1 May 2026Injectable drugs
Ketamine injectable
Ketamine injectable guidance for induction and maintenance of general anaesthesia.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
General anaesthetic.
Indications
Induction and maintenance of general anaesthesia.
Forms and strengths, route of administration
- 250 mg in 5 ml ampoule (50 mg/ml) for IM injection, IV injection, or infusion.
Dose
Child and adult
Induction:
- IV: 2 mg/kg injected slowly. Anaesthesia is produced within one minute and lasts 10 to 15 minutes.
- IM: 8 to 10 mg/kg. Anaesthesia is produced within 5 minutes and lasts 15 to 30 minutes.
- Maintenance: IV 0.5 to 1 mg/kg depending on recovery signs, approximately every 15 minutes.
- Maintenance: IM 5 mg/kg approximately every 20 to 30 minutes.
Duration
Depending on the duration of the operation.
Contra-indications, adverse effects, precautions
- Do not administer to patients with intraocular hypertension or pre-eclampsia.
- Administer with caution to patients with arterial or intracranial hypertension, coronary insufficiency, or psychiatric disorders.
- May cause hypertension, hypersalivation, hallucinations during recovery, and apnoea following rapid IV injection.
- Premedication to prevent hypersalivation and hallucinations: atropine IV 0.01 to 0.015 mg/kg plus diazepam slow IV 0.1 mg/kg during induction, or atropine IM 0.01 to 0.015 mg/kg plus diazepam IM 0.1 mg/kg 30 minutes before induction.
- Technical equipment for intubation and ventilation must be available and ready for use.
- Pregnancy: no contra-indication except in pre-eclampsia. For caesarean sections, do not exceed 1 mg/kg by IV injection.
- Breast-feeding: no contra-indication.
- Ketamine has no muscle relaxant properties.
- In some countries ketamine is on the list of narcotics: follow national regulations.
- Also comes in a 10 ml ampoule containing 500 mg (50 mg/ml).
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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