etomidate (Rx)

Brand and Other Names:Amidate

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 2mg/mL

General Anesthesia Induction

0.2-0.6 mg/kg IVP over 30-60 sec  

Cushing Syndrome (Off-label)

Inhibition of steroidogenesis in patients with Cushing syndrome

0.2-0.6 mg/kg IV infused over 30-60 seconds for induction of anesthesia blocks normal stress-induced increase in adrenal cortisol production for 4-8 h  

ICU continuous infusion: 0.04-0.05 mg/kg/hr IV; continuous monitoring required

Dosing considerations

  • Used rarely; often toxic at doses required to reduce cortisol secretion
  • Long-term use limited by the requirement for repeated IV administration

Sedation (Off-label)

0.1 mg/kg IV bolus x1-3 doses; other dosing regimens may exist  

Dosage Forms & Strengths

injectable solution

  • 2mg/mL

General Anesthesia Induction

<10 years: Safety and efficacy not established

>10 years: Same as adults; 0.2-0.6 mg/kg IVP over 30-60 sec  

Sedation (Off-label)

0.1-0.4 mg/kg IV bolus x1; additional doses may be necessary; other dosing regimens may exist  

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Interactions

Interaction Checker

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            Contraindicated (0)

              Serious - Use Alternative (17)

              • benzhydrocodone/acetaminophen

                benzhydrocodone/acetaminophen, etomidate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).

              • calcium/magnesium/potassium/sodium oxybates

                etomidate, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • doxapram

                doxapram, etomidate. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.

              • epinephrine

                etomidate increases levels of epinephrine by decreasing metabolism. Contraindicated.

              • epinephrine racemic

                etomidate increases levels of epinephrine racemic by decreasing metabolism. Contraindicated.

              • fentanyl

                fentanyl, etomidate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl intranasal

                fentanyl intranasal, etomidate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl transdermal

                fentanyl transdermal, etomidate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl transmucosal

                fentanyl transmucosal, etomidate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • hydrocodone

                hydrocodone, etomidate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).

              • metoclopramide intranasal

                etomidate, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              • norepinephrine

                etomidate increases levels of norepinephrine by decreasing metabolism. Contraindicated.

              • olopatadine intranasal

                etomidate and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • phenylephrine

                etomidate increases levels of phenylephrine by decreasing metabolism. Contraindicated.

              • phenylephrine PO

                etomidate increases levels of phenylephrine PO by decreasing metabolism. Contraindicated.

              • sodium oxybate

                etomidate, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • sufentanil SL

                sufentanil SL, etomidate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              Monitor Closely (153)

              • acebutolol

                etomidate, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • alfentanil

                etomidate and alfentanil both increase sedation. Use Caution/Monitor.

              • alprazolam

                etomidate and alprazolam both increase sedation. Use Caution/Monitor.

              • amitriptyline

                etomidate and amitriptyline both increase sedation. Use Caution/Monitor.

              • amobarbital

                etomidate and amobarbital both increase sedation. Use Caution/Monitor.

              • amoxapine

                etomidate and amoxapine both increase sedation. Use Caution/Monitor.

              • apomorphine

                etomidate and apomorphine both increase sedation. Use Caution/Monitor.

              • aripiprazole

                etomidate and aripiprazole both increase sedation. Use Caution/Monitor.

              • atenolol

                etomidate, atenolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • azelastine

                etomidate and azelastine both increase sedation. Use Caution/Monitor.

              • baclofen

                etomidate and baclofen both increase sedation. Use Caution/Monitor.

              • belladonna and opium

                etomidate and belladonna and opium both increase sedation. Use Caution/Monitor.

              • benperidol

                etomidate and benperidol both increase sedation. Use Caution/Monitor.

              • benzphetamine

                etomidate increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • betaxolol

                etomidate, betaxolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • bisoprolol

                etomidate, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • brompheniramine

                etomidate and brompheniramine both increase sedation. Use Caution/Monitor.

              • buprenorphine

                etomidate and buprenorphine both increase sedation. Use Caution/Monitor.

              • buprenorphine buccal

                etomidate and buprenorphine buccal both increase sedation. Use Caution/Monitor.

