Fospropofol

Fospropofol is a new sedative / hypnotic / anesthetic drug awaiting FDA approval in the USA. It will be marked under the brand name “Aquavan”.

As a water-soluble prodrug of the popular sedative / hypnotic / anesthetic drug propofol, fospropofol is metabolized into propofol by the liver. This fact means that blood levels of propofol after the administration of a bolus of fospropofol reach lower peak levels than for an equipotent dose of propofol and also that its clinical effect is more sustained. These traits can be desirable for endoscopic procedures such as upper GI endoscopy, colonoscopy, bronchoscopy, as well as for some surgical procedures done under local or regional anesthesia. Often, fospropofol is administered in conjunction with an opioid such as fentanyl.

One advantage of fospropofol is that, being water-soluble, the problems associated with lipid formulated propofol (e.g., pain at the IV catheter site, potential for hyperlipidemia with long-term administration, and an increased chance for bacteremia) are expected to be less frequent.

Following the administration of fospropofol 12.5 mg/kg (the maximum recommended dose) loss of consciousness takes about four minutes, compared to one circulatory time with propofol 2.5 mg/kg (the maximum recommended dose).