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Uses
LUSEDRATM (fospropofol disodium) injection is an intravenous sedative-hypnotic agent indicated for monitored anesthesia care (MAC) sedation in adult patients undergoing diagnostic or therapeutic procedures.
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Other Information
LUSEDRA is an injection solution intended for intravenous administration as a sedative-hypnotic agent. LUSEDRA is an aqueous, sterile, nonpyrogenic, clear, colorless, iso-osmotic solution containing 35 mg/mL of fospropofol disodium. Fospropofol disodium is a water-soluble prodrug of propofol, chemically described as 2,6-diisopropylphenoxymethyl phosphate, disodium salt. The structural and molecular formulas are shown in Figure 1.
Molecular Formula: C13H19O5PNa2
Molecular Weight: 332.24
Figure 1. Structural and Molecular Formulas of Fospropofol Disodium
The inactive components include monothioglycerol (0.25 wt%) and tromethamine (0.12 wt%). LUSEDRA has a pH of 8.2 to 9.0. LUSEDRA does not contain any antimicrobial preservatives and is intended for single-use administration.
Sources
Lusedra Manufacturers
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Eisai, Inc
Lusedra | Eisai, Inc
2.1 Dosing Guidelines Administer LUSEDRA intravenously as a bolus injection. Use supplemental oxygen for all patients undergoing sedation with LUSEDRA. Individualize the dosage of LUSEDRA and titrate to the level of sedation required for the procedure. In adults aged 18 to <65 years who are healthy or have mild systemic disease as categorized by the American Society of Anesthesiologists (ASA P1 or P2), the standard dosing regimen of LUSEDRA should be followed [see Standard Dosing Regimen for Sedation (2.2)]. In adults who are ≥ 65 years of age or who have severe systemic disease (ASA P3 or P4), the modified dosing regimen should be followed [see Modified Dosing Regimen for Sedation in Patients ≥ 65 years or Those with Severe Systemic Disease (2.3)]. Administer supplemental doses of LUSEDRA based on the patient's level of sedation and the level of sedation required for the procedure. Give supplemental doses only when patients can demonstrate purposeful movement in response to verbal or light tactile stimulation and no more frequently than every 4 minutes. Use only the minimum dosage required to facilitate the procedure. Consider the potential for worsened cardiorespiratory depression prior to using LUSEDRA concomitantly with other drugs that have the same potential (e.g., sedative-hypnotics or narcotic analgesics) [see Warnings and Precautions (5.2, 5.3)]. In clinical studies, an opioid premedication (fentanyl citrate 50 mcg intravenously) was administered five minutes prior to the initial dose of LUSEDRA. 2.2 Standard Dosing Regimen for SedationIn adults aged 18 to <65 years who are healthy or have mild systemic disease (ASA P1 or P2)1, the standard dosing regimen of LUSEDRA is an initial intravenous bolus of 6.5 mg/kg followed by supplemental doses of 1.6 mg/kg intravenously (25% of initial dosage) as needed to achieve the desired level of sedation as shown in Table 1.
The dosage of LUSEDRA is limited by lower and upper weight bounds of 60 kg and 90 kg. Adults who weigh >90 kg should be dosed as if they weigh 90 kg. No initial dose should exceed 16.5 mL; no supplemental dose should exceed 4 mL. Adults who weigh <60 kg should be dosed as if they weigh 60 kg. Dosages lower than those specified for the lower weight limit may be used to achieve lesser levels of sedation. In clinical studies, an opioid premedication (fentanyl citrate 50 mcg IV) was administered five minutes prior to the initial dose of LUSEDRA.
Table 1. Standard Dosing Regimen, Adults 18 to <65 Years of Age Who are Healthy or Have Mild Systemic Disease (ASA P1 or P2) Initial Dose Supplemental Dose
No more frequently than every 4 min. Weight (kg) mg mL mg mL Note: Doses in this table are rounded to the nearest half-milliliter volume to facilitate practical measurement; hence, they may differ slightly from the dose recommended on the basis of mg/kg. ≤60 385 11 105 3 61 to 63 402.5 11.5 105 3 64 to 65 420 12 105 3 66 to 68 437.5 12.5 105 3 69 to 71 455 13 105 3 72 to 74 472.5 13.5 122.5 3.5 75 to 76 490 14 122.5 3.5 77 to 79 507.5 14.5 122.5 3.5 80 to 82 525 15 140 4 83 to 84 542.5 15.5 140 4 85 to 87 560 16 140 4 88 to 89 577.5 16.5 140 4 ≥90 577.5 16.5 140 4 2.3 Modified Dosing Regimen for Sedation in Patients ≥65 years or Those with Severe Systemic Disease (ASA P3 or P4)Adults ≥65 years of age or those with severe systemic disease (ASA P3 or P4)1 should receive initial and supplemental intravenous dosages of 75% of the standard dosing regimen, as presented in Table 2. LUSEDRA is administered intravenously as a bolus injection. In clinical studies, an opioid premedication (fentanyl citrate 50 mcg IV) was administered five minutes prior to the initial dose of LUSEDRA.
Table 2. Modified Dosing Regimen, Ages ≥ 65 Years Or Those with Severe Systemic Disease (ASA P3 or P4) Initial Dose Supplemental Dose
No more frequently than every 4 min. Weight (kg) mg mL mg mL Note: Doses in this table are rounded to the nearest half-milliliter volume to facilitate practical measurement; hence, they may differ slightly from the dose recommended on the basis of mg/kg. ≤60 297.5 8.5 70 2 61 to 62 297.5 8.5 70 2 63 to 64 315 9 87.5 2.5 65 to 66 315 9 87.5 2.5 67 to 69 332.5 9.5 87.5 2.5 70 to 73 350 10 87.5 2.5 74 to 77 367.5 10.5 87.5 2.5 78 to 80 385 11 105 3 81 to 84 402.5 11.5 105 3 85 to 87 420 12 105 3 88 to 89 437.5 12.5 105 3 ≥90 437.5 12.5 105 3 2.4 PreparationLUSEDRA is provided as a ready to use formulation intended for single-patient use only. Prepare LUSEDRA following strict aseptic techniques. Draw LUSEDRA into sterile syringes immediately after vials are opened. Discard any unused portion at the end of the procedure.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not use if there is evidence of particulate matter or discoloration.
LUSEDRA has been shown to be compatible with the following fluids:
5% Dextrose Injection, USP 5% Dextrose and 0.2% Sodium Chloride, USP 5% Dextrose and 0.45% Sodium Chloride Injection, USP 0.9% Sodium Chloride Injection, USP Lactated Ringer's Injection, USP Lactated Ringer's and 5% Dextrose Injection, USP 0.45% Sodium Chloride Injection, USP 5% Dextrose, 0.45% NaCl and 20 mEq KCl, USPDo not mix LUSEDRA with other drugs or fluids prior to administration. LUSEDRA is not physically compatible with midazolam HCl or meperidine HCl, and compatibility with other agents has not been adequately evaluated.
Administer LUSEDRA through a secure, freely flowing, peripheral intravenous line using commonly available intravenous administration sets. Flush the infusion line with normal saline before and after administration of LUSEDRA.
LUSEDRA is not light sensitive. LUSEDRA does not need to be filtered before use.
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