Oral Ketamine

[Tramadeezy]

Anyone with much experience with this for neuropathic pain syndromes? Is it well tolerated by patient's at low doses i.e 25-50mg? I have a lot of experience with IV Ketamine for various pain syndromes but haven't tried the oral preparation. I have a couple of patient's with refractory CRPS and was thinking of trialing oral Ketamine, curious about yall's thoughts. Thanks.

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[Aether2000]

Short acting for chronic pain- needs to be dosed 3-4 times a day in some cases, and there is a fine line between pain relief and hallucinations. Range 25-150 mg/day

 

[Orin]

I had a patient who was put on oral tablets postoperatively on the West coast.

They tolerated it but weren't very impressed. I keep thinking to try it but the need for compounding, bioavailability, side effect profile, and abusability make me hold off in most cases.

The bioavailability of ketamine is about 20% orally and about 30% sublingually but most folks dose 1:1 with an IV dosage. Depending on if you feel they're benefiting from the ketamine or norketamine, you'll end up dosing q4h - q12h. Most people seem to start at 10 - 20 mg PO q8h and titrate q3d.

 

[jettavr6]

Compounded caps 10-25mg max 100mg/daily work ok in certain patients. Start on the lower side.

 

[Ferrismonk]

If you really want to venture into it, I had a patient referred to me who was vaping the powder...