U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C13H16ClNO.C4H6O6.2H2O
Molecular Weight 423.843
Optical Activity ( + )
Defined Stereocenters 3 / 3
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of ESKETAMINE TARTRATE DIHYDRATE

SMILES

O.O.O[C@H]([C@@H](O)C(O)=O)C(O)=O.CN[C@@]1(CCCCC1=O)C2=C(Cl)C=CC=C2

InChI

InChIKey=XMQAQXCKQQMVLE-ILMXIRRWSA-N
InChI=1S/C13H16ClNO.C4H6O6.2H2O/c1-15-13(9-5-4-8-12(13)16)10-6-2-3-7-11(10)14;5-1(3(7)8)2(6)4(9)10;;/h2-3,6-7,15H,4-5,8-9H2,1H3;1-2,5-6H,(H,7,8)(H,9,10);2*1H2/t13-;1-,2-;;/m01../s1

HIDE SMILES / InChI

Description

Esketamine is an S(+)-enantiomer of ketamine. It is a nonselective, noncompetitive antagonist of N-methyl-D-aspartate (NMDA) receptor. A nasal spray, containing esketamine, was approved in 2019 for the treatment of treatment-resistant depression in adults, in conjunction with an oral antidepressant, and is marketed under tradename SPARAVATO. Esketamine is a schedule III drug product in the USA.

Approval Year

1970
63
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
153 ng/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/28100533/
0.7 mg/kg single, respiratory
dose: 0.7 mg/kg
route of administration: Respiratory
experiment type: SINGLE
co-administered:
NORKETAMINE, (S)- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
52 ng/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/28100533/
0.35 mg/kg single, respiratory
dose: 0.35 mg/kg
route of administration: Respiratory
experiment type: SINGLE
co-administered:
NORKETAMINE, (S)- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
97 ng/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/28100533/
0.5 mg/kg single, respiratory
dose: 0.5 mg/kg
route of administration: Respiratory
experiment type: SINGLE
co-administered:
NORKETAMINE, (S)- plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
2277.6 ng/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/31827320/
0.5 mg/kg single, intramuscular
dose: 0.5 mg/kg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
ESKETAMINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
128 ng/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/28100533/
0.35 mg/kg single, respiratory
dose: 0.35 mg/kg
route of administration: Respiratory
experiment type: SINGLE
co-administered:
ESKETAMINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
180 ng/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/28100533/
0.5 mg/kg single, respiratory
dose: 0.5 mg/kg
route of administration: Respiratory
experiment type: SINGLE
co-administered:
ESKETAMINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
227 ng/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/28100533/
0.7 mg/kg single, respiratory
dose: 0.7 mg/kg
route of administration: Respiratory
experiment type: SINGLE
co-administered:
ESKETAMINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
475.2 ng × h/mL
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/31827320/
0.5 mg/kg single, intramuscular
dose: 0.5 mg/kg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
ESKETAMINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
7.5 h
OTHER GOV
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
single, respiratory
 NORKETAMINE, (S)- plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
287.5 min
EXPERIMENT
https://pubmed.ncbi.nlm.nih.gov/31827320/
0.5 mg/kg single, intramuscular
dose: 0.5 mg/kg
route of administration: Intramuscular
experiment type: SINGLE
co-administered:
ESKETAMINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
11.1 h
OTHER GOV
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
single, respiratory
 ESKETAMINE plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
56%
REVIEW
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
ESKETAMINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Other AEs: Vomiting...
Other AEs:
Vomiting (3%)
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Other AEs: Dissociation, Dizziness...
Other AEs:
Dissociation (17%)
Dizziness (3%)
Dry mouth (7%)
Headache (23%)
Nasopharyngitis (7%)
Nausea (10%)
Oropharyngeal pain (3%)
Paresthesia (7%)
Vertigo (7%)
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Disc. AE: Depression, Blood pressure increased...
AEs leading to
discontinuation/dose reduction:
Depression (0.9%)
Blood pressure increased (0.6%)
Dizziness (0.6%)
Suicidal ideation (0.5%)
Dissociation (0.4%)
Nausea (0.4%)
Vomiting (0.4%)
Headache (0.3%)
Muscular weakness (0.3%)
Vertigo (0.2%)
Hypertension (0.2%)
Panic attack (0.2%)
Sedation (0.2%)
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant(oral)
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Disc. AE: Anxiety...
AEs leading to
discontinuation/dose reduction:
Anxiety (1.2%)
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
10 mg 1 times / day multiple, oral (starting)
Dose: 10 mg, 1 times / day
Route: oral
Route: multiple
Dose: 10 mg, 1 times / day
Sources:
https://pubmed.ncbi.nlm.nih.gov/31783823
unhealthy, adult
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: adult
Sex: M+F
Sources:
https://pubmed.ncbi.nlm.nih.gov/31783823
Sources:
https://pubmed.ncbi.nlm.nih.gov/31783823
28 mg single, intravenous
Dose: 28 mg
Route: intravenous
Route: single
Dose: 28 mg
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
Page: p. 43
unhealthy|healthy
n = 18
Health Status: unhealthy|healthy
Condition: treatment-resistant depression
Population Size: 18
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
Page: p. 43
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
Page: p. 43
84 mg single, oral
Dose: 84 mg
Route: oral
Route: single
Dose: 84 mg
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
Page: p. 43
unhealthy|healthy
n = 14
Health Status: unhealthy|healthy
Condition: treatment-resistant depression
Sex: M+F
Population Size: 14
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
Page: p. 43
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/211243Orig1s000ClinPharmR.pdf
Page: p. 43
AEs

