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