065 | 1716780 |
| Anaphylactic shock | 182.68 | 64.05 | 44 | 892 | 2855 | 1742990 |
| Cystitis | 176.33 | 64.05 | 37 | 899 | 1274 | 1744571 |
| Hypotension | 140.51 | 64.05 | 63 | 873 | 29591 | 1716254 |
| Drug screen positive | 131.54 | 64.05 | 28 | 908 | 1029 | 1744816 |
| Cholestasis | 124.37 | 64.05 | 34 | 902 | 3631 | 1742214 |
| Cystitis ulcerative | 113.73 | 64.05 | 14 | 922 | 3 | 1745842 |
| Cystitis interstitial | 94.89 | 64.05 | 13 | 923 | 23 | 1745822 |
| Bladder disorder | 93.85 | 64.05 | 19 | 917 | 541 | 1745304 |
| Cardiac arrest | 91.82 | 64.05 | 39 | 897 | 15891 | 1729954 |
| Biliary dilatation | 91.26 | 64.05 | 16 | 920 | 203 | 1745642 |
| Bradycardia | 89.07 | 64.05 | 34 | 902 | 10500 | 1735345 |
| Drug ineffective | 83.08 | 64.05 | 58 | 878 | 63743 | 1682102 |
| Biopsy bladder abnormal | 81.33 | 64.05 | 10 | 926 | 2 | 1745843 |
| Contracted bladder | 79.40 | 64.05 | 11 | 925 | 22 | 1745823 |
| Bronchospasm | 78.41 | 64.05 | 21 | 915 | 2061 | 1743784 |
| Delirium | 77.85 | 64.05 | 27 | 909 | 6335 | 1739510 |
| Accidental death | 74.83 | 64.05 | 15 | 921 | 405 | 1745440 |
| Intentional product misuse | 74.01 | 64.05 | 27 | 909 | 7331 | 1738514 |
| Respiratory depression | 72.19 | 64.05 | 20 | 916 | 2227 | 1743618 |
| Anaphylactic reaction | 71.15 | 64.05 | 25 | 911 | 6088 | 1739757 |
| Hepatocellular injury | 69.28 | 64.05 | 21 | 915 | 3210 | 1742635 |
| Reduced bladder capacity | 69.11 | 64.05 | 9 | 927 | 8 | 1745837 |
| Drug interaction | 65.44 | 64.05 | 37 | 899 | 27921 | 1717924 |
Pharmacologic Action:
| Source | Code | Description |
|---|---|---|
| ATC | N01AX03 | NERVOUS SYSTEM ANESTHETICS ANESTHETICS, GENERAL Other general anesthetics |
| FDA PE | N0000175975 | General Anesthesia |
| FDA EPC | N0000175681 | General Anesthetic |
| MeSH PA | D000700 | Analgesics |
| MeSH PA | D000777 | Anesthetics |
| MeSH PA | D000778 | Anesthetics, Dissociative |
| MeSH PA | D018686 | Anesthetics, Intravenous |
| CHEBI has role | CHEBI:38877 | intravenous anaesthetic |
| CHEBI has role | CHEBI:35480 | analgesic |
| MeSH PA | D002491 | Central Nervous System Agents |
| MeSH PA | D002492 | Central Nervous System Depressants |
| MeSH PA | D018691 | Excitatory Amino Acid Antagonists |
| MeSH PA | D018377 | Neurotransmitter Agents |
| MeSH PA | D018373 | Peripheral Nervous System Agents |
| MeSH PA | D018689 | Sensory System Agents |
Drug Use (View source of the data)
| Disease | Relation | SNOMED_ID | DOID |
|---|---|---|---|
| General anesthesia | indication | 50697003 | |
| Local anesthesia | indication | 386761002 | |
| Major depressive disorder | off-label use | 370143000 | |
| Delirium | contraindication | 2776000 | |
| Ocular hypertension | contraindication | 4210003 | DOID:9282 |
| Alcoholism | contraindication | 7200002 | |
| Myocardial infarction | contraindication | 22298006 | DOID:5844 |
| Alcohol intoxication | contraindication | 25702006 | |
| Hypertensive disorder | contraindication | 38341003 | DOID:10763 |
| Decreased respiratory function | contraindication | 80954004 | |
| Thyrotoxicosis | contraindication | 90739004 | DOID:7997 |
| Acute disease of cardiovascular system | contraindication | 128487001 | |
| Decompensated cardiac failure | contraindication | 195111005 | |
| Cerebrovascular accident | contraindication | 230690007 | |
| Raised intracranial pressure | contraindication | 271719001 | DOID:9428 |
| Cerebral trauma | contraindication | 275382005 | |
| Impaired cognition | contraindication | 386806002 | |
| Myocardial ischemia | contraindication | 414795007 | DOID:3393 |
| Hypertensive urgency | contraindication | 443482000 | |
| Cardiac Decompensation | contraindication | ||
| Psychiatric Disturbance | contraindication |
Acid dissociation constants calculated using MoKa v3.0.0
| Dissociation level | Dissociation constant | Type (acidic/basic) |
