Fospropofol (Intravenous)

Overview

Used for its sedative effects, Fospropofol (also known by the brand name Lusedra) can be prescribed to adult patients prior to surgery or medical procedures. Due to its hypnotic and anesthetic properties, Fospropofol can be used to prevent patients from being conscious during surgical procedures, experiencing pain during these procedures and having any recollection of the procedure itself.

As Fospropofol is a water-soluble drug, it is more commonly used than other similar drugs. Fospropofol does not activate transient receptor potential ankyrin 1 (TRPA1) and is, therefore, less likely to cause pain or discomfort at the injection site. In addition to this, the water-soluble nature of Fospropofol means that the medicine is less likely to cause patients to develop hyperlipidemia, or high levels of lipids in the blood. Similarly, patients are less likely to experience bacteremia, or bacteria in the blood, when Fospropofol is used as a sedative agent.

Although Fospropofol can be used alone, it may also be administered alongside other types of medications. Prior to some procedures, patients may be prescribed an opioid drug, as well as being given Fospropofol.

As Fospropofol is a strong sedative, it can be used prior to numerous types of surgeries and procedures. Although patients may be given it prior to undergoing a therapeutic procedure, Fospropofol may also be prescribed prior to some diagnostic procedures, such as endoscopies.

Conditions Treated

  • Used to sedate patients prior to surgery

Type Of Medicine

  • Sedative agent

Side Effects

Whenever patients are given medication, there is the risk that side effects will occur. Often, these side effects are fairly mild and do not require any additional treatment. When patients are given Fospropofol, for example, they may display the following side effects:

  • Nausea
  • Vomiting
  • Itching of the skin
  • Headache

Although these side effects may not need medical attention, patients should always seek help if they are concerned about the presence of any adverse effects. In addition to this, patients should obtain medical advice if they experience any of the following side effects after being given Fospropofol:

  • Bluish skin or lips
  • Tingling, crawling, burning, numbness, prickling, itching or "pins and needles"feelings
  • Blurred vision
  • Lightheadedness, faintness or dizziness when getting up suddenly from a lying or sitting position
  • Unusual weakness or tiredness
  • Sweating
  • Confusion
  • Troubled breathing
  • Blue or pale lips, skin and/or fingernails
  • Slow, shallow, fast or irregular breathing
  • Difficulty breathing
  • Shortness of breath

As these side effects may require medical treatment, it's important that patients alert a doctor or nurse if they begin to exhibit any of these adverse effects. Similarly, patients should obtain medical assistance if they experience any other side effects after being sedated with Fospropofol.

As Fospropofol is generally administered in a clinical setting, patients should be monitored whilst under sedation and should find it easy to access medical help once they have awoken.

Dosage

When patients are prescribed Fospropofol, their dose will be calculated based on their age, weight and existing health problems. If patients are over the age of sixty-five years or have health issues, for example, they may be given a lower dose of Fospropofol.

When using Fospropofol to sedate patients, physicians will use as little medication as possible in order to achieve the desired effect. If the intended procedure only requires light sedation, for example, patients may be given less Fospropofol than if they need to be fully unconscious, for example.

All patients should be treated with additional oxygen while they are sedated with Fospropofol. In addition to this, patients should be constantly monitored whilst they are sedated.

If healthy adult patients, between the ages of eighteen and sixty-five years, are prescribed Fospropofol, they will usually be given the drug at a rate of 6.5mg per kilogram of body weight as an initial dose, followed by additional doses of 1.6mg per kilogram of body weight. This extra administration of Fospropofol enables physicians to increase the level of sedation experienced by the patient. However, additional doses of Fospropofol should not be administered more frequently than every four minutes.

Initial doses of Fospropofol are limited by weight bounds. The minimum and maximum weights used to calculate the initial dose of Fospropofol are 60kg and 90kg. The initial dose of Fospropofol should not, therefore, exceed 16.5mL, whilst each additional dose of Fospropofol should not exceed 4mL.

If patients over the age of sixty-five or patients with systemic diseases are prescribed Fospropofol, their dose should be 75% of the standard dose. An initial dose of 4.8mg per kilogram of body weight should, therefore, be used and additional doses of 1.2mg per kilogram of body weight may be given.

As Fospropofol needs to be administered intravenously, the patient will be given this medication via an injection into one of their veins. Due to this, Fospropofol will be administered by a trained healthcare professional and patients will not be expected to prepare, calculate or handle their own dose of Fospropofol.

Potential Drug Interactions:

Prior to being given Fospropofol, patients should tell their doctor if they are taking any of medicines or if they have been given any other medications. Due to the possibility of interactions occurring, it's important that the patient's doctors are aware of any other medicines the patient may be taking.

