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