Drug reference

Etomidate

General Anesthetic · General Anaesthesia

General AnestheticGeneral Anaesthesia

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

5 major

SEVERE in our sources

PREGNANCY

Manufacturer advises avoid unless essential.

FDA category + note

Top interactionssee all 5 →

IsocarboxazidSevereDatabaseDDInter
PhenelzineSevereDatabaseDDInter
SelegilineSevereDatabaseDDInter
Sodium OxybateSevereDatabaseDDInter

Mechanism

Etomidate is an imidazole-derived intravenous anesthetic that selectively modulates GABA-A receptors containing β2 and β3 subunits, enhancing chloride channel conductance at concentrations lower than those required for barbiturate or propofol activity. Its unique subunit selectivity provides hypnosis with remarkable cardiovascular stability — minimal effect on heart rate, blood pressure, or cardiac output — making it the agent of choice for hemodynamically unstable patients. However, it inhibits 11-β-hydroxylase in the adrenal cortex, causing reversible suppression of cortisol synthesis even after a single induction dose.

Indications

Induction of general anaesthesiaIntravenous anestheticanesthetic induction (primarily for patients at risk for hypotension or myocardial ischemia)hypercortisolism (rapid control in emergency setting, off-label use)Hypercortisolism associated with Cushing’s Syndrome Caused by Ectopic ACTH Production

Dosing

Adult: l INDICATIONS AND DOSE Acute porphyrias | Acute intermittent porphyria | Porphyria variegata | Hereditary coproporphyria ▶ BY INTRAVENOUS INFUSION ▶ Adult: Initially 3 mg/kg once daily for 4 days, if response inadequate, repeat 4-day course with close biochemical monitoring; maximum 250 mg per day l SIDE-EFFECTS ▶ Common or very common Poor venous access ▶ Rare or very rare Fever ▶ Frequency not k…