              • buprenorphine, long-acting injection

                etomidate increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

              • butabarbital

                etomidate and butabarbital both increase sedation. Use Caution/Monitor.

              • butalbital

                etomidate and butalbital both increase sedation. Use Caution/Monitor.

              • butorphanol

                etomidate and butorphanol both increase sedation. Use Caution/Monitor.

              • carbinoxamine

                etomidate and carbinoxamine both increase sedation. Use Caution/Monitor.

              • carisoprodol

                etomidate and carisoprodol both increase sedation. Use Caution/Monitor.

              • carvedilol

                etomidate, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • celiprolol

                etomidate, celiprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • cenobamate

                cenobamate, etomidate. Either increases effects of the other by sedation. Use Caution/Monitor.

              • chloral hydrate

                etomidate and chloral hydrate both increase sedation. Use Caution/Monitor.

              • chlordiazepoxide

                etomidate and chlordiazepoxide both increase sedation. Use Caution/Monitor.

              • chlorpheniramine

                etomidate and chlorpheniramine both increase sedation. Use Caution/Monitor.

              • chlorpromazine

                etomidate and chlorpromazine both increase sedation. Use Caution/Monitor.

              • chlorzoxazone

                etomidate and chlorzoxazone both increase sedation. Use Caution/Monitor.

              • cinnarizine

                etomidate and cinnarizine both increase sedation. Use Caution/Monitor.

              • clemastine

                etomidate and clemastine both increase sedation. Use Caution/Monitor.

              • clobazam

                etomidate, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

              • clomipramine

                etomidate and clomipramine both increase sedation. Use Caution/Monitor.

              • clonazepam

                etomidate and clonazepam both increase sedation. Use Caution/Monitor.

              • clorazepate

                etomidate and clorazepate both increase sedation. Use Caution/Monitor.

              • clozapine

                etomidate and clozapine both increase sedation. Use Caution/Monitor.

              • codeine

                etomidate and codeine both increase sedation. Use Caution/Monitor.

              • cyclizine

                etomidate and cyclizine both increase sedation. Use Caution/Monitor.

              • cyclobenzaprine

                etomidate and cyclobenzaprine both increase sedation. Use Caution/Monitor.

              • cyproheptadine

                etomidate and cyproheptadine both increase sedation. Use Caution/Monitor.

              • dantrolene

                etomidate and dantrolene both increase sedation. Use Caution/Monitor.

              • daridorexant

                etomidate and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • desflurane

                desflurane and etomidate both increase sedation. Use Caution/Monitor.

              • desipramine

                etomidate and desipramine both increase sedation. Use Caution/Monitor.

              • dexchlorpheniramine

                etomidate and dexchlorpheniramine both increase sedation. Use Caution/Monitor.

              • dexfenfluramine

                etomidate increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dexmedetomidine

                etomidate and dexmedetomidine both increase sedation. Use Caution/Monitor.

              • dextromoramide

                etomidate and dextromoramide both increase sedation. Use Caution/Monitor.

              • diamorphine

                etomidate and diamorphine both increase sedation. Use Caution/Monitor.

              • diazepam

                etomidate and diazepam both increase sedation. Use Caution/Monitor.

              • difelikefalin

                difelikefalin and etomidate both increase sedation. Use Caution/Monitor.

              • difenoxin hcl

                etomidate and difenoxin hcl both increase sedation. Use Caution/Monitor.

              • dimenhydrinate

                etomidate and dimenhydrinate both increase sedation. Use Caution/Monitor.

              • diphenhydramine

                etomidate and diphenhydramine both increase sedation. Use Caution/Monitor.

              • diphenoxylate hcl

                etomidate and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

              • dipipanone

                etomidate and dipipanone both increase sedation. Use Caution/Monitor.

              • dopexamine

                etomidate increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dosulepin

                etomidate and dosulepin both increase sedation. Use Caution/Monitor.

              • doxepin

                etomidate and doxepin both increase sedation. Use Caution/Monitor.

              • doxylamine

                etomidate and doxylamine both increase sedation. Use Caution/Monitor.

              • droperidol

                etomidate and droperidol both increase sedation. Use Caution/Monitor.

              • esmolol

                etomidate, esmolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • estazolam

                etomidate and estazolam both increase sedation. Use Caution/Monitor.

