Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 10mg/mL
Anesthesia
Induction
- <55 years ASA I/II: 40 mg IVP q10sec until onset (2-2.5 mg/kg IV when not premedicated with oral benzodiazepines or intramuscular opioids)
- >55 years or debilitated or ASA III/IV: 20 mg IVP q10sec until onset (1-1.5 mg/kg); do not use rapid bolus because as it will increase likelihood of undesirable cardiorespiratory depression, including hypotension, apnea, airway obstruction, and/or oxygen desaturation
Maintenance
- <55 years ASA I/II: 0.1-0.2 mg/kg/min IV; administered in a variable rate infusion with nitrous oxide 60% to 70% and oxygen provides anesthesia for patients undergoing general surgery; maintenance infusion should immediately follow induction dose to provide satisfactory or continuous anesthesia during induction phase
- Intermittent bolus: Increments of 25-50 mg (2.5-5 mL) may be administered with nitrous oxide in adults undergoing general surgery; administer incremental boluses when changes in vital signs indicate response to surgical stimulation or light anesthesia
- >55 years or debilitated or ASA III/IV: 0.05-0.1 mg/kg/min IV
MAC Sedation
Initiation
- 0.1-0.15 mg/kg/min IV for 3-5 min; titrate to desired clinical effect; monitor respiratory function; administered as slow infusion or slow injection while monitoring cardiorespiratory function
- Slow injection: 0.5 mg/kg administered over 3-5 min; titrate to clinical response
- Elderly: Do not use rapid bolus dose administration; administer over 3-5 min; reduce dose to approximately 80% of usual adult dose according to their condition, response, and changes in vital signs
Maintenance
- Variable rate of infusion method preferable over intermittent bolus dose method
- Variable rate infusion method: 0.025-0.075 mg/kg/min IV during first 10-15 min sedation maintenance; subsequently decrease infusion rates over time to 25 to 50 mcg/kg/min and adjust clinical response; allow approximately 2 min for onset of peak drug effect to titrate to clinical response; titrate downward in absence of clinical signs of light sedation until mild response to stimulation obtained to avoid sedative administration at rates higher than clinically necessary
- Intermittent bolus method: Administer 10-20 mg increments and titrate to desired level of sedation
- Elderly: 0.02-0.06 mg/kg/min IV; do not use rapid bolus dose administration; reduce rate of administration to 80% of usual adult dose according to their condition, response, and changes in vital signs
Postoperative Nausea/Vomiting
20 mg IV; may repeat
ICU Patient
Initiation: 0.005 mg/kg/min IV for at least 5 min; titrate to desired clinical effect; increase by 5-10 mcg/kg/min over 5-10 min intervals until desired sedation level achieved; allow a minimum of 5 min between adjustments for onset of peak effect
For medical ICU patients or patients who recovered from effect of general anesthesia or deep sedation, rate of administration of 50 mcg/kg/min or more may be required to achieve adequate sedation
Maintenance: 0.005-0.05 mg/kg/min IV individualized and titrated to clinical response; (0.005 mg/kg/min increment increase q5min)
Discontinuation: Avoid discontinuation prior to weaning or for daily evaluation of sedation levels; may result in rapid awakening with associated anxiety, agitation, and resistance to mechanical ventilation
Dosage Forms & Strengths
injectable solution
- 10mg/mL
Anesthesia
Induction
- <3 years: Not recommended
- 3-16 years ASA I/II: 2.5-3.5 mg/kg IVP over 20-30 sec when not premedicated or when lightly premedicated with oral benzodiazepines or intramuscular opioids; younger patients may required higher induction doses than older children; lower dosage recommended for children ASA III/IV
Maintenance
- 2 months-16 years ASA I/II: 0.125-0.3 mg/kg/min IV; after 30 min, if clinical signs of light anesthesia are absent, decrease infusion rate; children 5 years or younger may require larger infusion rates compared to older children
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- mavacamten
propofol will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction.
