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Propofol Dosage

Applies to the following strength(s): 10 mg/mL ; with medium chain triglycerides 10 mg/mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Geriatric Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Anesthesia

INDUCTION OF GENERAL ANESTHESIA:
-ADULTS LESS THAN 55 YEARS OF AGE AND CLASSIFIED AS ASA-PS I OR II: 40 mg IV every 10 seconds until induction onset (2 to 2.5 mg/kg)
-CARDIAC ANESTHESIA: 20 mg IV every 10 seconds until induction onset (0.5 to 1.5 mg/kg)
-NEUROSURGICAL PATIENTS: 20 mg IV every 10 seconds until induction onset (1 to 2 mg/kg)

MAINTENANCE OF GENERAL ANESTHESIA (INFUSION):
-ADULTS LESS THAN 55 YEARS OF AGE AND CLASSIFIED AS ASA-PS I OR II: 100 to 200 mcg/kg/min IV (6 to 12 mg/kg/hr)
-CARDIAC ANESTHESIA: Most patients require:
PRIMARY PROPOFOL WITH SECONDARY OPIOID: 100 to 150 mcg/kg/min IV
PRIMARY OPIOID WITH SECONDARY PROPOFOL: 50 to 100 mcg/kg/min IV
-NEUROSURGICAL PATIENTS: 100 to 200 mcg/kg/min (6 to 12 mg/kg/hr)

MAINTENANCE OF GENERAL ANESTHESIA (INTERMITTENT BOLUS):
-ADULTS LESS THAN 55 YEARS OF AGE AND CLASSIFIED AS ASA-PS I OR II: Increments of 20 to 50 mg as needed

INITIATION OF MONITORED ANESTHESIA CARE (MAC) SEDATION:
-ADULTS LESS THAN 55 YEARS OF AGE AND CLASSIFIED AS ASA-PS I OR II: A variable rate infusion technique is preferable over an intermittent bolus technique; most patients require an infusion of 25 to 75 mcg/kg/min IV (1.5 to 4.5 mg/kg/hr) or incremental bolus doses of 10 mg or 20 mg

INITIATION AND MAINTENANCE OF ICU SEDATION IN INTUBATED, MECHANICALLY VENTILATED PATIENTS:
-ADULT PATIENTS: Because of the residual effects of previous anesthetic or sedative agents, in most patients the initial infusion should be 5 mcg/kg/min IV (0.3 mg/kg/hr) for at least 5 minutes; subsequent increments of 5 to 10 mcg/kg/min (0.3 to 0.6 mg/kg/hr) over 5 to 10 minutes may be used until the desired clinical effect is achieved; maintenance rates of 5 to 50 mcg/kg/min IV (0.3 to 3 mg/kg/hr) or higher may be required; administration should not exceed 4 mg/kg/hr IV unless the benefits outweigh the risks

Uses:
-Induction of general anesthesia
-Maintenance of general anesthesia
-Initiation and maintenance of monitored anesthesia care (MAC) sedation
-Intensive care unit (ICU) sedation of intubated, mechanically ventilated patients

Usual Geriatric Dose for Anesthesia

INDUCTION OF GENERAL ANESTHESIA:
-Elderly, debilitated, or ASA III/IV patients: 20 mg IV every 10 seconds until induction onset (1 to 1.5 mg/kg)

MAINTENANCE OF GENERAL ANESTHESIA (INFUSION):
-Elderly, debilitated, or ASA III/IV patients: 50 to 100 mcg/kg/min IV (3 to 6 mg/kg/hr)

INITIATION OF MONITORED ANESTHESIA CARE (MAC) SEDATION:
-Elderly, debilitated, or ASA III/IV patients: Most patients require dosages similar to healthy adults; rapid boluses should be avoided

-MAINTENANCE OF MAC SEDATION:
-Elderly, debilitated, or ASA III/IV patients: Most patients require 80% of the usual adult dose; a rapid (single or repeated) bolus dose should not be used

