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Fospropofol: a new sedative-hypnotic agent for monitored anesthesia care
Gina D Moore1, Alyssa M Walker, Robert MacLaren
1School of Pharmacy, University of Colorado Denver, 12631 E. 17th Ave., Mail Stop C238-L15, Aurora, CO 80045, USA. gina.moore@ucdenver.edu
The Annals of Pharmacotherapy
|October 15, 2009
Summary
Fospropofol offers advantages over propofol for procedural sedation by reducing adverse effects and improving recovery. However, limited safety data necessitates careful administration by anesthesia professionals.
Area of Science:
- Pharmacology
- Anesthesiology
- Drug Development
Background:
- Propofol, a sedative-hypnotic, has limitations including pain on injection and potential for deep sedation.
- Fospropofol is a water-soluble prodrug designed to overcome propofol's lipid emulsion-associated disadvantages.
Purpose of the Study:
- To review clinical data on fospropofol's safety and efficacy.
- To provide information for formulary review of fospropofol.
- To critically assess fospropofol as a sedative-hypnotic agent.
Main Methods:
- Searched MEDLINE, EMBASE, bibliographies, and FDA databases (up to June 2009).
- Included key terms: fospropofol, Lusedra, Aquavan, sedative-hypnotic, monitored anesthesia care.
- Reviewed all Phase 1, 2, and 3 clinical trials on fospropofol safety and efficacy.
Main Results:
- Fospropofol offers a more predictable onset and gradual recovery compared to propofol.
- Limited patient numbers and safety data exist, with reported hypoxemia and hypotension.
- FDA approval is restricted to monitored anesthesia care for diagnostic/therapeutic procedures.
Conclusions:
- Fospropofol is a promising sedative-hypnotic agent, minimizing propofol's adverse effects.
- Its pharmacokinetic profile supports sedation, anxiolysis, and rapid recovery.
- Limited safety data warrant use only with dedicated anesthesia personnel.
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