              • ethanol

                etomidate and ethanol both increase sedation. Use Caution/Monitor.

              • fenfluramine

                etomidate increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fluphenazine

                etomidate and fluphenazine both increase sedation. Use Caution/Monitor.

              • flurazepam

                etomidate and flurazepam both increase sedation. Use Caution/Monitor.

              • haloperidol

                etomidate and haloperidol both increase sedation. Use Caution/Monitor.

              • hydromorphone

                etomidate and hydromorphone both increase sedation. Use Caution/Monitor.

              • hydroxyzine

                etomidate and hydroxyzine both increase sedation. Use Caution/Monitor.

              • iloperidone

                etomidate and iloperidone both increase sedation. Use Caution/Monitor.

              • imipramine

                etomidate and imipramine both increase sedation. Use Caution/Monitor.

              • isocarboxazid

                isocarboxazid increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.

              • ketotifen, ophthalmic

                etomidate and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

              • labetalol

                etomidate, labetalol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • levorphanol

                etomidate and levorphanol both increase sedation. Use Caution/Monitor.

              • linezolid

                linezolid increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.

              • lofepramine

                etomidate and lofepramine both increase sedation. Use Caution/Monitor.

              • lofexidine

                etomidate and lofexidine both increase sedation. Use Caution/Monitor.

              • loprazolam

                etomidate and loprazolam both increase sedation. Use Caution/Monitor.

              • lorazepam

                etomidate and lorazepam both increase sedation. Use Caution/Monitor.

              • lormetazepam

                etomidate and lormetazepam both increase sedation. Use Caution/Monitor.

              • loxapine

                etomidate and loxapine both increase sedation. Use Caution/Monitor.

              • loxapine inhaled

                etomidate and loxapine inhaled both increase sedation. Use Caution/Monitor.

              • maprotiline

                etomidate and maprotiline both increase sedation. Use Caution/Monitor.

              • meperidine

                etomidate and meperidine both increase sedation. Use Caution/Monitor.

              • meprobamate

                etomidate and meprobamate both increase sedation. Use Caution/Monitor.

              • metaxalone

                etomidate and metaxalone both increase sedation. Use Caution/Monitor.

              • methadone

                etomidate and methadone both increase sedation. Use Caution/Monitor.

              • methocarbamol

                etomidate and methocarbamol both increase sedation. Use Caution/Monitor.

              • methylenedioxymethamphetamine

                etomidate increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metoprolol

                etomidate, metoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • midazolam

                etomidate and midazolam both increase sedation. Use Caution/Monitor.

              • midazolam intranasal

                midazolam intranasal, etomidate. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

              • mirtazapine

                etomidate and mirtazapine both increase sedation. Use Caution/Monitor.

              • morphine

                etomidate and morphine both increase sedation. Use Caution/Monitor.

              • motherwort

                etomidate and motherwort both increase sedation. Use Caution/Monitor.

              • moxonidine

                etomidate and moxonidine both increase sedation. Use Caution/Monitor.

              • nabilone

                etomidate and nabilone both increase sedation. Use Caution/Monitor.

              • nadolol

                etomidate, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • nalbuphine

                etomidate and nalbuphine both increase sedation. Use Caution/Monitor.

              • nebivolol

                etomidate, nebivolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • nortriptyline

                etomidate and nortriptyline both increase sedation. Use Caution/Monitor.

              • opium tincture

                etomidate and opium tincture both increase sedation. Use Caution/Monitor.

              • orphenadrine

                etomidate and orphenadrine both increase sedation. Use Caution/Monitor.

              • oxazepam

                etomidate and oxazepam both increase sedation. Use Caution/Monitor.

              • oxycodone

                etomidate and oxycodone both increase sedation. Use Caution/Monitor.

              • oxymorphone

                etomidate and oxymorphone both increase sedation. Use Caution/Monitor.

              • papaveretum

                etomidate and papaveretum both increase sedation. Use Caution/Monitor.

              • papaverine

                etomidate and papaverine both increase sedation. Use Caution/Monitor.

              • penbutolol

                etomidate, penbutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • pentazocine

                etomidate and pentazocine both increase sedation. Use Caution/Monitor.

