Adult Dosing

Anesthesia induction

• 0.3 mg/kg IV injected over 30 to 60 sec
• Range: 0.2-0.6 mg/kg IV; according to clinical conditions
• Note: Smaller dose increments may be used during short procedures to supplement other agents

Pediatric Dosing

Anesthesia induction /rapid sequence intubation (Not FDA approved)

Child >10 yrs

• 0.3 mg/kg IV injected over 30 to 60 sec
• Range: 0.2-0.6 mg/kg IV; according to clinical conditions
• Note: Smaller dose increments may be used during short procedures to supplement other agents

• Induction of general anesthesia

• Hypersensitivity to etomidate or any component of the formulation

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Etomidate should be administered only by persons trained in the administration of general anesthetics and in the management of complications encountered during GA
• Avoid administration into small vessels as solution is highly irritating; pre-administration of lidocaine may be considered
• Due to the hazards of prolonged suppression of endogenous cortisol and aldosterone production, etomidate is not intended for prolonged infusion
• Insufficient data to support use of IV etomidate in obstetrics, including c-section deliveries; use not recommended
• Monitor renal function in elderly patients. Monitor plasma cortisol and aldosterone levels during induction
• Monitor ECG, Vital signs continuously
• As etomidate is excreted primarily by the kidney, the risk of toxicity may be increased in patients with renal impairment

Cautions: Use cautiously in

• Geriatric patients (reduce dose)
• Pediatric population (use not recommended for patients < 10 yrs)
• Pregnancy
• Lactation

Pregnancy Category:C

Breastfeeding: Safety unknown; minimal amounts are excreted in breast milk. Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia. This information based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 20 August 2010). Manufacturer advises caution

• LOCAL: Transient injection site pain
• MUSC: Transient skeletal muscle movements (myoclonic movements, tonic movements)
• RESP: Short duration apnea, laryngospasm, hyperventilation, hypoventilation, hiccup, snoring
• ENDO: Adrenal Suppression
• GI: Postoperative nausea/vomiting
• CV: Arrhythmias, hypertension, hypotension, tachycardia, bradycardia, shock

• Non-barbiturate hypnotic: Exact mechanism of action unknown; acts at the level of the reticular-activating system to produce anesthetic effect via GABA
• Rapid onset of action (within one min); duration of hypnosis is dose dependent but relatively brief (3-5 mins)
• Rapidly metabolized by liver; CYP450: unknown
• Renally excreted: 75%
• Half-life: 75 mins

US Trade Name(s)

• Amidate

US Availability

etomidate (generic)

• INJ: 2 mg/mL [10 mL (20 mg)]
• INJ: 2 mg/mL [20 mL (40 mg)]

Amidate

• INJ: 2 mg/mL [10 mL (20 mg)]
• INJ: 2 mg/mL [20 mL (40 mg)]

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• Hypnomidate

UK Availability

etomidate-Lipuro (generic)

• INJ (emulsion): 2 mg/mL (10 mL amp)

Hypnomidate

• INJ: 2 mg/mL (10 mL amp)

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Anesthesia

General Anesthetic

Non Barbiturate