Interactions : אינטראקציות

4.5    Interaction with other medicinal products and other forms of interaction
The hypnotic effect of etomidate may be enhanced by:
•      neuroleptic drugs
•      opioids
•      sedatives
•      alcohol.

Induction with etomidate may be accompanied by a slight and transient reduction in peripheral resistance which may enhance the effect of other drugs reducing blood pressure.

Alfentanil
Co-administration of etomidate with alfentanil has been reported to decrease the terminal half-life of etomidate to approximately 29 minutes. Caution should be used when both drugs are administered together as the concentrations of etomidate may drop below the hypnotic threshold.

Fentanyl
The total plasma clearance and volume of distribution of etomidate is decreased by a factor of 2 to 3 without a change in half-life when administered with fentanyl intravenously. When etomidate is co-administered with fentanyl intravenously, the dose may need to be reduced.

Ketamine
Co-administration of etomidate and ketamine appears to have no significant effect on the plasma concentrations or pharmacokinetic parameters of ketamine or its principal metabolite, norketamine.

Adrenergic neurone blockers, alpha blockers
Combination with general anaesthetics leads to an enhancement of the hypotensive effect of these substances.

Calcium channel blockers (Verapamil, Diltiazem)
Combination with general anaesthetics results in an enhancement of the hypotensive effect and also AV delay.

Monoamine oxidase inhibitors (MAOI)
Because of hazardous interactions between general anaesthetics and MAOIs, MAOIs should normally be stopped 2 weeks before surgery.