What is Ketamine?
Take a tour of our accredited compounding labs.
Ketamine Dosage Forms
Ketamine can be compounded into different dosage forms depending on dosage form, indication, and patient-specific response.
Compare Dosage Forms
Ketamine Dosage Form Comparison
Compare commonly used dosage forms across bioavailability, onset, dosing, storage, and key considerations at T&C.
| Category | Nasal Spray | Sublingual Four-Scored Troches | Sublingual Mini Troches | Rapid Dissolve Tablet (RDT) | Oral / Sublingual Solution | Oral Capsule |
|---|---|---|---|---|---|---|
| T&C Dosage Form Highlights | Nasal Spray Pros Flexible titration option for patients. It does not require office administration as the commercial product does. Cons Skills for using nasal spray may be difficult for some patients. | Sublingual Four-Scored Troches Pros One troche may be cut into four pieces for flexible dosing – allowing for easy titration, and can hold higher strength of drug than mini troches. | Sublingual Mini Troches Pros Very small, dissolves quickly. Cons It cannot be cut and is limited to lower doses of the drug per troche due to size. | Rapid Dissolve Tablet (RDT) Pros One tablet may be cut into four pieces for flexible dosing – allowing for easy titration. Dissolves fast, and can hold higher strength of drug than mini troches. | Oral / Sublingual Solution Pros Flexible titration. Cons Low bioavailability; short exp date; needs refrigeration. | Oral Capsule Pros Slow-release formulation possible; taste is masked. Cons Low bioavailability; not ideal for titration. |
| Bioavailability | Nasal Spray 25–45% | Sublingual Four-Scored Troches 20–30% | Sublingual Mini Troches 20–30% | Rapid Dissolve Tablet (RDT) ~8–30% Variable depending on how much is swallowed vs. sublingual | Oral / Sublingual Solution 8–20% | Oral Capsule 8–20% |
| Onset | Nasal Spray Rapid onset: 5–10 mins | Sublingual Four-Scored Troches Rapid onset: 10–15 mins | Sublingual Mini Troches Rapid onset: 10–15 mins | Rapid Dissolve Tablet (RDT) ~15–30 mins | Oral / Sublingual Solution Variable onset: 30 mins–hours | Oral Capsule Variable onset: 30 mins–hours |
| Common Doses at T&C | Nasal Spray Most common dosage form at T&C 100, 150 mg/mL Max 170 mg/mL | Sublingual Four-Scored Troches 20–200 mg per troche | Sublingual Mini Troches 2nd most common dosage form at T&C 5–100 mg per troche | Rapid Dissolve Tablet (RDT) 50, 100, 150, 200 mg per tablet | Oral / Sublingual Solution Due to the lowest bioavailability, not common | Oral Capsule Due to the lowest bioavailability, not common |
| Exp Date / Storage | Nasal Spray 60 days Room Temp | Sublingual Four-Scored Troches 180 days Room Temp | Sublingual Mini Troches 180 days Room Temp | Rapid Dissolve Tablet (RDT) 180 days Room Temp | Oral / Sublingual Solution 14 days Refrigerated | Oral Capsule 180 days Room Temp |
Prescribing Ketamine
It's easy to send prescriptions for Ketamine to Town & Country Compounding
Not all pharmacies uphold the same standards
Our accreditations place us in the top 1% of compounding pharmacies.
We Work with Ketamine Prescribers in Multiple States
Practitioners trust our pharmacy for the highest quality ketamine medications.
Dr. Pradeep Chopra Trusts Town & Country Compounding for the Highest Quality Compounded Ketamine
Watch our podcast interview where we talk about how prescribers, such as Dr Pradeep Chopra, MD, utilizes compounded ketamine for their patients' unique needs.
Dr. Pradeep Chopra, MD
Center for Complex Conditions Assistant Professor (Clinical) Brown Medical School
Related Blogs
Ketamine Therapy: A Comprehensive Guide to Its Diverse Therapeutic Applications
Lorem ipsum dolor sit amet. Et officiis libero ut delectus facilis qui laborum aperiam.
FAQs: Frequently Asked Questions About Ketamine
What is compounded ketamine?
Compounded ketamine is ketamine prepared by a licensed compounding pharmacy in a strength or dosage form prescribed for an individual patient. Depending on the prescription, compounded options may include nasal sprays, rapid dissolve tablets, troches, lozenges, sublingual liquids, oral capsules, injection vials, or prefilled syringes.
Why is ketamine compounded?
Ketamine may be compounded when a prescriber determines that a patient needs a strength, dosage form, or method of administration that is not available in an appropriate commercially manufactured product. Compounding can give prescribers additional flexibility when developing an individualized medication plan.
What is ketamine therapy?
Ketamine therapy refers broadly to provider-directed use of ketamine within a medical treatment plan. Depending on the clinical setting and prescription, ketamine may be administered by IV infusion, injection, nasal spray, sublingual or buccal dosage forms, or oral formulations. The route, dose, frequency, and monitoring requirements are determined by the treating provider
What forms of ketamine are available?
Ketamine can be administered in several dosage forms, including IV infusion, injection, nasal spray, rapid dissolve tablets, oral capsules, lozenges, mini troches, sublingual liquids, and prefilled syringes. Each route differs in absorption, onset, administration requirements, and where it may be used, so the appropriate form depends on the prescriber’s treatment plan.
What are ketamine troches?
Ketamine troches are compounded lozenge-style dosage forms designed to dissolve gradually in the mouth. They may be placed under the tongue or between the cheek and gum, allowing a portion of the medication to absorb through the oral mucosa rather than being completely swallowed.
What is a ketamine rapid dissolve tablet?
A ketamine rapid dissolve tablet, or RDT, is a compounded tablet designed to break down quickly in the mouth. When used sublingually as prescribed, some medication can be absorbed through the tissues beneath the tongue, providing an alternative to a conventional swallowed capsule or an injectable dosage form.
What is the difference between ketamine troches and rapid dissolve tablets?
Both ketamine troches and rapid dissolve tablets can support sublingual or buccal administration, but they dissolve differently. Troches generally dissolve more gradually, while RDTs are designed to disintegrate quickly. The prescribed strength, desired administration method, and patient preferences can help determine which dosage form is appropriate.
Is sublingual ketamine absorbed differently than oral ketamine?
Yes. Medication held under the tongue can be absorbed through the sublingual tissues, allowing a portion of the dose to bypass gastrointestinal absorption and first-pass metabolism in the liver. Research has generally found higher ketamine bioavailability with sublingual administration than with fully swallowed oral administration, although absorption varies by formulation and patient.
Can ketamine be taken at home?
Certain compounded oral, buccal, sublingual, or intranasal formulations may be prescribed for use outside a clinic when the prescriber determines that this is appropriate. Injectable and IV formulations are generally administered by healthcare professionals. Because ketamine can cause sedation, dissociation, and other significant effects, patients should follow their prescriber’s administration and monitoring instructions exactly.
Do you need a prescription for ketamine?
Yes. Ketamine is a Schedule III controlled substance and requires a prescription from a licensed prescriber. A compounding pharmacy prepares and dispenses ketamine according to the prescription and applicable federal and state requirements.
Where can I fill a compounded ketamine prescription?
A compounded ketamine prescription must be filled by a pharmacy that is appropriately licensed to dispense the prescribed controlled substance in the patient’s state. Town & Country Compounding works with the prescribers on available dosage forms, strengths, prescription requirements, and dispensing logistics.