Posology : מינונים

4.2   Posology and method of administration

Posology
The dosage is adjusted acc. to the individual response and the clinical effect.


The following dosage guidelines should be followed:
As a rule, the effective hypnotic dose is between 0.15 and 0.3 mg of etomidate per kg body weight, corresponding to 0.075 to 0.15 ml of Etomidate-Lipuro per kg body weight.
Children up to the age of 15 and elderly patients are given a single dose of 0.15 to 0.2 mg of etomidate, corresponding to 0.075 to 0.1 ml of Etomidate-Lipuro per kg body weight. Also in patients belonging to these age groups, the exact dosage has to be adjusted acc. to the clinical effect. In children up to the age of 15 the dosage may be increased by up to 30 % of the adult dose because it is sometimes necessary in order to obtain the same depth and duration of sleep.
Since etomidate has no analgesic action, appropriate analgesics should be used in procedures involving painful stimuli.
Do not exceed a total dose of 30 ml (3 ampoules). Etomidate should only be given by slow intravenous injection.
In patients with liver cirrhosis and patients having been premedicated with neuroleptics opioids or sedatives the dose has to be reduced.
In the special case of narcosis to terminate a status epilepticus or serial epileptic seizures a sufficient dose of etomidate (0.3 mg/kg body weight, corresponding to 0.15 ml/kg body weight of Etomidate-Lipuro) should be injected quickly, i. e. within 10 sec. This dose may be repeated several times, if required.

Method of administration
Etomidate-Lipuro must be injected strictly intravenously and, as a rule, slowly (a single dose in approx. 30 sec), and fractionated, if required.
Intra-arterial injection must be avoided as there is a danger of Etomidate-Lipuro to cause necroses if injected intra-arterially. Paravenous injection will cause strong pain.
Prior to administration of Etomidate-Lipuro appropriate premedication should be given in order to avoid the occurrence of myocloni. The use of benzodiazepines is recommended, e. g. diazepam which may be injected intramuscularly about 1 hour or intravenously 10 min. prior to administration of Etomidate-Lipuro.
In patients with manifest epilepsy or with an increased tendency to convulsions, Etomidate-Lipuro should be injected quickly, i. e. within a few seconds, in order to avoid too slow diffusion of etomidate into the brain. The good bioavailability of etomidate and its rapid distribution within the brain prevent activation of convulsions.