A new double-strength propofol may hit your shelves...to help meet demand during the COVID-19 pandemic.
It's because more patients are requiring sedation due to mechanical ventilation for COVID-19...and regular propofol and other sedatives (midazolam, etc) have been in short supply.
"Double-strength" means the product is propofol 2%, or 20 mg/mL...compared to regular propofol, which is 1%, or 10 mg/mL.
Anticipate that the double-strength propofol product will be the brand-name med, Propoven 2%...not Diprivan or a generic...in 100 mL vials.
Plus it will only be available through an "emergency use authorization" (EUA), which means it isn't FDA-approved.
Take steps to avoid dangerous mix-ups between double-strength and regular propofol.
Store the products separately on pharmacy shelves, in automated dispensing cabinets, etc.
Place tags on shelves and brightly colored labels on double-strength propofol vials to differentiate it from regular propofol.
Continue scanning bar codes and getting double checks of stock for automated dispensing cabinets...to ensure you have the right product.
But be aware, the bar code on double-strength propofol labels may not scan properly...since it's an international code. In this case, you may need to add bar-code labels to the vials.
Follow your pharmacy's guidelines on dispensing double-strength propofol. It'll likely be restricted to critical care...since it's only for continuous infusion in ventilated adult ICU patients.
Help educate nurses about this higher concentration...to reduce the risk of dosing confusion, pump errors, etc.
Get more error-prevention tips for propofol and other sedatives in our technician tutorials, Dispensing Meds for Surgeries and Inpatient Emergencies 101.
- ISMP Med Safety Alert! Acute Care 2020;25(Suppl 9):1-4
- www.fda.gov/media/137888/download (6-29-20)
- www.aha.org/news/headline/2020-05-12-fda-authorizes-propofol-emulsion-emergency-use-covid-19-ventilator (6-29-20)
- www.asahq.org/advocacy-and-asapac/fda-and-washington-alerts/fda-alerts/2020/05/emergency-use-authorization-eua-for-propofol (6-29-20)
- www.ismp.org/news/ismp-warns-about-medication-safety-issues-drug-shortage-replacement-products (6-29-20)
- ISMP Med Safety Alert! Acute Care 2020;25(12):1-5
- Technician Tutorial: Inpatient Emergencies 101
- Technician Tutorial: Dispensing Meds for Surgeries