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Propofol injection 0.5%


Emulsion for injection or infusion containing 100mg propofol per 20ml (0.5%)

Drugs List

  • propofol 100mg/20ml (0.5%) injection (emulsion)
  • PROPOFOL-LIPURO 100mg/20ml (0.5%) injection (emulsion)
  • Therapeutic Indications


    Induction of anaesthesia
    Sedation for surgical and diagnostic procedures

    Induction of general anaesthesia in adults and children over 1 month.

    Induction of sedation for surgical and diagnostic procedures in adults and children over 1 month.

    Short term sedation for surgical and diagnostic procedures, alone or in combination with local or regional anaesthesia, in adults only.

    Not licensed for all indications in all age groups.


    This monograph relates only to the specific indications of the 0.5% propofol injection or infusion.Different strength preparations of propofol are available for other specific uses and the separate monographs should be consulted for further information.

    Circulatory and respiratory functions should be monitored constantly (e.g. ECG, pulse rate). Facilities for the maintenance of a patent airway, for artificial ventilation, oxygen enrichment and other resuscitation facilities must be immediately available at all times.

    The manufacturer states that propofol 0.5% may be administered for a maximum period of 1 hour.

    Individual requirements vary and the recommended dosages are only a guide. Smaller doses are indicated in ill, shocked or debilitated patients and in significant hepatic impairment.

    Propofol has no analgesic properties and therefore supplementary analgesic agents are generally required in addition.


    Doses should be adjusted according to the response of the patient. For patients aged over 55 years, see Elderly section.

    Patients aged up to and including 55 years
    Induction of general anaesthesia
    Propofol 0.5% should be titrated (approximately 20mg to 40mg every 10 seconds) against the response of the patient until the clinical signs show the onset of anaesthesia. Administration may be by bolus injection or infusion. Most adult patients are likely to require 1.5mg/kg to 2.5mg/kg body weight of propofol 0.5%.

    In patients of American Society of Anaesthesiologists (ASA) grades 3 and 4, especially those with cardiac impairment, the dosage requirements will be less (e.g. to a suggested minimum dose of 1mg/kg). In these patients lower rates of administration should be used (approximately 4ml (20mg) every 10 seconds).

    Sedation for surgical and diagnostic procedures
    Patients of ASA grades 3 and 4 or debilitated patients may require further reductions in dose and dose rate.
    To provide sedation for surgical and diagnostic procedures, rates of administration should be individualised and titrated to clinical response.

    Most patients will require 0.5mg/kg to 1mg/kg by intravenous injection over 1 to 5 minutes for onset of sedation.
    Maintenance of sedation may be accomplished by titrating propofol 0.5% infusion to the desired level of sedation (most patients will require 1.5 to 4.5mg/kg/hour). In addition to the infusion, bolus administration of 10mg to 20mg may be used if a rapid increase in depth of sedation is required.


    Patients of ASA grades 3 and 4 or debilitated patients may require further reductions in dose and dose rate.

    Patients aged over 55 years
    Induction of general anaesthesia
    In patients over 55 years, especially those with cardiac impairment, the dosage requirements will be less than in younger adults and the total dose of propofol 0.5% may be reduced (e.g. to a suggested minimum dose of dose of 1mg/kg). In these patients lower rates of administration should be used (approximately 4ml (20mg) every 10 seconds) and the reduction should take into account the physical status and age of the patient.
    (See Dosage; Adult)

    Sedation for surgical and diagnostic procedures
    When propofol 0.5% is used for sedation the rate of infusion should also be reduced.
    (See Dosage; Adult)


    Lower dosage is recommended for children of ASA grades 3 and 4.

    Induction of general anaesthesia
    When used to induce anaesthesia in children, it is recommended that propofol 0.5% be slowly titrated against the patient's response until the clinical signs show the onset of anaesthesia. The dose should be adjusted for age and/or weight.

    Children aged over 8 years
    Approximately 2.5mg/kg body weight for induction of anaesthesia.

    Children aged 1 month to 8 years
    Dose requirements may be 2.5mg/kg to 4mg/kg, particularly in those aged up to 3 years.