Serious - Use Alternative (33)
- abametapir
abametapir will increase the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP2B6 substrates. If not feasible, avoid use of abametapir.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, propofol. 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
propofol, 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.
- carbamazepine
carbamazepine will decrease the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Avoid or Use Alternate Drug.
- ceritinib
ceritinib increases levels of propofol by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid concurrent use of CYP2C9 substrates known to have narrow therapeutic indices or substrates primarily metabolized by CYP2C9 during treatment with ceritinib; if use of these medications is unavoidable, consider dose.
- doxapram
doxapram, propofol. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.
- epinephrine
propofol increases levels of epinephrine by unknown mechanism. Avoid or Use Alternate Drug.
- epinephrine racemic
propofol increases levels of epinephrine racemic by unknown mechanism. Avoid or Use Alternate Drug.
- fedratinib
propofol will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.
- fentanyl
fentanyl, propofol. 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, propofol. 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, propofol. 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, propofol. 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.
- fexinidazole
fexinidazole will decrease the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Avoid or Use Alternate Drug. Coadministration may decrease plasma concentrations of CYP2B6 substrates owing to fexinidazole inducing CYP2B6.
fexinidazole and propofol both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval. - hydrocodone
hydrocodone, propofol. 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).
- isocarboxazid
isocarboxazid increases levels of propofol by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib will decrease the level or effect of propofol by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2C9 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.
- lefamulin
lefamulin and propofol both increase QTc interval. Avoid or Use Alternate Drug.
- lonafarnib
propofol will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.
- metoclopramide intranasal
propofol, 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
propofol increases levels of norepinephrine by decreasing metabolism. Contraindicated.
- phenelzine
phenelzine increases levels of propofol by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- phenylephrine
propofol increases levels of phenylephrine by decreasing metabolism. Contraindicated.
- phenylephrine PO
propofol increases levels of phenylephrine PO by decreasing metabolism. Contraindicated.
- pirfenidone
propofol will increase the level or effect of pirfenidone by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid; coadministration of pirfenidone and moderate CYP1A2 inhibitors result in moderately increased exposure to pirfenidone; if unable to avoid, decrease dose of moderate CYP1A2 inhibitor
- ponesimod
ponesimod, propofol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.
- rasagiline
rasagiline increases levels of propofol by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- rifampin
rifampin will decrease the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Avoid or Use Alternate Drug.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b and propofol both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- selegiline
selegiline increases levels of propofol by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- sodium oxybate
propofol, 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, propofol. 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.
- tranylcypromine
tranylcypromine increases levels of propofol by pharmacodynamic synergism. Avoid or Use Alternate Drug.
Monitor Closely (190)
- acebutolol
propofol, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- alfentanil
propofol and alfentanil both increase sedation. Use Caution/Monitor.
- alpelisib
alpelisib will decrease the level or effect of propofol by pharmacodynamic synergism. Modify Therapy/Monitor Closely.
- alprazolam
propofol and alprazolam both increase sedation. Use Caution/Monitor.
- amitriptyline
propofol and amitriptyline both increase sedation. Use Caution/Monitor.
- amobarbital
propofol and amobarbital both increase sedation. Use Caution/Monitor.
- amoxapine
propofol and amoxapine both increase sedation. Use Caution/Monitor.
- apalutamide
apalutamide will decrease the level or effect of propofol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.
- apomorphine
propofol and apomorphine both increase sedation. Use Caution/Monitor.
apomorphine and propofol both increase QTc interval. Use Caution/Monitor. - atenolol
propofol, atenolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- atogepant
propofol will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- avapritinib
propofol will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- axitinib
propofol increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- baclofen
propofol and baclofen both increase sedation. Use Caution/Monitor.
- belladonna and opium
propofol and belladonna and opium both increase sedation. Use Caution/Monitor.
- benazepril
propofol, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.
