The Kingsley Clinic

Propofol Anesthesia: Uses, Dosage, and Side Effects Explained

Summary or Key Points

Propofol is a medication used to induce and maintain anesthesia or sedation during medical procedures. It works by slowing brain activity, helping patients relax or sleep. Propofol is commonly used for surgeries, endoscopies, and other procedures requiring sedation. It is administered intravenously under the supervision of a healthcare professional. Always consult your doctor before using Propofol to ensure it is appropriate for your condition.

Names of Medication

US Brand Name: Diprivan (Propofol)

The ‘generic name’ refers to the active ingredient in a medication, while the brand name is the name given by the manufacturer. In this case, Propofol is the generic name.

Pharmacologic Category

General Anesthetic

Sedative-Hypnotic

Propofol Dosage

Propofol is used for various medical conditions, and the dosage varies depending on the specific indication. Always consult your healthcare provider before adjusting your dose. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.

Propofol for Anesthesia

Induction of Anesthesia: 2 to 2.5 mg/kg IV as a single dose.

Maintenance of Anesthesia: 100 to 200 mcg/kg/min IV infusion.

Propofol for Sedation

Procedural Sedation: 0.5 to 1 mg/kg IV bolus, followed by 0.5 mg/kg as needed.

Conscious Sedation: 0.3 to 0.5 mg/kg IV bolus, followed by 0.1 to 0.2 mg/kg/min infusion.

Ventilator Management

Sedation for Ventilated Patients: 5 to 50 mcg/kg/min IV infusion.

Propofol for Status Epilepticus

Refractory Status Epilepticus: 2 to 5 mg/kg IV bolus, followed by 1 to 15 mg/kg/hour infusion.

Pain Management with Propofol

For Pain During Procedures: 0.5 to 1 mg/kg IV bolus, followed by 0.5 mg/kg as needed.

Propofol for Endoscopy

Sedation for Endoscopy: 0.5 to 1 mg/kg IV bolus, followed by 0.5 mg/kg as needed.

Propofol for Cardiac Procedures

Sedation for Cardiac Procedures: 0.5 to 1 mg/kg IV bolus, followed by 0.5 mg/kg as needed.

Dosage Forms and Strengths

Injectable Emulsion: 10 mg/mL (vial, ampule)

Administration Instructions for Propofol

Propofol is administered intravenously by a healthcare professional, typically in a hospital or clinical setting. It is important to follow your healthcare provider’s instructions carefully. The medication is given slowly through an IV line, and your vital signs will be monitored throughout the procedure. Do not attempt to self-administer Propofol. If you have any concerns about your treatment, consult a healthcare provider immediately or schedule a telemedicine appointment with us.

Propofol Side Effects and Adverse Reactions

Like all medications, Propofol may cause side effects. While not everyone experiences them, it is important to be aware of potential reactions. Always inform your healthcare provider if you experience any unusual symptoms.

Common Side Effects (10% or more):

Low Blood Pressure (Hypotension): A drop in blood pressure is common and typically resolves after the procedure.

Pain at Injection Site: Some patients report discomfort or pain where the IV is inserted.

Nausea and Vomiting: These symptoms may occur after waking up from anesthesia.

Less Common Side Effects (1-10%):

Bradycardia: A slower-than-normal heart rate may occur but is usually temporary.

Respiratory Depression: Breathing may slow down, requiring close monitoring during administration.

Rare Side Effects (Less than 1%):

Propofol Infusion Syndrome: A rare but serious condition that can cause heart failure, metabolic acidosis, and muscle breakdown.

Severe Allergic Reactions: Symptoms may include rash, difficulty breathing, or swelling of the face and throat.

Contraindications for Propofol

A contraindication is a specific situation where a drug, procedure, or surgery should not be used because it may be harmful to the patient. For Propofol, there are several contraindications you and your healthcare provider should be aware of before starting treatment.

Allergy to Propofol or its components: If you have a known allergy to Propofol or any of its ingredients (such as egg lecithin or soybean oil), you should not take this medication. Allergic reactions can range from mild to severe, including life-threatening anaphylaxis.

Severe heart disease: Propofol can lower blood pressure and slow the heart rate, which can be dangerous for people with significant heart conditions. This may lead to worsening heart function or even heart failure.

Severe respiratory conditions: Propofol can suppress breathing, making it unsafe for people with severe respiratory diseases, such as chronic obstructive pulmonary disease (COPD) or asthma, unless closely monitored in a hospital setting.

Unstable blood pressure: If you have low or unstable blood pressure, Propofol may cause further drops in blood pressure, which could lead to dangerous complications.

Pregnancy: Propofol is generally not recommended during pregnancy unless absolutely necessary, as it may affect the developing fetus (see more details in the “Propofol in Pregnancy” section below).

Drug to Drug Interactions with Propofol

Propofol can interact with other medications, which may increase the risk of side effects or reduce the effectiveness of either drug. Be sure to inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs and supplements. Some notable drug interactions include:

Benzodiazepines (e.g., Valium [diazepam], Ativan [lorazepam]): These medications can increase the sedative effects of Propofol, leading to excessive drowsiness or respiratory depression.

