Ketacil Pregnancy

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Pregnancy of Ketacil in details

Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.

Ketacil crosses the placenta (Ellingson 1977; Little 1972).

Ketacil produces dose dependent increases in uterine contractions; effects may vary by trimester. The plasma clearance of Ketacil is reduced during pregnancy. Dose related neonatal depression and decreased Apgar scores have been reported with large doses administered at delivery (Little 1972; Neuman 2013; White 1982).

Based on animal data, repeated or prolonged use of general anesthetic and sedation medications that block N-methyl-D-aspartate (NMDA) receptors and/or potentiate gamma-aminobutyric acid (GABA) activity may affect brain development. Evaluate benefits and potential risks of fetal exposure to Ketacil when duration of surgery is expected to be >3 hours (Olutoye 2018).

Although obstetric use is not recommended by the manufacturer, Ketacil has been evaluated for use during cesarean and vaginal delivery (ACOG 209 2019; Akamatsu 1974; Galbert 1973). Ketacil may be considered as an alternative induction agent in females requiring general anesthesia for cesarean delivery who are hemodynamically unstable (Devroe 2015). Use of Ketacil as an adjunctive analgesic in cesarean section has also been evaluated; however, use for this purpose may require additional studies (Carvalho 2017; Heesen 2015). When sedation and analgesia is needed for other procedures during pregnancy, low doses of Ketacil may be used, but other agents are preferred (Neuman 2013; Schwenk 2018). Use of Ketacil infusion for the treatment of refractory status epilepticus in a pregnant patient has been noted in a case report (Talahma 2018).

The ACOG recommends that pregnant women should not be denied medically necessary surgery, regardless of trimester. If the procedure is elective, it should be delayed until after delivery (ACOG 775 2019).

Ketacil breastfeeding

When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!

Use is not recommended. Excreted into human milk: Likely Excreted into animal milk: Yes

Breastmilk levels of this drug have not been measured after administration to humans. Minimal data indicate that use in nursing mothers may not affect the breastfed infant or lactation. This drug should only be used with careful monitoring during breastfeeding.

See references

References for pregnancy information

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Pharmaceutical Society of Australia "APPGuide online. Australian prescription products guide online. Available from: URL:" ():
  3. "Product Information. Ketalar (Ketacil)." JHP Pharmaceuticals, Saddle River, NJ.

References for breastfeeding information

  1. Pharmaceutical Society of Australia "APPGuide online. Australian prescription products guide online. Available from: URL:" ():
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. "Product Information. Ketalar (Ketacil)." JHP Pharmaceuticals, Saddle River, NJ.
  4. United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL:" ([cited 2013 -]):



  1. PubMed Health. "Ketamine (By injection) (Ketalar): This section provide the link out information of drugs collectetd in PubMed Health. ". (accessed September 17, 2018).
  2. Human Metabolome Database (HMDB). "Ketamine: The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body.". (accessed September 17, 2018).
  3. LiverTox. "Ketamine: LIVERTOX provides up-to-date, accurate, and easily accessed information on the diagnosis, cause, frequency, patterns, and management of liver injury attributable to prescription and nonprescription medications, herbals and dietary supplements. ". (accessed September 17, 2018).


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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