Ketamine Capsule

Ketamine Capsules
Usage
Ketamine capsules are a compounded oral formulation used in selected patients for pain management and certain psychiatric conditions under specialist supervision. While ketamine is traditionally used as an anaesthetic, oral formulations are used for off-label therapeutic purposes.
They may be prescribed for:
• Chronic neuropathic pain
• Complex regional pain syndrome (CRPS)
• Treatment-resistant depression (specialist use)
• Other practitioner-directed uses where NMDA receptor modulation is beneficial
Use should be restricted to experienced prescribers with appropriate monitoring.

Dosage
Dosage should be individualised and carefully titrated by the prescribing practitioner based on the indication and patient response.
Typical dosing considerations include:
• Administered once to several times daily, depending on treatment goals
• Usually started at a low dose and gradually increased
• Capsules may be taken with or without food
• Close monitoring is required during dose titration
Patients should follow the prescriber’s instructions strictly and should not adjust the dose independently.

Mechanisms of Action
Ketamine is a dissociative anaesthetic and NMDA receptor antagonist.
Its mechanisms include:
NMDA receptor antagonism
Ketamine blocks N-methyl-D-aspartate (NMDA) receptors, reducing excitatory glutamate activity.
Modulation of pain pathways
This helps reduce central sensitisation and neuropathic pain signalling.
Effects on mood and neuroplasticity
Ketamine may enhance synaptic plasticity and modulate neurotransmitters involved in mood regulation.
Rapid antidepressant effects
In certain settings, ketamine can produce rapid improvement in depressive symptoms.

Contraindications
Ketamine capsules should not be used in patients with:
• Hypersensitivity to ketamine or any component of the formulation
• Conditions where increased blood pressure may be hazardous
• Certain psychiatric conditions (e.g., uncontrolled psychosis)
• Situations where ketamine use is not clinically appropriate

Precautions
Ketamine should be used with caution in patients with:
• Cardiovascular disease (e.g., hypertension, heart disease)
• Psychiatric disorders, including anxiety or psychosis
• Hepatic impairment
• History of substance misuse
Additional considerations include:
• May cause dissociation, dizziness, sedation, or altered perception
• Risk of misuse or dependence
• Avoid driving or operating machinery after dosing
• Monitor for changes in mood, cognition, or blood pressure
• Long-term use may be associated with bladder or liver effects
Patients should seek medical advice if they experience severe confusion, hallucinations, chest pain, or urinary symptoms.

Storage
• Store below 25°C unless otherwise directed
• Keep capsules in a tightly closed container
• Protect from heat, moisture, and direct light
• Store securely due to potential for misuse
• Keep out of reach of children and pets
Patients should follow the storage instructions provided on the dispensing label supplied by the pharmacy.