- benperidol
propofol and benperidol both increase sedation. Use Caution/Monitor.
- betaxolol
propofol, betaxolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- bisoprolol
propofol, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- brompheniramine
propofol and brompheniramine both increase sedation. Use Caution/Monitor.
- buprenorphine
propofol and buprenorphine both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
propofol and buprenorphine buccal both increase sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
propofol 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
propofol and butabarbital both increase sedation. Use Caution/Monitor.
- butalbital
propofol and butalbital both increase sedation. Use Caution/Monitor.
- butorphanol
propofol and butorphanol both increase sedation. Use Caution/Monitor.
- cannabidiol
propofol will increase the level or effect of cannabidiol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP2C19 inhibitor.
cannabidiol will increase the level or effect of propofol by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.
cannabidiol will increase the level or effect of propofol by Other (see comment). Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit UGT1A9 activity. Consider reducing the dose when concomitantly using UGT1A9 substrates. - captopril
propofol, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.
- carbinoxamine
propofol and carbinoxamine both increase sedation. Use Caution/Monitor.
- carisoprodol
propofol and carisoprodol both increase sedation. Use Caution/Monitor.
- carvedilol
propofol, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- celiprolol
propofol, celiprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- cenobamate
cenobamate will decrease the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP2B6 substrate, as needed, when coadministered with cenobamate.
cenobamate, propofol. Either increases effects of the other by sedation. Use Caution/Monitor. - chloral hydrate
propofol and chloral hydrate both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
propofol and chlordiazepoxide both increase sedation. Use Caution/Monitor.
- chlorpheniramine
propofol and chlorpheniramine both increase sedation. Use Caution/Monitor.
- chlorpromazine
propofol and chlorpromazine both increase sedation. Use Caution/Monitor.
- chlorzoxazone
propofol and chlorzoxazone both increase sedation. Use Caution/Monitor.
- cilostazol
propofol increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider decreasing cilostazol dose; moderate CYP2C19 inhibitors may increase serum levels of 3,4-dehydrocilostazol (active metabolite).
- cinnarizine
propofol and cinnarizine both increase sedation. Use Caution/Monitor.
- clemastine
propofol and clemastine both increase sedation. Use Caution/Monitor.
- clomipramine
propofol and clomipramine both increase sedation. Use Caution/Monitor.
- clonazepam
propofol and clonazepam both increase sedation. Use Caution/Monitor.
- clorazepate
propofol and clorazepate both increase sedation. Use Caution/Monitor.
- clozapine
propofol and clozapine both increase sedation. Use Caution/Monitor.
- codeine
propofol and codeine both increase sedation. Use Caution/Monitor.
- cyclizine
propofol and cyclizine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
propofol and cyclobenzaprine both increase sedation. Use Caution/Monitor.
- cyproheptadine
propofol and cyproheptadine both increase sedation. Use Caution/Monitor.
- dantrolene
propofol and dantrolene both increase sedation. Use Caution/Monitor.
- daridorexant
propofol 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 propofol both increase sedation. Use Caution/Monitor.
- desipramine
propofol and desipramine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
propofol and dexchlorpheniramine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
propofol increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
propofol and dexmedetomidine both increase sedation. Use Caution/Monitor.
- dextromoramide
propofol and dextromoramide both increase sedation. Use Caution/Monitor.
- diamorphine
propofol and diamorphine both increase sedation. Use Caution/Monitor.
- diazepam
propofol and diazepam both increase sedation. Use Caution/Monitor.
- diazepam intranasal
propofol will increase the level or effect of diazepam intranasal by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Strong or moderate CYP2C19 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.
- dichlorphenamide
dichlorphenamide, propofol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.
- diethylpropion
propofol increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and propofol both increase sedation. Use Caution/Monitor.
- difenoxin hcl
propofol and difenoxin hcl both increase sedation. Use Caution/Monitor.
