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