Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (16)
- 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.
- 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 (151)
- 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.
- 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.
- 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.
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)
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
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.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
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| etomidate intravenous - | 2 mg/mL vial |  | |
| Amidate intravenous - | 2 mg/mL solution |  | |
| Amidate intravenous - | 2 mg/mL vial |  | |
| Amidate intravenous - | 2 mg/mL vial |  | |
| Amidate intravenous - | 2 mg/mL solution |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
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) 2021 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.
Formulary
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.
