Ketamine and its primary metabolite norketamine attenuate morphine tolerance by antagonising N-methyl-D-aspartate (NMDA) receptors. Ketamine is extensively metabolized to several other metabolites. The major secondary metabolite (2S,6S;2R,6R)-hydroxynorketamine (6-hydroxynorketamine) is not an NMDA antagonist. However, it may modulate nociception through negative allosteric modulation of a7 nicotinic acetylcholine receptors. We studied whether 6-hydroxynorketamine could affect nociception or the effects of morphine in acute or chronic administration settings. Male Sprague Dawley rats received subcutaneous 6-hydroxynorketamine or ketamine alone or in combination with morphine, as a cotreatment during induction of morphine tolerance, and after the development of tolerance induced by subcutaneous minipumps administering 9.6 mg morphine daily. Tail flick, hot plate, paw pressure and rotarod tests were used. Brain and serum drug concentrations were quantified with high-performance liquid chromatography-tandem mass spectrometry. Ketamine (10 mg/kg), but not 6-hydroxynorketamine (10 and 30 mg/kg), enhanced antinociception and decreased rotarod performance following acute administration either alone or combined with morphine. Ketamine efficiently attenuated morphine tolerance. Acutely administered 6-hydroxynorketamine increased the brain concentration of morphine (by 60%), and brain and serum concentrations of 6-hydroxynorketamine were doubled by morphine pre-treatment. This pharmacokinetic interaction did not, however, lead to altered morphine tolerance. Co-administration of 6-hydroxynorketamine 20 mg/kg twice daily did not influence development of morphine tolerance. Even though morphine and 6-hydroxynorketamine brain concentrations were increased after co-administration, the pharmacokinetic interaction had no effect on acute morphine nociception or tolerance. These results indicate that 6-hydroxynorketamine does not have antinociceptive properties or attenuate opioid tolerance in a similar way as ketamine.Opioids are widely used to manage severe acute and cancer pain. However, prolonged opioid use in chronic non-cancer pain may have severe drawbacks, including the development of tolerance and dependence. In the United States, eighty per cent of new heroin users have previously misused prescription opioids, and the opioid epidemic has been declared a national emergency [1]. Long-term opioid use may even lead to opioid-induced hyperalgesia that can compromise opioid analgesia and lead to further increases in opioid doses [2]. New approaches are needed to provide safer opioid analgesia with lower doses.Several N-methyl-D-aspartate (NMDA) receptor antagonists have been shown to attenuate opioid tolerance [3-5] mainly via pharmacodynamic interactions. Ketamine, a clinically used NMDA antagonist, produces anaesthesia and also analgesia at lower doses. Clinical evidence supports the perioperative use of low-dose ketamine with morphine to decrease the need for morphine [6], whereas there is lack of evidence to supp...