Using Fospropofol alongside the following medicines is not usually recommended but may be considered appropriate in some cases:

  • Amobarbital
  • Codeine
  • Barbital
  • Clorazepate
  • Bromazepam
  • Chloral Hydrate
  • Bupivacaine
  • Clonazepam
  • Bupivacaine Liposome
  • Diazepam
  • Buprenorphine
  • Dichloralphenazone
  • Butabarbital
  • Hydromorphone
  • Chlordiazepoxide
  • Butorphanol
  • Hydrocodone
  • Carbinoxamine
  • Alfentanil
  • Lorazepam
  • Alprazolam
  • Dihydrocodeine
  • Lidocaine
  • Doxylamine
  • Hexobarbital
  • Estazolam
  • Meperidine
  • Eszopiclone
  • Levorphanol
  • Fentanyl
  • Meclizine
  • Flibanserin
  • Remifentanil
  • Mephobarbital
  • Prazepam
  • Meprobamate
  • Periciazine
  • Methadone
  • Pentazocine
  • Midazolam
  • Propoxyphene
  • Sufentanil
  • Morphine
  • Temazepam
  • Ramelteon
  • Morphine Sulfate Liposome
  • Oxymorphone
  • Nalbuphine
  • Tramadol
  • Paraldehyde
  • Triazolam
  • Oxazepam
  • Zaleplon
  • Oxycodone
  • Tapentadol
  • Secobarbital
  • Zopiclone
  • Sodium Oxybate
  • Zolpidem
  • St John's Wort

If Fospropofol is prescribed alongside the following medicine, it may increase the risk of side effects occurring:

  • Succinylcholine

However, doctors may provide advice regarding the treatment of side effects and how they can be managed.

As well as interacting with other prescribed medicines, Fospropofol could interact with over-the-counter medications, supplements and/or vitamins. Due to this, patients should tell their doctor if they have taken or used any of these substances. In addition to this, patients should obtain medical advice before using any of these substances after they've been treated with Fospropofol.

Warnings

Existing health problems may affect the use of Fospropofol so it's important that patients disclose their medical history to their physician before they are given this medication. The following conditions may prevent Fospropofol from being used or may mean that a modified dose of Fospropofol is required:

  • Low blood pressure (Hypotension)
  • Heart disease
  • Breathing problems
  • Low levels of oxygen in the blood (Hypoxemia)

Fospropofol can make patients feel drowsy or dizzy. Patients should not, therefore, drive, operate machinery or carry out tasks which require their full attention when they have been treated with Fospropofol recently.

If patients experience lightheadedness or dizziness when getting up from a lying or sitting position, they should attempt to get up slowly until the effects of the medication have worn off.

Fospropofol can cause patients to exhibit a side effect known as paresthesia. This causes tingling, itching and burning of the skin, and may also involve a sensation of crawling, numbness, prickling or "pins and needles". If patients experience these symptoms after receiving a Fospropofol injection, they should inform their physician straight away.

It is not known whether Fospropofol poses a risk to pregnant patients and their unborn child. Due to this, Fospropofol should only be prescribed to pregnant patients if it is absolutely necessary. If patients are pregnant, they must inform their physician prior to being given Fospropofol.

If patients are treated with Fospropofol, it is possible that the medication could be excreted in their breastmilk. If so, it could cause harm to an infant. Due to this, patients are normally advised to stop breastfeeding if they are treated with Fospropofol. In addition to this, patients should obtain medical advice before they resume breastfeeding after being treated with Fospropofol.

If patients exhibit any of the following symptoms whilst being treated with Fospropofol, they may be suffering from an allergic reaction and will require urgent medical assistance:

  • Wheezing
  • Difficulty breathing
  • Hives
  • Difficulty swallowing
  • Swelling of the hands, face, lips, mouth, tongue and/or throat

Storage

As Fospropofol is normally stored in single-use vials, each vial should be disposed of once it has been opened, even if some medication remains. When keeping Fospropofol, it should be stored in a controlled room temperature.

However, patients will not be required to store Fospropofol at home. As the medicine is administered intravenously, it will be stored and prepared in a clinical setting.

Summary

When patients are undergoing diagnostic or therapeutic procedures, they may need to be partially or completely sedated. As well as being less stressful for the patient, being sedated can make it easier for physicians to carry out the relevant procedure.

As Fospropofol is associated with fewer side effects than other, similar, drugs, it is often used to induce sedation in adult patients. Appropriate for use during various types of procedures, Fospropofol can be used to facilitate various levels of sedation and is, therefore, a commonly used product.