Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet. Monitor therapy, Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy, Brimonidine (Topical): May enhance the CNS depressant effect of CNS Depressants. Breakthrough seizure while on propofol infusion: IV: Increase infusion rate by 0.3 to 0.6 mg/kg/hour (5 to 10 mcg/kg/minute) every 5 minutes with or without an additional 1 mg/kg bolus (NCS [Brophy 2012]). Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. The basis of the petition was the reports of increased incidences of propofol abuse during the past decade. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. 3.5 Stars. Canadian labeling: Additional contraindication (not in US labeling): Hypersensitivity to lipid emulsions; sedation of children ≤18 years of age receiving intensive care. Serum triglyceride levels should be obtained prior to initiation of therapy and every 3 to 7 days thereafter, especially if receiving for >48 hours with doses ≥50 mcg/kg/minute (Devlin 2005); use IV port opposite propofol infusion or temporarily suspend infusion and flush port prior to blood draw. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Interrupt oxybate salt treatment during short-term opioid use Consider therapy modification, OxyCODONE: CNS Depressants may enhance the CNS depressant effect of OxyCODONE. • Analgesic supplementation: Propofol lacks analgesic properties; pain management requires specific use of analgesic agents, at effective dosages, propofol must be titrated separately from the analgesic agent. Propofol is chemically described as 2,6-diisopropylphenol. Talk to your doctor if you have questions. Monitor therapy, Terlipressin: May enhance the bradycardic effect of Bradycardia-Causing Agents. Soybean fat emulsion is used as a vehicle for propofol. • Pediatric neurotoxicity: In pediatric and neonatal patients <3 years of age and patients in third trimester of pregnancy (ie, times of rapid brain growth and synaptogenesis), the repeated or lengthy exposure to sedatives or anesthetics during surgery/procedures may have detrimental effects on child or fetal brain development and may contribute to various cognitive and behavioral problems. Propofol is a hypnotic alkylphenol derivative. According to the manufacturer, use is contraindicated in patients who are hypersensitive to eggs, egg products, soybeans, or soy products. Monitor therapy, Midazolam: May increase the serum concentration of Propofol. Use to induce moderate (conscious) sedation in patients warrants monitoring equivalent to that seen with deep anesthesia. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Consider therapy modification, Blood Pressure Lowering Agents: May enhance the hypotensive effect of Hypotension-Associated Agents. Usual dose range: 30 to 60 mcg/kg/minute. Monitor therapy, MetyroSINE: CNS Depressants may enhance the sedative effect of MetyroSINE. Propofol is an intravenous (IV) sedative-hypnotic agent that can be used for initiation and maintenance of Monitored Anesthesia Care (MAC) sedation, combined sedation and regional anesthesia, induction of general anesthesia, maintenance of general anesthesia, and intensive care unit (ICU) sedation of intubated, mechanically ventilated patients. Monitor therapy, Lemborexant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lemborexant. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Monitor therapy, CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants. Taking other medicines that make you sleepy or slow your breathing can worsen these effects. Avoid combination, Tofacitinib: May enhance the bradycardic effect of Bradycardia-Causing Agents. Drug Class: General Anesthetics, Systemic What Is Propofol and How Does It Work? Prior to use, consult local/state regulations and institutional policies and procedures regarding administration and monitoring requirements. Health care providers should review the Fact Sheet for Health Care Providers for key differences between products: https://www.fda.gov/media/137889/download. Propofol is a short-acting, lipophilic intravenous general anesthetic. Medically speaking, the term "myalgia" refers to what type of pain? This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Strict aseptic technique must be maintained in handling although a preservative has been added. Induction of general anesthesia: Children and Adolescents (healthy) 3 to 16 years, ASA-PS 1 or 2: IV: 2.5 to 3.5 mg/kg over 20 to 30 seconds; use a lower dose for ASA-PS 3 or 4. Monitor therapy, Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Other drugs that cause CNS depression (e.g., sedatives, anesthetics, and opioids) can increase CNS depression induced by propofol. Refer to adult dosing. Maximum dose (not well defined and may vary by institution): 200 mcg/kg/minute. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Note: For dosing in obese patients, use adjusted body weight for initial weight-based dosing (Schumann 2020). Shake well before use. Long-term infusions can result in some tolerance; taper propofol infusions to prevent withdrawal. All drugs may cause side effects. Less common side effects of propofol include: This document does not contain all possible side effects and others may occur. Avoid combination, Buprenorphine: CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Monitor therapy, Cannabis: May enhance the CNS depressant effect of CNS Depressants. If used in a nonintubated and/or nonmechanically ventilated patient, qualified personnel and appropriate equipment for rapid institution of respiratory and/or cardiovascular support must be immediately available. Consider therapy modification, Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy, Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy, Dimethindene (Topical): May enhance the CNS depressant effect of CNS Depressants. • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. Monitor therapy, Brexanolone: CNS Depressants may enhance the CNS depressant effect of Brexanolone. • Sulfites: Some formulations may contain sulfites. Monitor therapy, Midodrine: May enhance the bradycardic effect of Bradycardia-Causing Agents. Reduce dose in elderly, hypovolemic, and high-risk patients. In patients with more severe soy or egg allergy, some experts recommend the use of an alternative anesthetic or a small trial dose of propofol prior to full dose administration (Sicherer 2020). Consider therapy modification, Trimeprazine: May enhance the CNS depressant effect of CNS Depressants. Formulations also contain egg phospholipids (egg lecithin) and glycerol. Monitor therapy, Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem. Propofol is formulated in an oil-in-water emulsion. Wait at least 3 to 5 minutes between dosage adjustments to clinically assess drug effects. Monitor therapy, Tetrahydrocannabinol and Cannabidiol: May enhance the CNS depressant effect of CNS Depressants. Some experts use a combination of propofol and ketamine (0.5 to 0.75 mg/kg dose for each drug) (ACEP [Godwin 2014]). General anesthesia: Induction of anesthesia in patients ≥3 years of age; maintenance of anesthesia in patients ≥2 months of age. patent 4,447,657) is a short acting intravenous anesthetic and marketed (Diprivan®, AstraZeneca) as a sterile emulsion. lidocaine, fentanyl, hyoscyamine, ketamine, glycopyrrolate, Levsin. These agents should only be combined if alternative treatment options are inadequate. Introduction: Propofol (2,6diisopropylphenol, U- .S. The pKa is 11. Monitor therapy, Herbs (Hypotensive Properties): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy, Perampanel: May enhance the CNS depressant effect of CNS Depressants. If the procedure is elective, it should be delayed until after delivery (ACOG 775 2019). Two veterinary versions, Rapinovet and PropoFlo/ PropoVet were approved for marketing in 1999 and 2000, respectively. Administration should begin immediately and completed within 12 hours after the vial has been opened. Monitor therapy, Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Status epilepticus, refractory (off-label use): Note: Used as an alternative or adjunctive agent to midazolam, barbiturates, or ketamine after conventional intermittent therapies have failed. Patients with additional risk factors for QTc prolongation may be at even higher risk. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Instances of self-administration of propofol by health care professionals have also been reported, which have resulted in fatalities and other injuries. Does not need to be diluted; however, propofol may be further diluted in 5% dextrose in water to a concentration of ≥2 mg/mL. Maximum dose (not well defined; may vary by institution): 60 to 80 mcg/kg/minute. After you have been treated with propofol, ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures (especially valproic acid). General DIPRIVAN is an intravenous general anesthetic and sedation drug for use in the induction and maintenance of anesthesia or sedation. Mechanically ventilated patients in the ICU, sedation: Note: Used as part of a multimodal strategy (eg, combination