AEs

AESignificanceDosePopulation
Vomiting 3%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Nausea 10%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Dissociation 17%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Headache 23%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Dizziness 3%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Oropharyngeal pain 3%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Dry mouth 7%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Nasopharyngitis 7%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Paresthesia 7%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Vertigo 7%
40 mg/kg 2 times / week multiple, intravenous
Dose: 40 mg/kg, 2 times / week
Route: intravenous
Route: multiple
Dose: 40 mg/kg, 2 times / week
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
unhealthy, 41.8 years (range: 11 - 63 years)
n = 11
Health Status: unhealthy
Condition: treatment resistant depression
Age Group: 41.8 years (range: 11 - 63 years)
Sex: M+F
Population Size: 11
Sources:
https://pubmed.ncbi.nlm.nih.gov/26707087
Hypertension 0.2%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Panic attack 0.2%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Sedation 0.2%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Vertigo 0.2%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Headache 0.3%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Muscular weakness 0.3%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Dissociation 0.4%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Nausea 0.4%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Vomiting 0.4%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Suicidal ideation 0.5%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Blood pressure increased 0.6%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Dizziness 0.6%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Depression 0.9%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Anxiety 1.2%
Disc. AE
56 mg 2 times / week steady, intranasal (starting)
Recommended
Dose: 56 mg, 2 times / week
Route: intranasal
Route: steady
Dose: 56 mg, 2 times / week
Co-administed with::
antidepressant(oral)
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
unhealthy, adult
Health Status: unhealthy
Condition: major depressive disorder
Age Group: adult
Sex: M+F
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG
substrate
1737

inducer
781

inhibitor
1587
substrate
1037
inhibitor
1612

OverviewOther

Other InhibitorOther SubstrateOther Inducer
CYP
111

UGT
35

P-gp
1461

BCRP
699

OATP1B1
788

OATP1B3
706

OAT1
599

OAT3
642

OCT2
647

MATE1
306

MATE2
263
CYP2B6
664

CYP2C19
991

P-gp
1537

BCRP
561

OATP1B1
406

OATP1B3
350

OAT1
326

OAT3
339

OCT1
327

OCT2
355
CYP2B6
547

CYP1A2
701
Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
CYP2B6
1001
 modest
no (co-administration study)
Comment: administration with bupropion (substrate): activity of hepatic CYP2B6 was not altered
Page: 33,34
CYP3A4
1925
 modest
weak (co-administration study)
Comment: twice-a-week dosing of nasal esketamine (84 mg) reduced the AUClast and AUC?? of probe CYP3A substrate Reference ID: 4397019 35 midazolam by a mean of 18% and 16%, respectively;
Page: 33,35
BCRP
773
 no
CYP
147
 no
CYP1A2
1692
 no
MATE1
308
 no
MATE2
263
 no
OAT1
603
 no
OAT3
644
 no
OATP1B1
803
 no
OATP1B3
715
 no
OCT2
648
 no
P-gp
1650
 no
UGT
59
 no
CYP3A4
1925
 yes [IC50 1.92 uM]
noresketamine
3
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
CYP2B6
664
 major
weak (co-administration study)
Comment: pretreatment with ticlopidine (inhibitor) had no effect on the mean esketamine Cmax following a 56-mg nasal dose, whereas the AUC of esketamine was increased by 29%; Cmax, AUClast, and AUCinf of esketamine were approximately 17%, 31%, and 28% lower, respectively, when subjects were pretreated with rifampicin (inducer);
Page: 33,36,37
CYP3A4
1737
 major
weak (co-administration study)
Comment: esketamine Cmax and AUCinf were increased by 11% and 4%, respectively, when coadministered with clarithromycin; Cmax, AUClast, and AUCinf of esketamine were approximately 17%, 31%, and 28% lower, respectively, when subjects were pretreated with rifampicin (inducer);
Page: 33,36,37
CYP2C19
991
 minor
CYP2C9
1037
 minor
BCRP
561
 no
OAT1
326
 no
noresketamine
3
OAT3
339
 no
noresketamine
3
OATP1B1
406
 no
OATP1B3
350
 no
OCT1
327
 no
noresketamine
3
OCT2
355
 no
noresketamine
3
P-gp
1537
 no
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
hERG
1647
Sourcing

Sourcing

Vendor/AggregatorIDURL
ChEBI
CHEBI:60799
https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:60799
ZINC
ZINC000035999642
http://zinc15.docking.org/substances/ZINC000035999642
PubMed

PubMed

TitleDatePubMed
Determination of absolute configuration of ketamine enantiomers by HPLC-CD-UV technique.
1999
Stereoselective interaction of ketamine with recombinant mu, kappa, and delta opioid receptors expressed in Chinese hamster ovary cells.
1999 Jan
Name Type Language
ESKETAMINE TARTRATE DIHYDRATE
Common Name English
Cyclohexanone, 2-(2-chlorophenyl)-2-(methylamino)-, (S)-, (2R,3R)-2,3-dihydroxybutanedioate (1:1), dihydrate
Systematic Name English
(S)-Ketamine monotartrate dihydrate
Common Name English
Code System Code Type Description
CAS
133358-55-1
Created by admin on Sat Dec 16 19:53:49 GMT 2023 , Edited by admin on Sat Dec 16 19:53:49 GMT 2023
PRIMARY
FDA UNII
K7FP5N62WR
Created by admin on Sat Dec 16 19:53:49 GMT 2023 , Edited by admin on Sat Dec 16 19:53:49 GMT 2023
PRIMARY
PUBCHEM
168429545
Created by admin on Sat Dec 16 19:53:49 GMT 2023 , Edited by admin on Sat Dec 16 19:53:49 GMT 2023
PRIMARY
NIH
NCATS
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