- dimenhydrinate
propofol and dimenhydrinate both increase sedation. Use Caution/Monitor.
- diphenhydramine
propofol and diphenhydramine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
propofol and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dipipanone
propofol and dipipanone both increase sedation. Use Caution/Monitor.
- dopexamine
propofol increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
propofol and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
propofol and doxepin both increase sedation. Use Caution/Monitor.
- doxylamine
propofol and doxylamine both increase sedation. Use Caution/Monitor.
- droperidol
propofol and droperidol both increase sedation. Use Caution/Monitor.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of propofol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Elvitegravir is a moderate CYP2C9 inducer.
- esketamine intranasal
esketamine intranasal, propofol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- esmolol
propofol, esmolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- estazolam
propofol and estazolam both increase sedation. Use Caution/Monitor.
- ethanol
propofol and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and propofol both increase sedation. Use Caution/Monitor.
- fenfluramine
propofol increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- finerenone
propofol will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.
- flibanserin
propofol will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.
- fluphenazine
propofol and fluphenazine both increase sedation. Use Caution/Monitor.
- flurazepam
propofol and flurazepam both increase sedation. Use Caution/Monitor.
- fluvoxamine
fluvoxamine will increase the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.
- fostemsavir
propofol and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- ganaxolone
propofol and ganaxolone both increase sedation. Use Caution/Monitor.
- haloperidol
propofol and haloperidol both increase sedation. Use Caution/Monitor.
- hydromorphone
propofol and hydromorphone both increase sedation. Use Caution/Monitor.
- hydroxyzine
propofol and hydroxyzine both increase sedation. Use Caution/Monitor.
- iloperidone
propofol and iloperidone both increase sedation. Use Caution/Monitor.
- imipramine
propofol and imipramine both increase sedation. Use Caution/Monitor.
- isavuconazonium sulfate
propofol will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ivacaftor
propofol increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .
- ketamine
ketamine and propofol both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
propofol and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- labetalol
propofol, labetalol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- lasmiditan
lasmiditan, propofol. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant will decrease the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Modify Therapy/Monitor Closely. Monitor CYP2B6 substrate for adequate clinical response. Consider increasing the CYP2B6 substrate dose according to specific prescribing recommendations.
propofol will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.
lemborexant, propofol. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. - levorphanol
propofol and levorphanol both increase sedation. Use Caution/Monitor.
- linezolid
linezolid increases levels of propofol by pharmacodynamic synergism. Use Caution/Monitor.
- lofepramine
propofol and lofepramine both increase sedation. Use Caution/Monitor.
- lofexidine
propofol and lofexidine both increase sedation. Use Caution/Monitor.
- lomitapide
propofol increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
- loprazolam
propofol and loprazolam both increase sedation. Use Caution/Monitor.
- lorazepam
propofol and lorazepam both increase sedation. Use Caution/Monitor.
- lormetazepam
propofol and lormetazepam both increase sedation. Use Caution/Monitor.
- loxapine
propofol and loxapine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
propofol and loxapine inhaled both increase sedation. Use Caution/Monitor.
- lumacaftor/ivacaftor
lumacaftor/ivacaftor, propofol. affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2B6 substrates. .
lumacaftor/ivacaftor, propofol. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C9 substrates. . - maprotiline
propofol and maprotiline both increase sedation. Use Caution/Monitor.
- meperidine
propofol and meperidine both increase sedation. Use Caution/Monitor.
- meprobamate
propofol and meprobamate both increase sedation. Use Caution/Monitor.
- metaxalone
propofol and metaxalone both increase sedation. Use Caution/Monitor.
- methadone
propofol and methadone both increase sedation. Use Caution/Monitor.
- methocarbamol
propofol and methocarbamol both increase sedation. Use Caution/Monitor.
- metoprolol
propofol, metoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- midazolam
propofol and midazolam both increase sedation. Use Caution/Monitor.
