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Metabolism Ketamine is metabolized through N-dealkylation to the Energetic metabolite norketamine mainly by CYP2B6 and CYP3A4 and to a lesser extent by other CYP enzymes. Norketamine undergoes hydroxylation from the cyclohexone ring to form hydroxynorketamine compounds by means of CYP-dependent pathways, which are conjugated with glucuronic acid an