Ketamine

  • Reference Number: HEY-695/2015
  • Departments: Pain Medicine

Introduction

This leaflet has been produced to give you general information regarding the drug ketamine.  Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is ketamine and what is it used for?

Ketamine is an anaesthetic medication, which in very small doses can be used to help control pain that has not responded to standard treatment. Ketamine is started on the advice of a specialist managing your care.

How do I take ketamine?

Your pain care consultant will discuss the best way for you to take ketamine. Where possible, ketamine is given as a liquid medicine by mouth. Most patients take ketamine three or four times a day.

Can I take other medicines together with ketamine?

You should take ketamine in addition to your current medications unless told otherwise. Ketamine is started at a low dose and increased gradually to minimise any side effects. Before you take or buy any new medicines, including herbal remedies, tell your doctor or pharmacist that you are taking ketamine and ask for their advice.

Where should I keep my ketamine?

Ketamine should be stored out of the reach of children, in a cool place away from sunlight.

This medicine is only for you, therefore never give it to anyone else, as it may harm them, even if their symptoms are the same as yours. Any unused medication should be returned to the hospital pharmacy for safe disposal.

How long will I need to take ketamine?

This will depend on why you are taking ketamine and how your pain responds to treatment. You can continue to take ketamine for as long as it helps your pain, if you are not having any side effects. It may be necessary for your doctor to change the dose during your treatment.

Are there side effects from taking ketamine?

Everyone reacts differently to medication. Some side effects of ketamine are listed below but you may not experience any of these. It is advisable to report any side effects to your doctor.

  • Vivid dreams, nightmares, mood swings, hallucinations or feeling restless.
    These symptoms can often be helped with the addition of other medications, enabling you to continue using ketamine without experiencing these side effects.
  • High blood pressure and fast pulse rate. The doctor will monitor your blood pressure and pulse rate when you start treatment and then as needed.

It is recognised that long term ketamine use may cause memory problems and permanent bladder damage in a small minority of patients.

What do I do if I forget to take a regular dose of ketamine?

You should take a missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your medication as normal. Do not try to ‘double up’ to make up for your missed dose.

How do I get a new prescription of ketamine?

Prescriptions are only issued by consultants employed within the pain service. You may have a trial period with ketamine for a period of four weeks followed by a “washout” period of two weeks without ketamine, in order to assess the effect.

Your ketamine liquid can only be supplied by the hospital so you will need to pick it up from the Pharmacy, either at Hull Royal Hospital or Castle Hill Hospital. If you need to arrange a new prescription, you can contact the Pain Clinic on (01482) 624198.

Can I drink alcohol?

Drinking alcohol with ketamine can make you drowsy so it is not advised. Remember alcohol, even in small amounts, whilst taking ketamine could greatly increase the likelihood that your driving will be impaired.

Can I drive?

There is a new Drug Driving Law that came into force in March 2015. This drug driving law directly affects ketamine. The new law states that it is an offence to drive if you have over the specified limits of certain drugs in your body, whether your driving is impaired or not.

You could be committing an offence driving with ketamine in your system unless you are:

  1. Taking the medication in accordance with provided information or advice given by the prescriber.
  2. AND your driving is NOT impaired by your medication.
    The law will then provide you with a “medical defence” and you will not be breaking the law.

If you are taking a prescribed medication and it impairs your driving, then you are not fit to drive and will be breaking the law if you do so.

If you are stopped by the police, roadside screening devices will be used to show if you are drug driving. This will involve giving a saliva sample and if your saliva tests positive, a blood sample may be needed.

If you give a positive sample and you are taking your medicine as directed by the prescriber or a healthcare professional and your driving is NOT impaired, then you are NOT breaking the law and you can raise a “medical defence”.

Consider keeping some evidence with you to show you have been prescribed the medicines and the dose you take. Please take care when deciding what to use as evidence as it may have your personal details on it.

Further information on Drug driving: https://www.gov.uk/drug-driving-law

Additional information

Please speak to your pain care consultant who has recommended ketamine treatment. You can also speak to the Pharmacy staff when collecting your ketamine.

Who should I contact if I need advice urgently about my ketamine?

If you have any queries do not hesitate to contact the pain clinic Monday to Friday 9:00am till 4:00pm.

Pain Clinic
Hull and East Yorkshire Hospitals NHS Trust
or
Pain Service
Outpatient Department
East Riding Community Hospital,
Hull and East Yorkshire
Beverley
Tel:- (01482) 478868

Outside the normal pain clinic hours (Monday to Friday 9:00am till 4:00pm) you can contact your own GP within their working hours.

Out of these hours, if you have any queries, contact NHS111 and inform them that you are taking ketamine. They will then be able to contact the medicine consultant on duty for advice.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.