- midazolam intranasal
propofol will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.
midazolam intranasal, propofol. 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. - midodrine
propofol increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mifepristone
mifepristone will increase the level or effect of propofol by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.
- mirtazapine
propofol and mirtazapine both increase sedation. Use Caution/Monitor.
mirtazapine and propofol both increase QTc interval. Use Caution/Monitor. - morphine
propofol and morphine both increase sedation. Use Caution/Monitor.
- moxonidine
propofol and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
propofol and nabilone both increase sedation. Use Caution/Monitor.
- nadolol
propofol, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- nalbuphine
propofol and nalbuphine both increase sedation. Use Caution/Monitor.
- nebivolol
propofol, nebivolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- nitisinone
nitisinone will increase the level or effect of propofol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.
- nortriptyline
propofol and nortriptyline both increase sedation. Use Caution/Monitor.
- olanzapine
propofol and olanzapine both increase sedation. Use Caution/Monitor.
- opium tincture
propofol and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
propofol and orphenadrine both increase sedation. Use Caution/Monitor.
- osilodrostat
osilodrostat and propofol both increase QTc interval. Use Caution/Monitor.
- oxazepam
propofol and oxazepam both increase sedation. Use Caution/Monitor.
- oxycodone
propofol and oxycodone both increase sedation. Use Caution/Monitor.
- oxymorphone
propofol and oxymorphone both increase sedation. Use Caution/Monitor.
- paliperidone
propofol and paliperidone both increase sedation. Use Caution/Monitor.
- papaveretum
propofol and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
propofol and papaverine both increase sedation. Use Caution/Monitor.
- penbutolol
propofol, penbutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- pentazocine
propofol and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
propofol and pentobarbital both increase sedation. Use Caution/Monitor.
- perphenazine
propofol and perphenazine both increase sedation. Use Caution/Monitor.
- phendimetrazine
propofol increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
propofol and phenobarbital both increase sedation. Use Caution/Monitor.
- phenylephrine
propofol increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
propofol increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
propofol and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
propofol and pimozide both increase sedation. Use Caution/Monitor.
- pindolol
propofol, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- primidone
propofol and primidone both increase sedation. Use Caution/Monitor.
- procarbazine
procarbazine increases levels of propofol by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension.
- prochlorperazine
propofol and prochlorperazine both increase sedation. Use Caution/Monitor.
- promethazine
propofol and promethazine both increase sedation. Use Caution/Monitor.
- propranolol
propofol, propranolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- propylhexedrine
propofol increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
propofol and protriptyline both increase sedation. Use Caution/Monitor.
- quazepam
propofol and quazepam both increase sedation. Use Caution/Monitor.
- quetiapine
propofol and quetiapine both increase sedation. Use Caution/Monitor.
- ramelteon
propofol and ramelteon both increase sedation. Use Caution/Monitor.
- risperidone
propofol and risperidone both increase sedation. Use Caution/Monitor.
- rucaparib
rucaparib will increase the level or effect of propofol by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.
- secobarbital
propofol and secobarbital both increase sedation. Use Caution/Monitor.
- selegiline transdermal
selegiline transdermal increases levels of propofol by pharmacodynamic synergism. Use Caution/Monitor.
- sevoflurane
propofol and sevoflurane both increase sedation. Use Caution/Monitor.
- sotalol
propofol, sotalol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- stiripentol
stiripentol, propofol. affecting hepatic enzyme CYP2B6 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP2B6 inhibitor and inducer. Monitor CYP2B6 substrates coadministered with stiripentol for increased or decreased effects. CYP2B6 substrates may require dosage adjustment.
stiripentol, propofol. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. - sufentanil
propofol and sufentanil both increase sedation. Use Caution/Monitor.
- tapentadol
propofol and tapentadol both increase sedation. Use Caution/Monitor.
- tazemetostat
propofol will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- temazepam
propofol and temazepam both increase sedation. Use Caution/Monitor.