|---|---|---|
| pKa1 | 7.65 | Basic |
Orange Book patent data (new drug applications)
None
Orange Book exclusivity data (new drug applications)
None
Bioactivity Summary:
| Target | Class | Pharos | UniProt | Action | Type | Activity value (-log[M]) | Mechanism action | Bioact source | MoA source |
|---|---|---|---|---|---|---|---|---|---|
| Glutamate [NMDA] receptor | Ion channel | BLOCKER | Ki | 6.38 | CHEMBL | CHEMBL | |||
| Glutamate receptor ionotropic AMPA | Ion channel | OPENER | SCIENTIFIC LITERATURE | SCIENTIFIC LITERATURE | |||||
| Glutamate NMDA receptor | Ion channel | IC50 | 6.21 | CHEMBL | |||||
| Acetylcholine receptor subunit alpha | Ion channel | IC50 | 5.31 | CHEMBL |
External reference:
| ID | Source |
|---|---|
| 4019796 | VUID |
| N0000147885 | NUI |
| C0022614 | UMLSCUI |
| D00711 | KEGG_DRUG |
| 690G0D6V8H | UNII |
| 2156 | INN_ID |
| 333847008 | SNOMEDCT_US |
| 6130 | RXNORM |
| 373464007 | SNOMEDCT_US |
| d00272 | MMSL |
| 4019796 | VANDF |
| 004581 | NDDF |
| 3821 | PUBCHEM_CID |
| CHEBI:6121 | CHEBI |
| CHEMBL742 | ChEMBL_ID |
| CHEMBL1714 | ChEMBL_ID |
| 1867-66-9 | SECONDARY_CAS_RN |
| DB01221 | DRUGBANK_ID |
| D007649 | MESH_DESCRIPTOR_UI |
| 4233 | IUPHAR_LIGAND_ID |
Pharmaceutical products:
| Product | Category | Ingredients | NDC | Form | Quantity | Route | Marketing | Label |
|---|---|---|---|---|---|---|---|---|
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 0143-9508 | INJECTION | 50 mg | INTRAMUSCULAR | ANDA | 14 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 0143-9509 | INJECTION | 100 mg | INTRAMUSCULAR | ANDA | 14 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 0409-2051 | INJECTION, SOLUTION, CONCENTRATE | 100 mg | INTRAMUSCULAR | ANDA | 14 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 0409-2053 | INJECTION, SOLUTION, CONCENTRATE | 50 mg | INTRAMUSCULAR | ANDA | 14 sections |
| Ketalar | HUMAN PRESCRIPTION DRUG LABEL | 1 | 42023-113 | INJECTION | 10 mg | INTRAMUSCULAR | NDA | 14 sections |
| Ketalar | HUMAN PRESCRIPTION DRUG LABEL | 1 | 42023-114 | INJECTION | 50 mg | INTRAMUSCULAR | NDA | 14 sections |
| Ketalar | HUMAN PRESCRIPTION DRUG LABEL | 1 | 42023-115 | INJECTION | 100 mg | INTRAMUSCULAR | NDA | 14 sections |
| KETALAR | HUMAN PRESCRIPTION DRUG LABEL | 1 | 52584-037 | INJECTION | 10 mg | INTRAVENOUS | NDA | 14 sections |
| KETAMINE HYDROCHLORIDE | HUMAN PRESCRIPTION DRUG LABEL | 1 | 52584-038 | INJECTION, SOLUTION, CONCENTRATE | 50 mg | INTRAMUSCULAR | ANDA | 14 sections |
| KETAMINE HYDROCHLORIDE | HUMAN PRESCRIPTION DRUG LABEL | 1 | 52584-040 | INJECTION, SOLUTION, CONCENTRATE | 100 mg | INTRAMUSCULAR | ANDA | 14 sections |
| KETAMINE HYDROCHLORIDE | HUMAN PRESCRIPTION DRUG LABEL | 1 | 52584-108 | INJECTION, SOLUTION | 100 mg | INTRAVENOUS | ANDA | 14 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 54868-4399 | INJECTION, SOLUTION, CONCENTRATE | 50 mg | INTRAMUSCULAR | ANDA | 13 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 67457-001 | INJECTION, SOLUTION | 50 mg | INTRAVENOUS | ANDA | 14 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 67457-108 | INJECTION, SOLUTION | 100 mg | INTRAVENOUS | ANDA | 14 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 67457-181 | INJECTION, SOLUTION | 10 mg | INTRAVENOUS | ANDA | 14 sections |
| MKO Melt Dose Pack | HUMAN PRESCRIPTION DRUG LABEL | 2 | 71384-410 | TROCHE | 25 mg | SUBLINGUAL | unapproved drug other | 2 sections |
| MKH Dose Pack | HUMAN PRESCRIPTION DRUG LABEL | 3 | 71384-420 | TROCHE | 25 mg | SUBLINGUAL | unapproved drug other | 2 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 72572-320 | INJECTION | 50 mg | INTRAMUSCULAR | ANDA | 14 sections |
| Ketamine Hydrochloride | HUMAN PRESCRIPTION DRUG LABEL | 1 | 72572-321 | INJECTION | 100 mg | INTRAMUSCULAR | ANDA | 14 sections |