    Induction of sedation for surgical and diagnostic procedures
    Children aged 1 month and older
    1mg/kg to 2mg/kg.

    The following alternative dosing schedule may be suitable:
    Children aged 17 to 18 years
    (See Dosage; Adults)

    Children aged 1 month to 17 years
    1mg/kg to 2 mg/kg by slow intravenous injection, titrate according to response.

    Maintenance of sedation for surgical and diagnostic procedures
    The manufacturer states that the product should not be used for the maintenance of sedation for diagnostic and surgical procedures in children.

    The following unlicensed dosing schedule may be suitable:
    Children aged 17 to 18 years
    Initial dose: 1.5 to 4.5mg/kg/hour by intravenous infusion titrated according to response.
    Followed by 10mg to 20mg by slow intravenous injection for rapid response if required.



    Additional Dosage Information

    In cases of repeated use for induction of anaesthesia the maximum fat administration should not exceed 150mg fat/kg/hour which corresponds to 1.5ml/kg/hour of propofol 0.5%.

    Propofol has no analgesic effect. Supplementary analgesia will generally be required and the extent to which target concentrations for maintenance of anaesthesia can be reduced will be influenced by the amount of concomitant analgesia administered.


    Administered by intravenous injection or by intravenous infusion. For infusion, suitable infusion control devices should be used (e.g. volumetric pump).

    The manufacturer states that propofol 0.5% may be administered for a maximum period of 1 hour.

    In order to reduce pain on initial injection, propofol 0.5% may be mixed with preservative-free lidocaine injection 1%.

    Microbiological filters are not recommended. If infusion sets with filters are used, these must be lipid permeable.



    Precautions and Warnings

    Severe obesity
    Cardiac impairment
    Disorder of lipid metabolism
    Epileptic disorder
    Hepatic impairment
    Raised intracranial pressure
    Renal impairment
    Respiratory impairment

    Advise ability to drive/operate machinery may be affected by side effects
    Contains arachis (peanut oil), soya or soya derivative
    Resuscitation facilities must be immediately available
    To be administered by anaesthetist or a doctor trained in intensive care
    Monitor blood lipid concentration in all patients at risk of fat overload
    Monitor cardio-respiratory function
    Monitor patients for hypotension,airway obstruction, oxygen desaturation
    Potential for drug abuse
    Discontinue immediately if signs of Propofol Infusion Syndrome occur
    Increases risk of relative vagal overactivity
    Onset of convulsions may be delayed-caution especially after day surgery
    Not licensed for all indications in all age groups
    Avoid alcohol before and at least 8 hours after administration
    Breastfeeding: Do not breastfeed & discard milk for 24 hours after therapy

    Use with caution in patients with epilepsy as there may be an increased risk of seizures. The administration rate of propofol should be reduced in these patients. An epileptic patient should have received antiepileptic medication before anaesthesia is induced.

    Convulsions have been reported in both those with and without a history of epilepsy. Use with caution after day surgery, since the onset of convulsions can be delayed. Such reactions can occur hours or even days after termination of propofol administration. Propofol should be used with caution when used to sedate patients undergoing procedures where spontaneous movements are particularly undesirable e.g. ophthalmic surgery. Extreme care is required in surgery of the mouth, pharynx or larynx and in patients with acute circulatory failure (shock) or fixed cardiac output.

    Before propofol is administered, hypovolaemia, cardiac impairment, circulatory depression or respiratory impairment should be corrected if possible. Patients with severe cardiac impairment should be treated with extreme caution and under intensive monitoring.

    An adequate period is needed prior to discharge of the patient to ensure full recovery after use of propofol 0.5%. The development of period of post-operative unconsciousness may be accompanied by an increase in muscle tone following treatment with propofol. This may or may not be preceded by a period of wakefulness.

    Concomitant use of other central nervous system depressants e.g. alcohol, other general anaesthetics, opioid analgesics will result in accentuation of their sedative effects. Respiratory or cardiovascular depression may occur when propofol is given along with other central nervous system depressants. Concomitant use of benzodiazepines, parasympatholytic agents and other anaesthetics has been reported to prolong the anaesthesia and to reduce the respiration rate.

