Fresofol 1% MCT/LCT can be used in combination with other medicinal products for anaesthesia (premedications, volatile anaesthetics, analgesics, muscle relaxants, local anaesthetics). Severe interactions with these medicinal products have been reported. Some of these centrally-acting medicinal products may exhibit a circulatory and respiratory depressive effect, thus leading to increased effects when used together with Fresofol 1% MCT/LCT.
Lower doses may be required when general anaesthesia is carried out in conjunction with regional anaesthesia.
Concomitant use of benzodiazepines, parasympatholytic agents or inhalational anaesthetics has been reported to prolong the anaesthesia and to reduce the respiratory rate.
After additional premedication with opioids, the sedative effects of propofol may be intensified and prolonged, and there may be a higher incidence and longer duration of apnoea.
It should be taken into consideration that concomitant use of propofol and medicinal products for premedication, inhalation agents or analgesic agents may potentiate anaesthesia and cardiovascular side effects.
Concomitant use of central nervous system depressants (eg, alcohol, general anaesthetics, narcotic analgesics) will result in intensification of their sedative effects.
When Fresofol 1% MCT/LCT is combined with centrally depressant drugs administered parenterally, severe respiratory and cardiovascular depression may occur.
After administration of fentanyl, the blood level of propofol may be temporarily increased with an increase in the rate of apnoea.
Bradycardia and cardiac arrest may occur after treatment with suxamethonium or neostigmine.
Leucoencephalopathy has been reported with administration of lipid emulsions eg, propofol in patients receiving cyclosporine.
Fresofol 1% MCT/LCT should not be mixed prior to administration with injection or infusion solutions other than 5% w/v glucose solution or 0.9% w/v sodium chloride solution or 1% preservative free lidocaine injection solution (see Dosage and Administration). Final propofol concentration must not be <2 mg/mL.