The Basics
What is Etomidate?
Used for the induction of general anaesthesia and sedation for short procedures such as reduction of dislocated joints, tracheal intubation, cardioversion and electroconvulsive therapy.
Brand names for Etomidate
Etomidate (Etomidate) Injection
How Etomidate is classified
Anesthetics – Intravenous, Hypnotics and Sedatives
Etomidate During Pregnancy
Etomidate pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Etomidate while pregnant
Etomidate has been shown to have an embryocidal effect in rats when given in doses 1 and 4 times the human dose. There are no adequate and well-controlled studies in pregnant women. Etomidate should be used during pregnancy only if the potential benefit justifies the potential risks to the fetus. Etomidate has not been shown to be teratogenic in animals. Reproduction studies with etomidate have been shown to: Decrease pup survival at 0.3 and 5 mg/kg in rats (approximately 1X and 16X human dosage) and at 1.5 and 4.5 mg/kg in rabbits (approximately 5X and 15X human dosage). No clear dose-related pattern was observed. Increase slightly the number of stillborn fetuses in rats at 0.3 and 1.25 mg/kg (approximately 1X and 4X human dosage). Cause maternal toxicity with deaths of 6/20 rats at 5 mg/kg (approximately 16X human dosage) and 6/20 rabbits at 4.5 mg/kg (approximately 15X human dosage).
Taking Etomidate While Breastfeeding
What are recommendations for lactation if you're taking Etomidate?
Amounts of etomidate in milk are very small and decrease rapidly. Existing data indicate that no waiting period is required before resuming breastfeeding after etomidate anesthesia. Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.
Maternal / infant drug levels
Amounts of etomidate in milk are very small and decrease rapidly. Existing data indicate that no waiting period is required before resuming breastfeeding after etomidate anesthesia. Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.
Possible effects of Etomidate on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Etomidate
Dexmedetomidine, Methohexital, Propofol, Thiopental.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Esener Z, Sarihasan B, Guven H et al. Thiopentone and etomidate concentrations in maternal and umbilical plasma, and in colostrum. Br J Anaesth. 1992;69:586-8. PMID: 1467101
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.