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