Monograph
N01AX10 - Propofol |
Not porphyrinogenic |
NP |
Rationale
No interactions with CYP- metabolism of other drugs noted. Thus no evidence pointing to capacity for CYP-induction or mechanism based CYP inhibition. Vast clinical experience of tolerance in acute porphyria.
Chemical description
Diisopropylphenol.
Therapeutic characteristics
General anaesthetic used for induction and maintenance of general anaesthesia, sedation of ventilated patients under intensive care and sedation under surgical or diagnostic procedures.
Metabolism and pharmacokinetics
Rapidly metabolized mainly by CYP2B6 to inactive conjugates which are excreted by urine. Substrate of CYPs 1A2, 2A6, 2C18, 2C19, 2C8, 2B6, 2C9, 2E1, 3A4. Inhibitor of CYPs 1A1, 1A2, 1B1, 2C9, 2D6, 2E1, 3A4 (Rendic, S., 2002). No molecular groupings or other evidence of possible mechanism based CYP-inhibition. No interactions with CYP-metabolism of other drugs noted.
Personal communication
Thunell, S. Many reports of tolerance in acute porphyria.
Published experience
Used uneventfully as an anaesthetic induction agent in 13 patienets with PV. No significant increase of porphyrin precursors or porphyrins were detected by urinary monitoring over a period from before administration to 5 days after (Meissner, P.N. et al, 1991). Used uneventfully to manage status epilepticus in 12 year old male with active AIP (Bhatia, R. et al, 2008). Used uneventfully on two occasions in 43 year old female with AIP (Mitterschiffthaler, G. et al, 1988). Used uneventfully to manage status epilepticus in 26 year old female with active AIP (Pandey, C.K. et al, 2003). Uneventful use in 30 year old female with latent AIP (Pazvanska, E.E. et al, 1999). Used uneventfully on two occasions as anaesthesia in 35 year old female with HCP (Sarantopoulos, C.D. et al, 2000). Used uneventfully on two occasions to induce anaesthesia in 57 year old female with latent AIP (Shaw I.H. & McKeith I.G., 1998). Used unevntfully in 63 year old AIP woman (McLouglin, C, 1989). Female PV patient experienced rise in urinary excretion of porphyrins without associated clinical manifestations following sedation with propofol (Bichel, T. et al, 1993).
IPNet drug reports
Uneventful use reported in 4 patients with acute porphyria.
Similar drugs
References
| # | Citation details | PMID |
|---|---|---|
| * | Scientific articles | |
| 1. | McLouglin, C. Use of propofol in a patient with porphyria. Br J of Anaesth 1989; 62(1):114.
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| 2. | Pandey CK, Singh N, Bose N, Sahay S, Gabapentin and propofol for treatment of status epilepticus in acute intermittent porphyria.
J Postgrad Med. 2003; 49(3):285. |
14597800 |
| 3. | Rendic, S. Summery of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448.
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| 4. | Sarantopoulos, C.D.; Bratanow, N.C.; Stowe, D. F.; Kampine, J.P. Uneventful Propofol Anesthesia in a Patient with Coexisting Hereditary Coproporphyria and Hereditary Angioneurotic Edema. Anesthesiology: 2000; 92(2):607.
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31831506 |
| 5. | Use of propofol anesthesia and adjunctive treatment with levetiracetam and gabapentin in managing status epilepticus in a patient of acute intermittent porphyria.
Bhatia R, Vibha D, Srivastava MV, Prasad K, Tripathi M, Bhushan Singh M. Epilepsia. 2008 May;49(5):934-6. |
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| 6. | Total intravenous anesthesia in South-African genetic porphyria (variegate porphyria).
Bichel T, Joris J, Jacquet N, Lamy M. Acta Anaesthesiol Belg. 1993;44(1):25-9. |
8342401 |
| 7. | v. anaesthetic induction agent in variegate porphyria.
Meissner PN, Harrison GG, Hift RJ. Propofol as an i. Br J Anaesth. 1991 Jan;66(1):60-5. |
1997060 |
| 8. | Safe use of propofol in a patient with acute intermittent porphyria.
Mitterschiffthaler G, Theiner A, Hetzel H, Fuith LC. Br J Anaesth. 1988;60(1):109-11. |
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| 9. | Uneventful propofol anaesthesia in a patient with acute intermittent porphyria.
Pazvanska EE, Hinkov OD, Stojnovska LV. Eur J Anaesthesiol. 1999;16(7):485-92. |
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| 10. | Propofol and electroconvulsive therapy in a patient at risk from acute intermittent porphyria.
Shaw IH, McKeith IG. Br J Anaesth. 1998;80(2):260-2. |
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| * | Drug reference publications | |
| 11. | Sweetman SC, editor. Martindale: The complete drug reference. Propofol. Pharmaceutical Press 2009.
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| * | Summary of Product Characteristics | |
| 12. | Norwegian medicines agency. Summary of Product Characteristics (SPC). Propofol-Lipuro.
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Tradenames
This list comprises raw data collected from different countries.
In some cases, a more comprehensive list of available drug packages is included.
Consequently, very similar terms may therefore appear multiple times.
Bold names are the searchable terms, while the gray names that follow are all mapped to the bolded term.
