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Metabolism Ketamine is metabolized by using N-dealkylation to the active metabolite norketamine principally by CYP2B6 and CYP3A4 also to a lesser extent by other CYP enzymes. Norketamine undergoes hydroxylation of the cyclohexone ring to kind hydroxynorketamine compounds by using CYP-dependent pathways, which are conjugated with glucuronic acid and