What is the Best for Me? Administration Routes, Frequency & Dosage
By Susan Clifton, LCSW-S/August 16, 2025
Administration Routes, Frequency & Dosage
Ketamine dosing is an art and ideally involves active collaboration between the prescriber, therapist and patient/client. Part of the challenge is that the ~0.5 mg/kg starting point can be experienced in vary different ways. Prescribers will generally err on the side of lower more conservative dose for the first medication session and address from there.
Different Routes, Different Experiences
The chart provides a conceptual (not actual) difference between a sublingual troche (dose split 15 mins apart) represented by the black line; an intramuscular dose provided in 2 shots as shown by the dashed line; and an intravenous continuous infusion shown by the dotted line.
Routes of Admission
| Route | PROs | CONs |
| Sublingual (Rapid Dissolving Tablets, Troches) | – very gradual onboarding helpful for anxious clients – gentle entrance/exit to/from the journey | – Tastes bad – Most inconsistent absorption route ~20-30% – Distracting swishing & spitting |
| Intramuscular Injection (IM) | – May feel like 0 to 90 is a few quick minutes – Can be creative with tiny dose initially, larger and then booster for extended journey – More consistent absorption ~90-95% bioavailability | – Generally, only available with private, MH clinics/offices |
| Intravenous Infusions | – 100% bioavailability – no guessing what dose you got – Consistent flow of medication can be stopped (still need to wait until what is present wears off) | – Needle phobic clients may be cringy with the needle going into vein – constant presence of the needle in the hand/arm feels medical, limits movement, distracting |
Doses by Weight and Route
| Weight | Sublingual | IV | IM |
| 150 lb | 100–300 mg | 34–68 mg | 50–100 mg |
| 175 lb | 120–350 mg | 40–79 mg | 60–115 mg |
| 200 lb | 140–400 mg | 45–91 mg | 70–130 mg |
| 225 lb | 160–450 mg | 50–102 mg | 80–145 mg |
Factors that Impact Dosing and Experience
- Prior psychedelic experience
- Current medical conditions
- Current medications
- Substance use
- Medication sensitivity
- Metabolism
- Mindset, relaxation level
- History of ketamine recent and repeated use
More is Not More
The ideal is to find the therapeutic window that allows for a robust journey with ego dissolution but not so much that the journey is hard to grasp and remember. In addition, higher doses may increase the impact of side effects, take longer to clear the system &/or increase likelihood of aggravating medical issues.
Disclaimer: This post contains information from research, expert consensus and personal observation/opinions. It is not a substitute for individualized, professional consultation. To learn more about our services reach out to Living Arts via our Contact Page.