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AI-Generated response:

My patient has an egg allergy, is Propofol a safe medication to use in this patient?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Propofol is contraindicated in patients with a history of anaphylaxis to eggs, egg products, soybeans, or soy products.[1-3]

  • Propofol contains components such as egg lecithin and soybean oil, which can trigger allergic reactions in individuals with egg or soy allergies.[4]

  • The FDA labels explicitly state that propofol is contraindicated in patients with known hypersensitivity to its components, including those with allergies to eggs and soy.[1-3]

  • Despite some studies suggesting no evidence for contraindications of propofol in adults allergic to egg, soy, or peanut, the official contraindications remain due to potential severe allergic reactions.[5]

  • It is important to assess the severity of the egg allergy and consider alternative sedatives if the allergy is severe or if there is a history of anaphylaxis.

  • Always monitor patients closely for any signs of allergic reactions when administering any medication, especially those with known allergen components.

Additional info

Given the contraindications listed in the FDA labeling, it is crucial to adhere to these guidelines to prevent potentially life-threatening reactions in patients with known allergies to eggs or soy. While some research, like the study by Asserhøj et al., suggests that propofol may be safe for use in patients with these allergies, the prevailing medical and regulatory advice based on the FDA's stance should be prioritized to ensure patient safety.[5] This is particularly important in cases where the patient has a history of severe allergic reactions. Alternative sedatives that do not contain allergenic substances should be considered in such cases to minimize the risk of anaphylaxis. Always ensure that emergency measures are in place to manage potential allergic reactions whenever administering any medication.

References

Reference 1

1.

Food and Drug Administration (DailyMed).

Publish date: September 1, 2023.

Contraindications 4 CONTRAINDICATIONS Propofol injectable emulsion is contraindicated in patients with a known hypersensitivity to propofol or any of propofol injectable emulsion components. Propofol injectable emulsion is contraindicated in patients with a history of anaphylaxis to eggs, egg products, soybeans or soy products. Known hypersensitivity to propofol, egg or soybean ( 4 )

Reference 2

2.

Food and Drug Administration (DailyMed).

Publish date: September 5, 2022.

Contraindications 4 CONTRAINDICATIONS Propofol injectable emulsion is contraindicated in patients with a known hypersensitivity to propofol or any of propofol injectable emulsion components. Propofol injectable emulsion is contraindicated in patients with a history of anaphylaxis to eggs, egg products, soybeans or soy products. Known hypersensitivity to propofol, egg or soybean ( 4 )

Reference 3

3.

Food and Drug Administration (DailyMed).

Publish date: November 1, 2023.

Contraindications CONTRAINDICATIONS: Diprivan (propofol) is contraindicated in patients with a known hypersensitivity to Diprivan (propofol) or any of Diprivan (propofol) components. Diprivan (propofol) is contraindicated in patients with allergies to eggs, egg products, soybeans or soy products.

Reference 4

4.

Elsevier ClinicalKey Drug Class Overview

Content last updated: June 0, 2020.

Propofol is dissolved in a lipid emulsion containing egg lecithin and soybean oil, which can precipitate allergic reactions in patients with egg or soy allergies. Some generic formulations contain sulfite preservatives, which may also cause allergic reactions.[[31036]](_WPS/RefShow.aspx?rid=31036) [[57161]](_WPS/RefShow.aspx?rid=57161)

Reference 5

5.

Asserhøj LL, Mosbech H, Krøigaard M, Garvey LH. British Journal of Anaesthesia. 2016;116(1):77-82. doi:10.1093/bja/aev360.

Publish date: January 5, 2016.

BACKGROUND: Propofol is thought to be a potential cause of allergic reactions in patients allergic to egg, soy or peanut, since current formulations contain an emulsion that includes egg lecithin and soybean oil. However, other than six case reports lacking in confirmatory evidence of an allergic reaction, there is no evidence linking the two types of allergies. The aim of this study was to examine the frequency of propofol allergy and to investigate if patients with specific immunoglobulin E (IgE) to egg, soy or peanut tolerated propofol. METHODS: Study A examined the frequency of propofol allergy in 273 patients systematically investigated for suspected perioperative allergic reactions. Of these, 153 had been exposed to propofol and underwent skin tests and intravenous provocation. Study B retrospectively investigated propofol exposure and tolerance in 520 adult patients with a positive specific IgE to egg, soy or peanut. RESULTS: Four of the 153 propofol-exposed patients (2.6%) investigated in study A were diagnosed with propofol allergy. Of these, three tested positive only on intravenous provocation. None of the four had allergic symptoms when eating egg, soy or peanut and none had detectable levels of specific IgE to egg or soy in their serum. In study B we found no signs of allergic reactions towards propofol in 171 retrieved anaesthetic charts from 99 patients with specific IgE to egg, soy or peanut. CONCLUSION: No connection between allergy to propofol and allergy to egg, soy or peanut was found. The present practice of choosing alternatives to propofol in patients with this kind of food allergy is not evidence based and should be reconsidered.

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