Fospropofol

Fospropofol Brand Name– Lusedra

What is Fospropofol

Fospropofol disodium (Lusedra) is an intravenous sedative-hypnotic agent for monitored anesthesia care sedation in adults undergoing diagnostic or therapeutic procedures.

Fospropofol disodium is a proprietary, water-soluble prodrug of propofol that is rapidly converted by alkaline phosphatase in the body into propofol.

The action of fospropofol is due to the liberation of propofol. Although the pharmacologic action of both fospropofol and propofol are due to propofol, use of fospropofol may circumvent some adverse reactions associated with the lipid emulsion of propofol.

For example, fospropofol does not appear to cause an injection site reaction. None of 36 adults who got fospropofol 5 to 30 mg/kg had injection site pain whereas 12 of 36 adults who got a propofol infusion of 50 mg/minute did.

Unfortunately, both fospropofol and propofol may cause hypoxia, hypotension, and apnea.

All fospropofol recipients must have supplemental oxygen and be continuously monitored during sedation and through the recovery process for early signs of hypotension, apnea, airway obstruction, and oxygen desaturation.

Further, fospropofol must only be administered by persons trained in the administration of general anesthesia and not involved in the conduct of the diagnostic or therapeutic procedure.

Fospropofol was approved by the FDA in December 2008.

Indications

  • monitored anesthesia care sedation

Side Effects

  1. apnea
  2. cough
  3. headache
  4. hypotension
  5. hypoxia
  6. nausea
  7. paresthesias
  8. pruritus
  9. respiratory depression
  10. ventricular tachycardia
  11. vomiting

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • breast-feeding
  • cardiac disease
  • children
  • dehydration
  • geriatric
  • hepatic disease
  • hypovolemia
  • hypoxemia
  • infants
  • labor
  • neonates
  • obstetric delivery
  • pregnancy
  • renal impairment
  • respiratory depression
  • sepsis

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Tramadol
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Ambrisentan
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amobarbital
  • Amoxapine
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Apraclonidine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine
  • Azelastine; Fluticasone
  • Bacitracin
  • Baclofen
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Beta-adrenergic blockers
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Calcium-channel blockers
  • Capreomycin
  • Capsaicin; Metaxalone
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carisoprodol
  • Cenobamate
  • Central-acting adrenergic agents
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chloroprocaine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpromazine
  • Chlorzoxazone
  • Cholinesterase inhibitors
  • Clobazam
  • Clomipramine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • COMT inhibitors
  • Dantrolene
  • Desipramine
  • Dexmedetomidine
  • Dextromethorphan; Promethazine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Doxazosin
  • Doxepin
  • Dronabinol
  • Dyphylline
  • Dyphylline; Guaifenesin
  • Eplerenone
  • Epoprostenol
  • Esketamine
  • Eszopiclone
  • Ethanol
  • Fenfluramine
  • Fentanyl
  • Fluphenazine
  • Gabapentin
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Haloperidol
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Iloprost
  • Imipramine
  • Ionic Contrast Media
  • Kanamycin
  • Lasmiditan
  • Lemborexant
  • Levocetirizine
  • Levorphanol
  • Lidocaine; Prilocaine
  • Lisdexamfetamine
  • Lofexidine
  • Loop diuretics
  • Loxapine
  • Lumateperone
  • Magnesium Salts
  • Mecamylamine
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Meprobamate
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methamphetamine
  • Methohexital
  • Minocycline
  • Mirtazapine
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Nesiritide, BNP
  • Nortriptyline
  • Orphenadrine
  • Oxycodone
  • Oxymorphone
  • Oxytocin
  • Papaverine
  • Pentobarbital
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenobarbital
  • Phenothiazines
  • Phenoxybenzamine
  • Phenylephrine; Promethazine
  • Polymyxin B
  • Polymyxins
  • Potassium-sparing diuretics
  • Prazosin
  • Pregabalin
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primidone
  • Procaine
  • Procarbazine
  • Prochlorperazine
  • Promethazine
  • Protriptyline
  • Rasagiline
  • Reserpine
  • Secobarbital
  • Sedating H1-blockers
  • Sodium Oxybate
  • St. John’s Wort, Hypericum perforatum
  • Streptomycin
  • Suvorexant
  • Tapentadol
  • Terazosin
  • Tetracaine
  • Thiazide diuretics
  • Thiethylperazine
  • Thiopental
  • Thioridazine
  • Thiothixene
  • Tobramycin
  • Tramadol
  • Treprostinil
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Trovafloxacin, Alatrofloxacin
  • Vancomycin
  • Vasodilators
  • Zaleplon
  • Zolpidem