Oral Ketamine for Chronic Pain: Towards an Evidence-Based Dosing Regimen

Oral ketamine benefits chronic pain, which may include allodynia and/or hyperalgesia, as deduced from various levels of evidence. Our evaluation suggests that oral ketamine has potential efficacy comparable to opioids for hyperalgesia and allodynia, and is generally well tolerated for chronic pain. Oral ketamine 0.5 mg/kg, when dosed 3 times daily for 7-90 days, can achieve efficacy with an acceptable safety profile. This dosage regimen helps inform a need for standardized, evidence-based oral ketamine dosing for clinical care and future research when used as a component of a multimodal regimen for chronic cancer and non-cancer pain.