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fentanyl citrate (PF) epidural

Interactions

Propofol/Fentanyl

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Fentanyl causes the propofol to be more effective in causing anesthesia.

What might happen:

It may take you longer than usual to recover from anesthesia.

What you should do about this interaction:

Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Fentanyl Australian prescribing information. Mayne Pharma October 31, 2003.

2.Vuyk J. Pharmacokinetic and pharmacodynamic interactions between opioids and propofol. J Clin Anesth 1997 Sep;9(6 Suppl):23S-26S.

3.Diprivan (propofol) Australian prescribing information. AstraZeneca Pty Ltd January 10, 2005.

4.Diprivan (propofol) US prescribing information. AstraZeneca Pharmaceuticals LP February, 2007.

5.Mi W, Sakai T, Kudo T, Kudo M, Matsuki A. The interaction between fentanyl and propofol during emergence from anesthesia: monitoring with the EEG-Bispectral index. J Clin Anesth 2003 Mar;15(2):103-7.

6.Billard V, Moulla F, Bourgain JL, Megnigbeto A, Stanski DR. Hemodynamic response to induction and intubation. Propofol/fentanyl interaction. Anesthesiology 1994 Dec;81(6):1384-93.

7.Vuyk J, Engbers FH, Burm AG, Vletter AA, Griever GE, Olofsen E, Bovill JG. Pharmacodynamic interaction between propofol and alfentanil when given for induction of anesthesia. Anesthesiology 1996 Feb;84(2):288-99.

8.Vuyk J. Clinical interpretation of pharmacokinetic and pharmacodynamic propofol-opioid interactions. Acta Anaesthesiol Belg 2001;52(4):445-51.

9.Larsen B, Buch U, Wilhelm W, Larsen R. Effects of propofol and fentanyl on the baroreceptor reflex in geriatric patients. Anasthesiol Intensivmed Notfallmed Schmerzther 1994 Nov;29(7):408-12.

10.Ghabash M, Matta M, Kehhaleh J. Depression of excitatory effects of propofol induction by fentanyl. Middle East J Anesthesiol 1996 Feb; 13(4):419-25.

11.Smith C, McEwan AI, Jhaveri R, Wilkinson M, Goodman D, Smith LR, Canada AT, Glass PS. The interaction of fentanyl on the Cp50 of propofol for loss of consciousness and skin incision. Anesthesiology 1994 Oct; 81(4):820-8; discussion 26A.

12.Vuyk J, Lim T, Engbers FH, Burm AG, Vletter AA, Bovill JG. The pharmacodynamic interaction of propofol and alfentanil during lower abdominal surgery in women. Anesthesiology 1995 Jul;83(1):8-22.

13.Kobayashi Y, Tsuchida A, Kamada Y, Seki S, Ichimiya T, Namiki A. Effects of speed of injection on anesthesia induction with propofol and fentanyl. Masui 1999 Aug;48(8):847-51.

14.Dixon J, Roberts FL, Tackley RM, Lewis GT, Connell H, Prys-Roberts C. Study of the possible interaction between fentanyl and propofol using a computer-controlled infusion of propofol. Br J Anaesth 1990 Feb; 64(2):142-7.

15.Cigarini I, Bonnet F, Lorino AM, Harf A, Desmonts JM. Comparison of the effects of fentanyl on respiratory mechanics under propofol or thiopental anaesthesia. Acta Anaesthesiol Scand 1990 May;34(4):253-6.

16.Gill SS, Wright EM, Reilly CS. Pharmacokinetic interaction of propofol and fentanyl: single bolus injection study. Br J Anaesth 1990 Dec; 65(6):760-5.

17.Kazama T, Ikeda K, Morita K. The pharmacodynamic interaction between propofol and fentanyl with respect to the suppression of somatic or hemodynamic responses to skin incision, peritoneum incision, and abdominal wall retraction. Anesthesiology 1998 Oct;89(4):894-906.

18.Mertens MJ, Vuyk J, Olofsen E, Bovill JG, Burm AG. Propofol alters the pharmacokinetics of alfentanil in healthy male volunteers. Anesthesiology 2001 Jun;94(6):949-57.

19.Mertens MJ, Olofsen E, Burm AG, Bovill JG, Vuyk J. Mixed-effects modeling of the influence of alfentanil on propofol pharmacokinetics. Anesthesiology 2004 Apr;100(4):795-805.

20.Pavlin DJ, Coda B, Shen DD, Tschanz J, Nguyen Q, Schaffer R, Donaldson G, Jacobson RC, Chapman CR. Effects of combining propofol and alfentanil on ventilation, analgesia, sedation, and emesis in human volunteers. Anesthesiology 1996 Jan;84(1):23-37.

21.Schraag S, Mohl U, Bothner U, Georgieff M. Interaction modeling of propofol and sufentanil on loss of consciousness. J Clin Anesth 1999 Aug; 11(5):391-6.

22.Kazama T, Ikeda K, Morita K, Katoh T, Kikura M. Propofol concentration required for endotracheal intubation with a laryngoscope or fiberscope and its interaction with fentanyl. Anesth Analg 1998 Apr;86(4):872-9.

23.Lysakowski C, Dumont L, Pellegrini M, Clergue F, Tassonyi E. Effects of fentanyl, alfentanil, remifentanil and sufentanil on loss of consciousness and bispectral index during propofol induction of anaesthesia. Br J Anaesth 2001 Apr;86(4):523-7.

24.Iselin-Chaves IA, Flaishon R, Sebel PS, Howell S, Gan TJ, Sigl J, Ginsberg B, Glass PS. The effect of the interaction of propofol and alfentanil on recall, loss of consciousness, and the Bispectral Index. Anesth Analg 1998 Oct;87(4):949-55.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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