MKO Melt

MKO Melt is a compounded sublingual troche formulation containing a combination of midazolam (3 mg), ketamine (25 mg), and ondansetron (2 mg). Developed by Imprimis Pharmaceuticals (now Imprimis NJOF, a subsidiary of Harrow Health), it is primarily utilized for conscious sedation during ophthalmic procedures, such as cataract surgery, providing a non-intravenous alternative for sedation. The formulation leverages the synergistic effects of its three components: midazolam, a benzodiazepine that acts as a GABA-A receptor positive allosteric modulator for sedation; ketamine, an NMDA receptor antagonist that provides dissociative anesthesia and analgesia; and ondansetron, a 5-HT3 receptor antagonist used to prevent post-operative nausea and vomiting. The troche is designed to dissolve slowly in the mouth, allowing for systemic medication delivery through oral mucosa absorption. As a compounded medication, it has not undergone formal FDA approval for safety and efficacy.

Brand names

MKO Melt

Other names

midazolam + ketamine + ondansetronmidazolam/ketamine/ondansetronMKO Melt troche