              • pentobarbital

                etomidate and pentobarbital both increase sedation. Use Caution/Monitor.

              • perphenazine

                etomidate and perphenazine both increase sedation. Use Caution/Monitor.

              • phenelzine

                phenelzine increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.

              • phenobarbital

                etomidate and phenobarbital both increase sedation. Use Caution/Monitor.

              • phenylephrine PO

                etomidate increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • pholcodine

                etomidate and pholcodine both increase sedation. Use Caution/Monitor.

              • pindolol

                etomidate, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • primidone

                etomidate and primidone both increase sedation. Use Caution/Monitor.

              • procarbazine

                procarbazine increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.

              • prochlorperazine

                etomidate and prochlorperazine both increase sedation. Use Caution/Monitor.

              • promethazine

                etomidate and promethazine both increase sedation. Use Caution/Monitor.

              • propofol

                etomidate and propofol both increase sedation. Use Caution/Monitor.

              • propranolol

                etomidate, propranolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • propylhexedrine

                etomidate increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • protriptyline

                etomidate and protriptyline both increase sedation. Use Caution/Monitor.

              • quazepam

                etomidate and quazepam both increase sedation. Use Caution/Monitor.

              • ramelteon

                etomidate and ramelteon both increase sedation. Use Caution/Monitor.

              • scullcap

                etomidate and scullcap both increase sedation. Use Caution/Monitor.

              • secobarbital

                etomidate and secobarbital both increase sedation. Use Caution/Monitor.

              • selegiline transdermal

                selegiline transdermal increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.

              • shepherd's purse

                etomidate and shepherd's purse both increase sedation. Use Caution/Monitor.

              • sotalol

                etomidate, sotalol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • sufentanil

                etomidate and sufentanil both increase sedation. Use Caution/Monitor.

              • tapentadol

                etomidate and tapentadol both increase sedation. Use Caution/Monitor.

              • temazepam

                etomidate and temazepam both increase sedation. Use Caution/Monitor.

              • timolol

                etomidate, timolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • tramadol

                etomidate and tramadol both increase sedation. Use Caution/Monitor.

              • tranylcypromine

                tranylcypromine increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.

              • trazodone

                etomidate and trazodone both increase sedation. Use Caution/Monitor.

              • triazolam

                etomidate and triazolam both increase sedation. Use Caution/Monitor.

              • triclofos

                etomidate and triclofos both increase sedation. Use Caution/Monitor.

              • trifluoperazine

                etomidate and trifluoperazine both increase sedation. Use Caution/Monitor.

              • trimipramine

                etomidate and trimipramine both increase sedation. Use Caution/Monitor.

              • triprolidine

                etomidate and triprolidine both increase sedation. Use Caution/Monitor.

              • xylometazoline

                etomidate increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ziprasidone

                etomidate and ziprasidone both increase sedation. Use Caution/Monitor.

              • zotepine

                etomidate and zotepine both increase sedation. Use Caution/Monitor.

              Minor (16)

              • amitriptyline

                etomidate, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • amoxapine

                etomidate, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • brimonidine

                brimonidine increases effects of etomidate by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • clomipramine

                etomidate, clomipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • desipramine

                etomidate, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • dosulepin

                etomidate, dosulepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • doxepin

                etomidate, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • eucalyptus

                etomidate and eucalyptus both increase sedation. Minor/Significance Unknown.

              • imipramine

                etomidate, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • lofepramine

                etomidate, lofepramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • maprotiline

                etomidate, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • nortriptyline

                etomidate, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • protriptyline

                etomidate, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • sage

                etomidate and sage both increase sedation. Minor/Significance Unknown.