- thioridazine
propofol and thioridazine both increase sedation. Use Caution/Monitor.
- thiothixene
propofol and thiothixene both increase sedation. Use Caution/Monitor.
- timolol
propofol, timolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- tinidazole
propofol will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- topiramate
propofol and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
propofol and tramadol both increase sedation. Use Caution/Monitor.
- trazodone
propofol and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
propofol and triazolam both increase sedation. Use Caution/Monitor.
- triclofos
propofol and triclofos both increase sedation. Use Caution/Monitor.
- trifluoperazine
propofol and trifluoperazine both increase sedation. Use Caution/Monitor.
- trimipramine
propofol and trimipramine both increase sedation. Use Caution/Monitor.
- triprolidine
propofol and triprolidine both increase sedation. Use Caution/Monitor.
- valproic acid
valproic acid increases effects of propofol by pharmacodynamic synergism. Use Caution/Monitor.
- warfarin
propofol will increase the level or effect of warfarin by Other (see comment). Use Caution/Monitor. Warfarin's less potent R-enantiomer is metabolized in part by CYP3A4 (and also CYP1A2 and CYP2C19). Monitor INR more frequently if coadministered with inhibitors of these isoenzymes and adjust warfarin dose if needed.
- xylometazoline
propofol increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
propofol and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
propofol and ziprasidone both increase sedation. Use Caution/Monitor.
- zotepine
propofol and zotepine both increase sedation. Use Caution/Monitor.
Minor (15)
- amitriptyline
propofol, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- amoxapine
propofol, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- clomipramine
propofol, clomipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- desipramine
propofol, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- dosulepin
propofol, dosulepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- doxepin
propofol, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- imipramine
propofol, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- lofepramine
propofol, lofepramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- maprotiline
propofol, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- nortriptyline
propofol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- protriptyline
propofol, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- ruxolitinib
propofol will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ruxolitinib topical
propofol will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- trazodone
propofol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- trimipramine
propofol, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
Adverse Effects
>10%
Hypotension (peds 17%; adults 3-26%)
Apnea lasting 30-60 sec (peds 10%; adults 24%)
Apnea lasting >60 sec (peds 5%; adults 12%)
Movement (peds 17%; adults 3-10%)
Injection site burning/stinging/pain (peds 10%; adults 18%)
1-10%
Respiratory acidosis during weaning (3-10%)
Hypertriglyceridemia (3-10%)
Hypertension (peds 8%)
Rash (peds 5%; adults 1-3%)
Pruritus (1-3%)
Arrhythmia (1-3%)
Bradycardia (1-3%)
Cardiac output decreased (1-3%; concurrent opioid use increases incidence)
Tachycardia (1-3%)
<1%
Arterial hypotension
Anaphylaxis
Asystole
Bronchospasm
Cardiac arrest
Seizures
Opisthotic rxn
Pancreatitis
Pulmonary edema
Phlebitis
Thrombosis
Renal tubular toxicity
Warnings
Contraindications
Documented hypersensitivity, egg allergy, soybean/soy allergy
Cautions
Drug vehicle (emulsion) is capable of supporting rapid growth of microorganisms; proper aseptic technique is imperative
Closely monitor patients with anemia, hepatic impairment, myxedema, or renal impairment
Risk of potentially fatal propofol infusion syndrome in ICU patients
May cause hypotension, especialy if patient is hypovolemic or if bolus dosing is used; reduction in mean arterial pressure may exceed 30%; use caution in patients who arehemodynamically unstable, hypovelimic, or have abnormally low vascular tone
Use with caution in patients with severe cardiac disease (<50% ejection fraction) or hypotension; may have more profound adverse cardiovascular responses to propofol