Opioids (e.g., OxyContin [oxycodone], Vicodin [hydrocodone]): Opioids can also enhance the sedative and respiratory-depressing effects of Propofol, which may increase the risk of overdose or breathing problems.

Antihypertensive drugs (e.g., Lopressor [metoprolol], Norvasc [amlodipine]): These medications can cause further drops in blood pressure when taken with Propofol, leading to dizziness, fainting, or even shock.

Alcohol: Drinking alcohol while using Propofol can increase the sedative effects and may lead to dangerous levels of drowsiness, confusion, or respiratory depression.

Antiepileptic drugs (e.g., Keppra [levetiracetam], Depakote [valproic acid]): These medications may alter the effectiveness of Propofol, potentially requiring dosage adjustments.

Propofol in Pregnancy

Is it safe to take Propofol when pregnant?

Propofol, commonly known by its brand name Diprivan, is classified as a Category B drug by the FDA for use during pregnancy. This classification indicates that animal studies have not shown harm to the fetus, but there are no well-controlled studies in pregnant women. In general, Propofol anesthesia is avoided during pregnancy unless absolutely necessary, such as in emergencies or when no safer alternatives are available. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of Propofol with your healthcare provider. Our telemedicine providers are here to help you make an informed decision about your care.

Propofol While Breastfeeding

Is it safe to take Propofol while breastfeeding?

Propofol is generally considered safe for use while breastfeeding. Although small amounts may pass into breast milk, studies suggest it is unlikely to harm a nursing infant. However, it is always best to discuss your specific situation with your healthcare provider. If you are breastfeeding and need to take Propofol, your provider may recommend waiting a few hours after the procedure before resuming breastfeeding to minimize any potential exposure to your baby.

Estimated Cost of Propofol

The cost of Propofol can vary depending on the pharmacy and location. With a GoodRx coupon, the estimated cost for a 30-day supply of Propofol (assuming it is prescribed for continuous sedation or similar use) ranges from $25 to $50 without insurance. Be sure to check with your pharmacy for the most accurate pricing, and consider using a GoodRx coupon to save on your prescription.

Possible Alternatives to Propofol

If Propofol is not suitable for you, or if you are exploring alternative treatments, there are other options available depending on the condition being treated. Always consult with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to discuss these alternatives with you.

Anesthesia Alternatives

Alternatives to Propofol for anesthesia include inhaled anesthetics such as sevoflurane or isoflurane, or intravenous agents like etomidate or ketamine. Non-pharmacological options, such as regional anesthesia (nerve blocks), may also be considered.

Sedation Alternatives

Other sedatives include midazolam (Versed) or dexmedetomidine (Precedex). In some cases, non-drug approaches like relaxation techniques or guided imagery may be helpful.

Status Epilepticus Alternatives

Alternatives for managing status epilepticus include benzodiazepines (e.g., lorazepam) or phenobarbital. Long-term management may involve antiepileptic drugs such as levetiracetam (Keppra) or valproate (Depakote).

Pain Management Alternatives

Non-opioid pain relievers like acetaminophen or ibuprofen may be used. In some cases, nerve blocks or physical therapy can be effective alternatives.

Induction of Anesthesia Alternatives

Alternatives to Propofol for the induction of anesthesia include etomidate or thiopental. Inhaled agents such as sevoflurane may also be used.

Procedural Sedation Alternatives

Alternatives for procedural sedation include midazolam or fentanyl. Non-drug techniques like distraction or hypnosis may be helpful in certain cases.

Ventilator Management Alternatives

Alternatives for sedation during ventilator management include dexmedetomidine or midazolam. Adjustments to ventilator settings and supportive care may also be considered.

Conscious Sedation Alternatives

Alternatives for conscious sedation include midazolam or fentanyl. Non-drug techniques such as deep breathing exercises or music therapy may provide additional support.

Endoscopy Alternatives

Alternatives for sedation during endoscopy include midazolam or fentanyl. In some cases, local anesthetics may be used instead of full sedation.

Cardiac Procedure Alternatives

Alternatives for sedation during cardiac procedures include etomidate or midazolam. Regional anesthesia or nerve blocks may also be considered in certain situations.

Recent Updates on Propofol Research

Recent studies have focused on the safety and effectiveness of Propofol in various medical settings. One area of research is the use of Propofol in patients with COVID-19 who require mechanical ventilation. Researchers are investigating whether Propofol can help manage sedation in these critically ill patients while minimizing complications. Additionally, studies are exploring the potential neuroprotective effects of Propofol in patients undergoing cardiac surgery, as well as its role in reducing postoperative delirium. These studies are ongoing, and more information will become available as the research progresses.

As always, it is important to stay informed about the latest research and discuss any concerns or questions with your healthcare provider. If you have any questions about Propofol or your treatment plan, our telemedicine providers are available to assist you.

James Kingsley
James Kingsley

Learn More
Scroll to Top