              • trazodone

                etomidate, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

              • trimipramine

                etomidate, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

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              Adverse Effects

              >10%

              Transient injection site pain (30-80%)

              Skeletal muscle movements, mainly myoclonic (32%)

              Opsoclonus (20%)

              Adrenal suppression

              1-10%

              Hiccups

              <1%

              Apnea (duration: 5-90 seconds)

              Arrhythmias

              Hyperventilation

              HTN

              Hypotension

              Hypoventilation

              Laryngospasm

              Nausea/vomiting

              Oxygen desaturation

              Snoring (may be associated with partial upper airway obstruction)

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              Warnings

              Contraindications

              Hypersensitivity

              Cautions

              Adrenal suppression (and prolonged therapy)

              Prolonged infusion associated with suppression of endogenous cortisol and aldosterone production; formulation is not intended for prolonged infusion

              Exacerbations of underlying myocardial dysfunction reported; monitor

              Risk of toxicity may increae in patients with renal impairment; used caution; monitor renal function

              Elderly patients may require lower doses; use associated with cardiac depression, especially those with hypertension

              Safety during labor and delivery not elucidated; not recommended

              General anesthetics and sedation drugs in young children and pregnant women

              • Brain development
                • Prolonged or repeated exposure may result in negative effects on fetal or young children’s brain development
                • Caution with use during surgeries or procedures in children younger than 3 yr or in pregnant women during their third trimester
                • Assess the risk:benefit ratio in these populations, especially for prolonged procedures (ie, >3 hr) or multiple procedures
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              Pregnancy & Lactation

              Pregnancy

              There are no adequate and well-controlled studies in pregnant women

              There are insufficient data to support intravenous use in obstetrics, including Caesarean section deliveries; such use not recommended

              Not known whether drug is excreted in human milk; because many drugs are excreted in human milk, use catuioin when administering to a nursing mother

              Animal data

              • In animal reproduction studies, fetal deaths and reduced pup survival were noted after intravenous administration of etomidate to pregnant rats at doses 0.17 times the human induction dose of 0.3 mg/kg
              • Reduced pup survival was noted after intravenous administration of etomidate to pregnant rabbits at 1.6 times the human induction dose
              • Published studies in pregnant primates demonstrate that the administration of anesthetic and sedation drugs that block NMDA receptors and/or potentiate GABA activity during the period of peak brain development increases neuronal apoptosis in developing brain of the offspring when used for longer than 3 hours
              • There are no data on pregnancy exposures in primates corresponding to periods prior to third trimester in humans

              Lactation

              Not known whether drug is excreted in human milk; because many drugs are excreted in human milk, caution should be exercised when administered to a nursing mother.

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Nonbarbiturate hypnotic used for the induction of anesthesia; lacks analgesic activity; has minimal cardiovascular effects

              Cushing syndrome (off-label): Blocks 11-beta-hydroxylase

              Blocks steroidogenesis; 0.3 mg/kg will reduce plasma cortisol for up to 24 hr

              Does not affect cardiac metabolism; no depression of cardiac output or of peripheral or pulmonary circulation

              Absorption

              Onset: Within 60 sec

              Duration: 3-5 min due to redistribution from CNS

              Distribution

              Protein bound: 76%

              Vd: 2-4.5 L/kg

              Metabolism

              Hepatic and plasma esterases

              Elimination

              Excretion: Urine, as inactive agent

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              Administration

              IV Incompatibilities

              Y-site: Ascorbic acid, vecuronium

              IV Compatibilities

              Syringe: Heparin

              Y-site: Alfentanil, atracurium, atropine, ephedrine, fentanyl, lidocaine, lorazepam, midazolam, mivacurium, morphine sulfate, pancuronium, phenylephrine, succinylcholine, sufentanil

              IV Administration

              The IV infusion should be administered by healthcare professionals trained in the administration of general anesthetics and the management of complications encountered during its administration

              Inject undiluted by direct IV injection over 30-60 sec; do not administer by prolonged IV infusion

              Inject into large forearm vein

              Consider lidocaine preadministration to minimize injection-site pain

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              etomidate intravenous
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              2 mg/mL vial
              Amidate intravenous
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              2 mg/mL vial
              Amidate intravenous
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              2 mg/mL vial
              Amidate intravenous
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              2 mg/mL vial
              Amidate intravenous
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              2 mg/mL solution
              Amidate intravenous
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              2 mg/mL vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              etomidate intravenous

              NO MONOGRAPH AVAILABLE AT THIS TIME

              USES: Consult your pharmacist.

              HOW TO USE: Consult your pharmacist.

              SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Consult your pharmacist.

              DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: No monograph available at this time.

              MISSED DOSE: Consult your pharmacist.

              STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.