    Intravenous administration of an anticholinergic agent before induction, or during maintenance of anaesthesia should be considered, especially in situations where vagal tone is likely to predominate, or when propofol is used in conjunction with other agents likely to cause bradycardia. The risk of relative vagal over activity may be increased because propofol lacks vagolytic activity which has been associated with reports of bradycardia (occasionally profound) and also asystole.

    If the patient is receiving other intravenous lipid concurrently, a reduction in quantity should be made in order to take account of the amount of lipid infused as part of the propofol 0.5% formulation, 1ml of propofol 0.5% contains approximately 0.1g of fat.

    Severely obese patients require higher doses of propofol to produce an adequate effect. There may consequently be an increased risk of haemodynamic effects in these patients.

    Propofol used for sedation in intensive care units has been associated with a combination of metabolic derangements and organ system failure known as Propofol Infusion Syndrome. Symptoms of Propofol Infusion Syndrome include metabolic acidosis, rhabomyolysis, hyperkalaemia, hepatomegaly, renal failure, hyperlipidaemia, cardiac arrhythmia, Brugada-type ECG and rapidly progressive cardiac failure. Risks include decreased oxygen delivery to tissues, serious neurological injury, sepsis, high doses or combination with vasoconstrictors, steroids and/or inotropes. Propofol must be immediately discontinued if the above symptoms occur.

    Pregnancy and Lactation


    Use propofol with caution during pregnancy.

    The manufacturer does not recommend using propofol during pregnancy. However, Schaefer (2007) concludes that propofol may be used in obstetrics to initiate anaesthesia for operations during pregnancy and labour. Newborns should be observed for a depressive effect on the breathing if used in labour. Doses above 2.5mg/kg for induction of anaesthesia or 6mg/kg/hour for maintenance of anaesthesia should not be exceeded.

    At the time of writing, the safety of propofol administration during human pregnancy has not been established. Propofol crosses the placenta with blood cord levels at term approximately 70% those of maternal blood. As propofol crosses the placenta it may be associated with neonatal respiratory depression, particularly in the third trimester. Embryonic toxicity studies in rats and rabbits showed no teratogenic effects and suggest low risk.


    Use propofol with caution during breastfeeding.

    The manufacturer recommend that mothers should stop breastfeeding and discard breast milk for 24 hours after administration of propofol.

    Propofol enters breast milk in small amounts and with a short half life of 30 to 60 minutes is not expected to be absorbed by the infant in significant amounts (Schaefer). The percentage of propofol excreted into breast milk, when compared to placental transfer, is considered negligible.

    Side Effects

    Brugada ECG pattern
    Cardiac failure
    Discolouration of urine
    Hypersensitivity reactions
    Local pain
    Metabolic acidosis
    Pulmonary oedema
    Quincke's oedema
    Renal failure
    Respiratory depression
    Sensation of cold
    Spontaneous movements
    Tissue damage


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: October 2019

    Reference Sources

    Committee on Safety of Medicines. Propofol and delayed convulsions. Current Problems in Pharmacovigilance (1992) 35: 2.

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Injectable Medicines Administration Guide, 2nd edition (2007) UCL NHS Foundation Trust. Blackwell Publishing, Oxford.

    Martindale: The Complete Drug Reference, 37th edition (2011) ed. Sweetman, S. Pharmaceutical Press, London.

    Medications and Mothers' Milk, 14th Edition (2010) Hale,T. Hale Publishing, Amarillo, Texas.

    Summary of Product Characteristics: Propofol-Lipuro 0.5%. B. Braun. Revised May 2017.

    The Renal Drug Handbook. 3rd edition. (2009) ed. Ashley, C and Currie, Radcliffe Publishing Ltd, Abingdon.

    NICE Evidence Services Available at: Last accessed: 22 September 2017

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Propofol. Last revised: August 14, 2012
    Last accessed: November 28, 2012

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