Propofol
- Atc Codes:N01AX10
- CAS Codes:2078-54-8
- PHARMGKB ID:2078-54-8
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Induces
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Diprivan, Propofol; Belgium: Diprivan, Propofol, Propolipid; Bulgaria: Diprivan, Dormofol, Plofed, Propofol; Cyprus: Diprivan; Czech Republic: Diprivan, Propofol; Denmark: Diprivan, Propofol, Propolipid; Estonia: Propofol, Propoven; Finland: Propofol, Propolipid, Recofol; France: Diprivan, Propofol; Germany: Disoprivan, Propofol, Recofol; Greece: Diprivan, Efekal, Morpheas, Propofol, Propogen, Rocofol; Hungary: Diprivan, Propofol; Ireland: Diprivan, Propofol; Luxembourg: Diprivan; Netherlands: Diprivan, Propofol, Recofol; Poland: Propofol; Portugal: Diprivan, Propofol; Romania: Propofol, Recofol; Slovakia: Diprivan, Propofol, Provive; Slovenia: Propofol, Propoven; Spain: Dipriván, Propofol, Recofol; Sweden: Diprivan, Propofol, Propolipid, Unifol; UK: Diprivan.
North America
Canada: Diprivan, Propofol; USA: Diprivan, Propofol.
Latin America
Argentina: Dipriván, Fresofol, Gobbifol, Oleo-Lax, Propofol; Brazil: Profolen, Propofol, Propovan; Mexico: Cryotol, Fresofol, Indufol, Propofol, Provive, Recofol.
Asia
Japan: Diprivan, Fresofol, Propofol.
Drug combinations
Chemistry
Propofol: C~12~H~18~O. Mw: 178.27. (1) Phenol, 2,6-bis(1-methylethyl); (2) 2,6-Diisopropylphenol. CAS-2078-54-8.
Pharmacologic Category
General Anesthetics, Miscellaneous. Anxiolytics, Sedatives, and Hypnotics, Miscellaneous. (ATC-Code: N01AX10).
Mechanism of action
A sterically hindered, alkyl-phenolic compound with intravenous general anesthetic properties.
Therapeutic use
Induction of anesthesia for surgery in patients ≥3 years of age. Maintenance of anesthesia for surgery in patients >2 months of age. In adults, for induction and maintenance of monitored anesthesia care sedation during procedures. Sedation in intubated, mechanically-ventilated intensive care unit patients.
Pregnancy and lactiation implications
Propofol should only be used in pregnancy if clearly needed. Crosses placenta and may be associated with neonatal CNS and respiratory depression. Not recommended in nursing women.
Unlabeled use
Postoperative antiemetic. Refractory delirium tremens (case reports). Moderate sedation (conscious sedation).
Contraindications
Hypersensitivity to propofol or any component of the formulation. Hypersensitivity to eggs, egg products, soybeans, or soy products.
Warnings and precautions
May rarely cause hypersensitivity, anaphylaxis, anaphylactoid reactions, angioedema, bronchospasm, and erythema. Hypertriglyceridemia is expected side effect. Patients who develop hypertriglyceridemia (e.g. >500 mg/dL) are at risk of developing pancreatitis (use with caution in pre-existing hyperlipidemia). Major cardiovascular effect hypotension especially if patient is hypovolemic or if bolus dosing is used (use with caution in patients who are hemodynamically unstable, hypovolemic, or have abnormally low vascular tone (e.g. sepsis)). Transient local pain may occur during I.V. injection. Perioperative myoclonus (e.g. convulsions and opisthotonos) occurred with administration. Propofol-related infusion syndrome is serious side-effect with high mortality rate characterized by dysrhythmia (e.g. bradycardia or tachycardia), heart failure, hyperkalemia, lipemia, metabolic acidosis, and/or rhabdomyolysis or myoglobinuria with subsequent renal failure. Use with caution in severe cardiac disease (ejection fraction <50%) or hypotension (may have more profound adverse cardiovascular responses to propofol). Use with caution in increased intracranial pressure or impaired cerebral circulation (substantial decreases in mean arterial pressure and subsequent decreases in cerebral perfusion pressure may occur). Propofol vials and prefilled syringes have potential risk of infection. Use with caution in pre-existing pancreatitis (may be exacerbated), in respiratory disease, and in history of epilepsy or seizures (seizure may occur during recovery phase). Concomitant use with opiates may lead to increased sedative or anesthetic effects of propofol, more pronounced decreases in systolic, diastolic, and mean arterial pressures and cardiac output. In addition, fentanyl may cause serious bradycardia when used with propofol in pediatric patients. Alfentanil use with propofol precipitated seizure activity in patients without history of epilepsy. Caution in elderly and debilitated patients (risk of cardiorespiratory-depressive events). Concurrent use of fentanyl and propofol in pediatric patients may result in bradycardia. Propofol should only be used in pregnancy if clearly needed. Not recommended for use in obstetrics, including cesarean section deliveries. Some products may contain benzyl alcohol («gasping syndrome» in neonates). Some formulations contain edetate disodium; may lead to decreased zinc levels in prolonged therapy (>5 days) or predisposition to zinc deficiency (e.g. burns, diarrhea, or sepsis). Some formulations may contain sulfites. Abrupt discontinuation should be avoided (can result in rapid awakening, anxiety, agitation, and resistance to mechanical ventilation).