Use with caution in patients with increased intracranial pressure or impaired cerebral circulation; mean arterial pressure may decrease substantially; cerebral perfusion may subsequently decrease; consider continuous infusion or administer as a slow bolus
Prefilled syringes may have potential to support growth of various microorganisms dispite additives intended to suppress microbial growth; strictly adhere to recommendations in product labeling for handling and administering propofol
Use caution in patients with respiratory disease and history of epilepsy or seizures; seizures may occur during recovery phase
Propofol lacks analgesic properties; pain management requires specific use of analgesic agents, at effective dosages; titrate propofol separately from analgesic agent
Do not give bolus to ASA III/IV patients; rapid bolus doses will increase cardiorespiratory effects (ie, hypotension, apnea, airway obstruction)
Significant hypertriglyceridemia may be observed during infusion of propofol; 0.1 g lipid (1.1 kcal) per 1 mL propofol
Accidental extravasation may result in tissue necrosis
Risk of chills, fever, body aches
Propofol infusion syndrome may occur; this is characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis, hepatomegaly, and cardiac and renal failure (esp with prolonged, high-dose infusions >5 mg/kg/hr for >48 hr)
Perioperative myoclonus reported with administration
Anxiety, agitation, and resistance to mechanical ventilation may occur with abrupt withdrawal
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 category: B
Lactation: Excreted in breast milk; effect on nursing infant not known
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
Short-acting, lipophilic sedative/hypnotic; causes global CNS depression, presumably through agonist actions on GABAa receptors
Absorption
Onset: 30-45 sec
Duration: 3-10 min (dose-dependent duration; dissipation is function of drug redistribution from CNS)
Distribution
Protein bound: 97-99%
Metabolism
Metabolized by hepatic conjugation to inactive compound
Elimination
Half-life: 40 min (initial); 24-72 hr (after 10-day infusion)
Excretion: Urine, feces
Administration
IV Incompatibilities
Y-site: Amikacin, amphotericin B, atracurium, bretylium, calcium chloride, ceftazidime (?), ciprofloxacin, cisatracurium, diazepam, digoxin, doxorubicin, gentamicin, levofloxacin, methotrexate, methylprednisolone sodium succinate, metoclopramide, minocycline, mitoxantrone, morphine sulfate (at high conc of morphine, compatible at 1 mg/mL), netilmicin, phenytoin, tobramycin, verapamil
Do not mix with other drugs prior to administration
IV Compatibilities
Solution: D5W, LR, D5/LR, D5/0.45% NaCl, D5/0.2% NaCl
Syringe: ondansetron, thiopental
Y-site (partial list): Acyclovir, buprenorphine, dopamine, dobutamine, epinephrine, fentanyl, furosemide, hydromorphone, ketamine, lidocaine, meperidine, midazolam (?), nitroglycerin, KCl, MgSO4, vecuronium
IV Preparation
Does not need to be diluted (available form: 10 mg/mL); however, may be further diluted in D5W to 2 mg/mL
IV Administration
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
Do not use filter with <5 micron for administration
Soybean fat emulsion is used as a vehicle for propofol
Strict aseptic technique must be maintained in handling, although a preservative has been added
Do not administer through the same IV catheter with blood or plasma
American College of Critical Care Medicine recommends use of a central vein for administration in an ICU setting
Storage
Store at room temp; refrigeration is not recommended
Protect from light
Do not use if there is evidence of separation of phases of emulsion
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| propofol intravenous - | 10 mg/mL vial |  | |
| propofol intravenous - | 10 mg/mL vial |  | |
| propofol intravenous - | 10 mg/mL vial |  | |
| propofol intravenous - | 10 mg/mL vial |  | |
| propofol intravenous - | 10 mg/mL vial |  | |
| propofol intravenous - | 10 mg/mL vial |  | |
| Diprivan intravenous - | 10 mg/mL vial |  | |
| Diprivan intravenous - | 10 mg/mL vial |  | |
| Diprivan intravenous - | 10 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
propofol 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) 2022 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
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- View the formulary and any restrictions for each plan.
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