Note: The cleaning is done automatically by a proprietary algorithm, and it may produce errors.
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Diprivan · Propofol 10 mg/ml MCT/LCT Fresenius, emulsie voor injectie of infusie · Propofol 10 mg/ml MCT/LCT Fresenius, emulsie voor injectie/infusie in een voorgevulde spuit · Propofol 20 mg/ml MCT/LCT Fresenius, emulsie voor injectie of infusie · Propofol 20 mg/ml MCT/LCT Fresenius, emulsie voor injectie/infusie in een voorgevulde spuit · Propofol Baxter 10 mg/ml, emulsie voor injectie of infusie · Propofol Baxter 20 mg/ml, emulsie voor injectie of infusie · Propofol BioQ Pharma 10 mg/ml emulsie voor injectie of infusie · Propofol BioQ Pharma 10 mg/ml, emulsie voor infusie in toedieningssysteem · Propofol BioQ Pharma 20 mg/ml emulsie voor injectie of infusie · Propofol Spiva 10 mg/ml, emulsie voor injectie of infusie · Propofol Spiva 20 mg/ml, emulsie voor injectie of infusie · Propofol-Lipuro 10 mg/ml, emulsie voor injectie of infusie · Propofol-Lipuro 20 mg/ml, emulsie voor injectie of infusie 
Diprivan · Propofol · Propofol B. Braun 1 % 10 mg/ml ?muls. inj./perf. i.v. amp. · Propofol B. Braun 1 % 10 mg/ml ?muls. inj./perf. i.v. flac. · Propofol B. Braun 2 % 20 mg/ml ?muls. inj./perf. i.v. flac. · Propofol Baxter 10 mg/ml ?muls. inj./perf. i.v. flac. · Propofol Baxter 20 mg/ml ?muls. inj./perf. i.v. flac. · Propolipid · Propolipid 1 % ?muls. inj./perf. i.v. amp. · Propolipid 1 % ?muls. inj./perf. i.v. flac. · Propolipid 1 % ?muls. inj./perf. i.v. ser. pr?remplie · Propolipid 2 % ?muls. inj./perf. i.v. flac. · Propolipid 2 % ?muls. inj./perf. i.v. ser. pr?remplie 
DIPRIVAN 10 mg/ml EMULSION INYECTABLE Y PARA PERFUSION · DIPRIVAN 20 mg/ml EMULSION PARA PERFUSION · Propofol · Propofol Baxter 10mg/ml Emulsion Inyectable y Para Perfusion efg · Propofol Baxter 20mg/ml Emulsion Inyectable y Para Perfusion efg · Propofol Bioq 10 mg/ml Emulsion Para Perfusion en Sistema de Administracion · Propofol Farmak 20 mg/ml Emulsion Inyectable y Para Perfusion efg · Propofol Fresenius 10 mg/ml Emulsion Inyectable y Para Perfusion efg · Propofol Fresenius 20 mg/ml Emulsion Inyectable y Para Perfusion efg · Propofol Lipoven · Propofol Lipoven Fresenius 10 mg/ml Emulsion Inyectable y Para Perfusion en Jeringa Precargada efg · PROPOFOL LIPOVEN FRESENIUS 20 mg/ml EMULSION INYECTABLE Y PARA PERFUSION · Propofol Lipuro · PROPOFOL LIPURO 20 mg/ml EMULSI?N INYECTABLE y PARA PERFUSI?N · PROPOFOL LIPURO 5 mg/ml EMULSI?N INYECTABLE Y PARA PERFUSI?N · Propofol Sandoz 10 mg/ml Emulsion Inyectable y Para Perfusion efg · Propofol Sandoz 20 mg/ml Emulsion Inyectable y Para Perfusion efg · RECOFOL N 10 mg/ml EMULSION INYECTABLE O PARA PERFUSION 
PROFAST 10 mg/ml · PROFAST 20 mg/ml · PROPOFOL MCT/LCT FRESENIUS 10 mg/ml · PROPOFOL MCT/LCT FRESENIUS 20 mg/ml · PROPOFOL ROMPHARM 10mg/ml · PROPOFOL-LIPURO 10 mg/ml 
Diprivan · Propofol · Propofol-Lipuro · Propoven 
Profast · Propofol 2care4 · Propofol B. Braun · Propofol Orifarm · Propolipid 
Diprivan · Disoprivan inf/inj · Profast · Propofol-Lipuro · Propolipid 
Diprivan · Plofed 1% · Propofol 1% Fresenius · Propofol 1% MCT/LCT Fresenius · Propofol 2% MCT/LCT Fresenius · Propofol Baxter · Propofol Farmak · Propofol-Lipuro · Propofol-Lipuro 2% (20 mg/ml) emulsja do wstrzykiwan lub infuzji · Provive 
Diprivan · Propofol Baxter · Propofol-Lipuro · Propolipid 1% · Propolipid 2% 
Propolipid 
Profast · Propofol-Lipuro · Propolipid 
Anesia · Propofol Fresenius · Propofol-Lipuro · Propoven 
Diprivan · Propofol 1% MCT Fresenius · Propofol 2% MCT Fresenius · Propofol Lipuro 1% · Propofol Lipuro 2% · Recofol® EDTA
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