Ketanest-S Multi-Dose

Esketamine, the active ingredient in Ketanest‑S Multi‑Dose, is a NMDA receptor antagonist presented as an injectable solution (multi‑dose vial) for intramuscular and intravenous use. It provides rapid dissociative anesthesia for induction of general anesthesia and procedural sedation in patients undergoing surgical or diagnostic procedures and is used by anesthesiologists to achieve controlled unconsciousness.

GNH USA supplies Ketanest‑S Multi‑Dose as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, clinics and surgical centres worldwide, ensuring quality and regulatory compliance across global markets.

Esketamine acts on the NMDA receptor pathway to produce dissociative anesthesia, making it suitable for the following clinical applications:

Induction of anesthesia: Provides rapid onset of unconsciousness and analgesia for surgical procedures. Procedural sedation: Enables safe, controlled sedation for diagnostic or minor therapeutic interventions. Emergency airway management: Facilitates rapid sequence induction when conventional agents are contraindicated.

Common Side Effects: - Dizziness or light‑headedness - Nausea and occasional vomiting - Increased blood pressure or heart rate - Transient visual disturbances or vivid dreams - Mild headache - Sense of dissociation or altered perception

Serious or Rare Side Effects: - Severe hypertension or hypertensive crisis - Respiratory depression requiring airway support - Emergence reactions such as agitation or hallucinations - Laryngospasm or airway obstruction - Seizure activity

Esketamine requires careful monitoring and specific safety measures before and during administration: - Cardiovascular monitoring: Observe blood pressure and heart rate continuously. - Airway assessment: Ensure airway patency and be prepared for assisted ventilation. - Contraindication in uncontrolled hypertension: Avoid use in patients with severe hypertension. - Caution in psychiatric history: Use with vigilance in patients with schizophrenia or severe mood disorders. - Avoid concurrent use with other NMDA antagonists or potent CNS depressants. - Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Esketamine may interact with several drug classes, requiring attention to dosing and monitoring:

Major Interactions (Avoid): - Concurrent use with other general anesthetics that depress respiration (e.g., propofol, opioids). - Co‑administration with monoamine oxidase inhibitors (MAOIs) due to risk of hypertensive crisis. - Strong CYP2B6 inhibitors (e.g., clopidogrel) that may increase esketamine plasma levels.

Moderate Interactions (Monitor Closely): - CYP3A4 inducers or inhibitors that can alter metabolism (e.g., rifampin, ketoconazole). - Antihypertensive agents that may blunt blood‑pressure elevations. - Serotonergic drugs that could potentiate central nervous system effects.