Uses:
-Induction of general anesthesia
-Maintenance of general anesthesia
-Initiation and maintenance of monitored anesthesia care (MAC) sedation
-Intensive care unit (ICU) sedation of intubated, mechanically ventilated patients

Usual Pediatric Dose for Anesthesia

INDUCTION OF GENERAL ANESTHESIA:
-Age 3 years to 16 years and healthy: 2.5 to 3.5 mg/kg IV over 20 to 30 seconds

MAINTENANCE OF GENERAL ANESTHESIA:
-Age 2 months to 16 years and healthy: 125 to 300 mcg/kg/min IV (7.5 to 18 mg/kg/hr); following the first half hour of maintenance, if clinical signs of light anesthesia are not present, the infusion rate should be decreased

Comments:
-For age 16 years to adult use adult dosing.
-Safety and dosing requirements for induction of anesthesia in pediatric patients have only been established for children 3 years of age or older.
-Safety and dosing requirements for the maintenance of anesthesia have only been established for children 2 months of age and older.

Uses:
-Induction of general anesthesia in pediatric patients 3 to 16 years of age
-Maintenance of general anesthesia in pediatric patients age 2 months to 16 years

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

-Safety and efficacy have not been established in patients younger than 3 years for induction of general anesthesia.
-Safety and efficacy have not been established in patients younger than 2 months for maintenance of general anesthesia.
-Safety and efficacy have not been established in patients younger than 16 years for initiation and maintenance of monitored anesthesia care (MAC) sedation.
-Safety and efficacy have not been established in patients younger than 16 years for intensive care unit (ICU) sedation of intubated, mechanically ventilated patients.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

General:
-This drug should be administered only by persons trained in the administration of general anesthesia and not involved in the diagnostic or therapeutic procedure.
-Facilities for maintenance of a patent airway, providing artificial ventilation, administering supplemental oxygen, and instituting cardiovascular resuscitation should be immediately available.
-The safety of this drug has not been established when used for continuous infusion.

Monitoring:
-Patients should be monitored for their ability to demonstrate purposeful response while sedated.
-Patients should be monitored during sedation and through the recovery process for early signs of hypotension, apnea, airway obstruction, and/or oxygen desaturation.
-Caution is recommended in patients with cardiac, respiratory, renal or hepatic dysfunction, and patients who are hypovolemic or debilitated.
-This drug should be used cautiously in patients with lipid metabolism disorders.
-This drug has been associated with reports of bradycardia (possibly profound) and asystole. The IV administration of an anticholinergic agent prior to induction, or during maintenance of anesthesia should be considered, especially in situations where vagal tone is likely to predominate or when this drug is used in conjunction with other agents likely to cause bradycardia.
-This drug reduces cerebral blood flow, intracranial pressure, and cerebral metabolism. This reduction in intracranial pressure is greater in patients with an elevated baseline intracranial pressure.
-There is a risk of seizure during the recovery phase following administration of this drug to a patient with epilepsy.
-There are very rare reports of metabolic acidosis, rhabdomyolysis, hyperkalemia, and/or rapidly progressive cardiac failure (occasionally fatal) in adults treated with an infusion in excess of 5 mg/kg/hour for more than a 58-hour duration. The majority of these reports, though not all, have been in patients with serious head injuries associated with intracranial pressure. Decreasing the dosage or switching to an alternative sedative should be considered if these adverse effects continue. -The maximum dosage of propofol for adult sedation in an intensive care setting should not exceed 4 mg/kg/hour.
-This drug is not recommended by the manufacturer for obstetrics, including Cesarean section deliveries as it crosses the placenta, and may be associated with neonatal depression.

Patient Advice:
-Patients undergoing anesthesia or sedation (particularly those undergoing outpatient surgery or procedures) should be warned of the potential for central nervous system depression. Driving, or other hazardous activities should be avoided.

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