of sedatives and analgesics) for ICU sedation and preferred over a benzodiazepine due to less risk of prolonged sedation and improved time to extubation; titrate to maintain a light level of sedation (eg, Richmond Agitation Sedation Scale 0 to −2) or clinical effect (eg, ventilator synchrony) (SCCM [Devlin 2018]). The onset of the syndrome is rapid, occurring within 4 days of initiation. anesthetic under the commercial name, Diprivan[supreg]. Monitor therapy, Tetrahydrocannabinol: May enhance the CNS depressant effect of CNS Depressants. Consider therapy modification, Metoclopramide: May enhance the CNS depressant effect of CNS Depressants. Bradycardia and other arrhythmias may indicate propofol infusion syndrome, a potentially fatal event accompanied by metabolic acidosis, rhabdomyolysis, and renal failure. IV: Administer intermittent bolus or by continuous IV infusion. Consider therapy modification, Amisulpride (Oral): May enhance the hypotensive effect of Hypotension-Associated Agents. This medication contains propofol. Report these signs to the physician or nursing staff immediately. Because Fresenius Propoven 2% contains double the concentration of propofol (20 mg/mL) compared to the FDA-approved propofol products (10 mg/mL), there is a risk of unintentional overdose. Propofol is available under the following different brand names: Diprivan. • Injection-site reaction: Transient local pain may occur during IV injection; lidocaine 1% solution may be administered prior to administration or may be added to propofol immediately prior to administration to reduce pain associated with injection (see Administration). Propofol is chemically described as 2,6‑diisopropylphenol. Continuous IV infusion: Initial: 25 to 75 mcg/kg/minute; titrate to adequate sedation. To reduce pain associated with injection, use larger veins of forearm or antecubital fossa; lidocaine IV (1 mL of a 1% solution) may also be used prior to administration or it may be added to propofol immediately before administration in a quantity not to exceed 20 mg lidocaine per 200 mg propofol. QT shortening/prolongation), hypertriglyceridaemia, hypotension, injection-site reaction, perioperative myoclonus (e.g. This change is applicable to all animal and analytical researchers across campus. Monitor therapy, Bradycardia-Causing Agents: May enhance the bradycardic effect of other Bradycardia-Causing Agents. Consider therapy modification, Opioid Agonists: CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Health care providers should review the Fact Sheet for Health Care Providers for key differences between products: https://www.fda.gov/media/137889/download. Consider therapy modification, ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole. Monitor therapy, Flunitrazepam: CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. Induction of anesthesia: Note: In high-risk patients (eg, debilitated, American Society of Anesthesiologists - Physical Status [ASA-PS] 3 or 4, hemodynamically compromised), avoid rapid bolus administration to minimize hypotension. With increasing age, the dose requirement decreases because of occurrence of higher peak plasma concentrations. Bolus slowly and avoid rapid repeat dosing. Monitor therapy, Ubrogepant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Ubrogepant. • Respiratory disease: Use with caution in patients with respiratory disease. To minimize the risks associated with the drug, organizations should consider treating it as a … • Opioids: Concomitant use may lead to increased sedative or anesthetic effects of propofol, more pronounced decreases in systolic, diastolic, and mean arterial pressures and cardiac output; lower doses of propofol may be needed. Monitor therapy, Magnesium Sulfate: May enhance the CNS depressant effect of CNS Depressants. What other drugs will affect propofol? Propofol is an anesthetic drug used to facilitate relaxation or sleepiness. