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