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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
This is a compounded oral solution containing ketamine hydrochloride, prepared to a prescriber's order for one patient. Compounded preparations are not FDA-approved. Ketamine is a Schedule III controlled substance.
These listings cover every salt or ester form of each drug in the FDA National Drug Code Directory.
FDA-approved products containing ketamine are listed in injection form. No ketamine product of any kind is listed in solution form.
Liquid bases can be aqueous or nonaqueous, and USP <795> classifies the preparation by its water activity. Aqueous preparations carry shorter default beyond-use dates than nonaqueous ones. The date printed on the label is the one to follow.
Ketamine is a dissociative anesthetic and NMDA receptor blocker, a Schedule III controlled substance, commonly compounded in topical creams, nasal sprays and oral preparations.
Ketamine is a nonbarbiturate dissociative anesthetic. It is a non-selective, non-competitive antagonist of the NMDA receptor, which carries excitatory glutamate signals in the nervous system; NMDA receptors are also found on peripheral nerve fibers, and their number increases with inflammation. The manufactured product is Ketalar (ketamine hydrochloride) injection, FDA-approved as the sole anesthetic agent for diagnostic and surgical procedures that do not require skeletal muscle relaxation, for induction of anesthesia before other general anesthetics, and as a supplement to other anesthetic agents. Ketamine is a Schedule III controlled substance.
A prescriber may order ketamine compounded when a patient needs a dosage form that is not manufactured, such as a topical cream applied over a painful area, a nasal spray or an oral solution, or a combination with other active ingredients. Compounded ketamine preparations are not FDA-approved and require a controlled-substance prescription.
The Ketalar label carries no boxed warning, but it warns of transient increases in blood pressure and heart rate, emergence reactions such as confusion, agitation or hallucinations, respiratory depression with overdose or rapid administration, liver injury with recurrent use, serious bladder problems including cystitis with long-term use or abuse, and raised pressure inside the skull. Ketamine can be misused, and physical dependence has been reported with prolonged use. Do not use ketamine if a significant rise in blood pressure would be dangerous for you or if you are allergic to it. A clinical review also advises avoiding ketamine in people with schizophrenia (StatPearls). Combining ketamine with benzodiazepines, opioids, alcohol or other sedating drugs can cause profound sedation, breathing problems, coma or death. Do not drive for at least 24 hours after a dose that affects you. The label states ketamine passes into breast milk and that use in nursing mothers should be limited to anesthesia; LactMed reports milk levels are very low and the risk to breastfed infants appears low. Tell your prescriber or pharmacist if you have heart, liver or bladder disease or a history of substance use. If you have trouble urinating, dark urine, yellowing skin, hallucinations or an irregular heartbeat, contact your prescriber or pharmacist right away.
Ketamine is a racemic cyclohexanone dissociative anesthetic acting as a non-competitive NMDA receptor antagonist, with HCN1 channel blockade, sigma receptor interaction and effects on BDNF and synaptogenesis also described. It is N-dealkylated to norketamine mainly by CYP2B6 and CYP3A4; norketamine is less potent at the NMDA receptor. The Ketalar label gives an alpha (distribution) half-life of 10 to 15 minutes and a beta (redistribution) half-life of about 2.5 hours. Bioavailability varies by route: intramuscular is high, intranasal roughly half, and oral substantially lower because of first-pass metabolism (StatPearls). In a review of compounded topical analgesics, plasma ketamine and norketamine were below the limit of detection after topical application, with peripheral NMDA receptors the proposed target (Cline and Turrentine, Dermatitis 2016).
Labeled indications: Ketalar injection for general anesthesia as above. Prescribers have ordered sub-dissociative ketamine off label for acute and chronic pain, treatment-resistant depression and refractory status epilepticus (StatPearls), and compounded topical ketamine, usually with other analgesics, for neuropathic pain; the evidence is largely small studies, one placebo-controlled trial of a low-strength cream was negative, and reviews describe it as low quality (Cline and Turrentine, Dermatitis 2016; Joseph, IJPC 2016). Dose, route and concentration are per prescriber. Monitor blood pressure, heart rate, mental status, urinary symptoms and liver function with repeated use. Ketamine is a DEA Schedule III controlled substance; every prescription must be issued and handled as a controlled-substance prescription. Electronic prescribing of controlled substances is voluntary under federal DEA rules, which still allow written and, for Schedule III to V, oral prescriptions. Separately, CMS requires prescribers to send at least 70 percent of their qualifying Medicare Part D controlled-substance prescriptions electronically each year, with exceptions, and a number of states mandate EPCS by law; where state rules are stricter, they control.
Measure each dose with the oral syringe or dosing cup provided, using the milliliter markings. Do not use household spoons. Take it by mouth as your label directs, with or without food as instructed. Rinse the measuring device after use and keep the bottle capped.
Oral solutions are aqueous. Under USP <795>, a preserved solution usually carries a beyond-use date of up to 35 days at room temperature or refrigerated, and an unpreserved one 14 days refrigerated. Your label shows whether to refrigerate and the beyond-use date. Keep out of reach of children and discard after that date.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Take orally