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Diprivan (propofol) slows the activity of your brain and nervous system. Monitor therapy, Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy, Droperidol: May enhance the CNS depressant effect of CNS Depressants. Diprivan is also used to sedate a patient who is under critical care and needs a … Rapid sequence intubation outside the operating room (induction): Note: May cause dose-related hypotension; consider alternative agent in patients who are hemodynamically unstable. Continuous IV infusion: Usual dosing range: 50 to 100 mcg/kg/minute; titrate to clinical response. The substance was found to be the cause of his death and was the center of the highly publicized trial of his doctor. • Debilitated patients: Use a lower induction dose, a slower maintenance rate of administration, and avoid rapidly delivered boluses in debilitated patients to reduce the incidence of unwanted cardiorespiratory depressive events. Inventories of propofol should be stored and managed to prevent the risk of diversion, including restriction of access and accounting procedures as appropriate to the clinical setting. Consider therapy modification, Suvorexant: CNS Depressants may enhance the CNS depressant effect of Suvorexant. • It may be given to you for other reasons. Teratology studies with propofol in rats and rabbits show some evidence of delayed ossification or abnormal cranial ossification with an increase in the incidence of subcutaneous haematomas. sedative-hypnotic. Specifically the development of opisthotonus (severe hyperextension and spasticity resulting in arching or bridging position) and/or tonic clonic seizures. Consider therapy modification, Lemborexant: May enhance the CNS depressant effect of CNS Depressants. However, prolongation of the QT interval, usually within normal limits, has occurred in case reports and small prospective studies and may be dose dependent (Hume-Smith 2008; Kim 2008; McConachie 1989; Saarnivaara 1990; Saarnivaara 1993; Sakabe 2002). Avoid combination, Bromperidol: May enhance the CNS depressant effect of CNS Depressants. Adult and Pediatric Dosage Forms and Strengths. Use of propofol in a patient who has been taking rifampin may result in clinically significant hypotension. Consider therapy modification, Fexinidazole [INT]: Bradycardia-Causing Agents may enhance the arrhythmogenic effect of Fexinidazole [INT]. • It is used to cause sleep during a procedure. On March 18, 2008, the Drug Enforcement Administration (DEA) received a petition requesting that 21 CFR 1308.13be amended so that propofol be controlled as a schedule III substance under the CSA. Keep out of reach of children. If combined, limit the dosages and duration of each drug. 100 people have reviewed this drug 3.5. Monitor therapy, Dofetilide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Dofetilide. The octanol/water partition coefficient for Propofol is 6761:1 at a pH of 6 to 8.5. Note: If rapid effect is desired, may initiate with a higher infusion rate (eg, 100 to 150 mcg/kg/minute for 3 to 5 minutes) or administer an initial bolus (eg, 0.25 to 0.5 mg/kg) (Rosero 2020; manufacturer's labeling). Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first. Monitor therapy, Bromopride: May enhance the CNS depressant effect of CNS Depressants. 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. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. The structural formula is:Propofol is slightly soluble in water and, thus, is formulated in a white, oil-in-water emulsion. Monitor therapy, FentaNYL: Propofol may enhance the CNS depressant effect of FentaNYL. Alfentanil use with propofol has precipitated seizure activity in patients without any history of epilepsy. An alternative sedative agent should be employed if significant hypertriglyceridemia occurs. • Cardiovascular disease: Use with caution in patients with severe cardiac disease (ejection fraction <50%) or hypotension; may have more profound adverse cardiovascular responses to propofol. Monitor therapy, Lofexidine: May enhance the CNS depressant effect of CNS Depressants. The medicines in drug classification Schedule IV /Schedule 4 can and are abused and can be addictive or create a dependency, but less than those of Schedules 1, 2 and 3. Monitor therapy, Bromperidol: Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Its uses include the starting and maintenance of general anesthesia, sedation for mechanically ventilated adults, and procedural sedation. In a large report of a pediatric sedation program in >4,000 patients (age range: 1 month to 21 years), after an initial bolus of at least 2 mg/kg, an infusion was started at an initial rate of 9 mg/kg/hour (150 mcg/kg/minute) and titrated as required; supplemental doses of 1 to 2 mg/kg were used as needed; however, hypotension occurred in up to 42.5% of patients undergoing MRI and 23.2% of patients undergoing other procedures (Vespasiano 2007). Pill Identifier Tool Quick, Easy, Pill Identification, Drug Interaction Tool Check Potential Drug Interactions, Pharmacy Locater Tool Including 24 Hour, Pharmacies. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration.