Prolonged use of ketamine, a drug prescribed for anesthesia or used in case of stubborn pain in palliative care, “leads to serious liver and uronephrological damage” alerts the National Agency for the Safety of Medicines and Health Products (ANSM) in its news of August 30, 2023.
⚠️#Ketamine | Faced with the increase in its consumption and the serious complications linked to prolonged or repeated use, medical or diverted, we recall the rules of its #Good use
➕ information: https://t.co/1HzsFJ4x1R pic.twitter.com/Y9dOFSjYuD
—ANSM (@ansm) August 30, 2023
Ketamine: the ANSM notes an increase in its use
This information is released as health authorities note an overall increase in the use of ketamine as well as an increase in the number of cases of disorders related to prolonged use of ketamine. Specifically, it is an increase in the number:
- hepatobiliary disorders (such as cholestasis or cholangitis),
- uro-nephrological (non-infectious cystitis, interstitial cystitis, acute renal failure, hydronephrosis).
Similarly, the ANSM notes an increase in the use of these treatments outside the marketing authorization. According to health authorities, this use is particularly noticeable in the in the management of chronic pain, including fibromyalgia.
As a reminder, ketamine “is a narcotic whose prescription is limited to 28 days, written in full on a secure prescription”, whose use must be hospital, as recalled by the ANSM.
Ketamine: what are the ANSM recommendations?
Faced with these data, the ANSM recommends that health professionals respect the dosages and limit exposure over time. Similarly, for patients who have taken repeated and prolonged use of ketamine, the ANSM recommends “monitor liver function closely”. The health authorities call for various examinations such as a complete liver test or the analysis of gamma-glutamyl transferase, known by the abbreviation GGT. The list of examinations can be found on the ANSM website. The patient’s renal function and urine cytology (the presence of abnormal substance in the urine) should be monitored.
Likewise, the authorities believe that “the occurrence of hepatobiliary and/or uro-nephrological damage should suggest repeated use of ketamine in a medical or non-medical setting (festive or sexual use – chemsex practice)”.
In the context of a prescription, the health authorities call for limiting the prescription to 28 days and writing it in full on a secure prescription. Similarly, in the case where the treatment is carried out at the patient’s home, the ampoules must be stored in a locked and secure place. Unused ampoules must be returned to the pharmacy.
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