Propofol

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Propofol

Examples of brand names: Disoprivan [DE]

ATC code: N01AX10

Main use (for orientation): Anaesthesia

Documented research summary

Several observational studies link cannabis use to higher propofol requirements, without an established metabolic explanation. Largest 2026 cohort, n=341,199: adjusted +6.85 µg/kg/min for non-medical and +2.87 for medical users (95% CI 6.07–7.63 and 0.88–4.86); authors emphasise modest effect sizes. Contrasting findings explicitly included: short upper-endoscopy study with 23 matched pairs without a significant difference; matched perioperative cohort n=570 also without a propofol difference; dental study n=53 not significant after adjustment. A 2009 study, n=60, found a higher requirement for laryngeal-mask insertion, not the BIS target or estimated ED50–95. No general dose increase can be inferred. Additional anaesthesia cohorts: Ripperger 2023 (n=189, 57 regular cannabis users) found greater requirements with a combined midazolam/fentanyl/propofol/ketamine regimen; not isolated pharmacokinetics. Gangwani 2023 (n=53) found no significant adjusted requirement difference for these four substances; do not present unadjusted differences as an established interaction.

Uncertainties and limitations

Observational design, self-report, different procedures/dosing targets and additional anaesthetics; cannabis status not randomised. Acute cannabinoid administration cannot be inferred from chronic use.

Separately recorded findings

4 separately recorded findings. Each statement applies to its documented study context.

Cannabis, observed use – clinical signals

Finding ID: B0139

Type of result: Mixed/context-dependent finding

Observation: Cohort n=189: propofol 152.5 versus 117.5 mg, p=0.004. Second cohort n=53: unadjusted 70 versus 45.26 mg, p=0.03; not significant after adjustment, p=0.06.

Mechanism: Anaesthetic requirements during a multi-drug regimen

Study type: Retrospective anaesthesia cohorts

Context studied: Outpatient oral surgery with additional anaesthetics.

Clinical interpretation: No fixed dose adjustment can be inferred

Limitations and uncertainties: Not isolated pharmacokinetics; do not present p=0.06 as an established difference.

Original sources for this finding: Cannabis Users Require More Anesthetic Agents for General Anesthesia in Ambulatory Oral and Maxillofacial Surgery Procedures. [CA_P_37783364]; Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation? [CA_P_36746375]

Cannabis, medical/non-medical use – clinical signals

Finding ID: B0153

Type of result: Positive finding / indication

Observation: Higher adjusted propofol requirement: non-medical +6.85 µg/kg/min (95% CI 6.07–7.63), medical +2.87 (0.88–4.86); authors characterise effects as modest.

Mechanism: Observed requirement association, not an isolated metabolic explanation

Study type: Multivariable-adjusted observational study

Context studied: Overall cohort of 341,199 anaesthesia/sedation patients, 2008–2024; 23,896 non-medical and 3,193 medical users. Overall n is not exclusively the propofol group.

Clinical interpretation: Effect size/clinical significance limited; no dosage formula

Limitations and uncertainties: Not randomised; recording of use/indication and residual confounding; no cannabinoid-specific pharmacokinetic evidence.

Original sources for this finding: Cannabis use and anaesthetic agent dosing in patients undergoing surgery or interventional procedures: a single-centre retrospective cohort study. [CA_P_42810868]

Cannabis, chronic use – clinically investigated

Finding ID: B0154

Type of result: Mixed/context-dependent finding

Observation: More propofol for laryngeal-mask insertion (314.0±109.3 versus 263.2±69.5 mg, p<0.04); BIS-target requirement and estimated ED50–95 not significantly different.

Mechanism: Clinical anaesthetic requirement

Study type: Prospective study with randomised propofol dose levels

Context studied: 30 male users (>weekly) and 30 non-users, aged 18–50.

Clinical interpretation: Endpoint-specific

Limitations and uncertainties: Cannabis use itself not randomised; not general clearance/tolerance evidence.

Original sources for this finding: Induction dose of propofol in patients using cannabis. [CA_P_19237981]

Cannabis, self-reported use – clinical signals

Finding ID: B0155

Type of result: No / minor effect under the conditions studied

Observation: No significant differences in propofol requirement; fentanyl/ketamine also not significantly different. No cardiac/respiratory events reported within 30 days.

Mechanism: Requirements during short endoscopy

Study type: 23 matched pairs

Context studied: Short oesophagogastroduodenoscopy; 47 users identified, 23 successfully matched.

Clinical interpretation: Contrasting finding under limited conditions

Limitations and uncertainties: Small sample; absence of events is not proof of safety or transferable to long operations.

Original sources for this finding: Anesthesia for Patients Who Self-Report Cannabis (Marijuana) Use Before Esophagogastroduodenoscopy: A Retrospective Review. [CA_P_34042571]

References and access status

[CA_L_D0156] D0156 official SPL

Original source / bibliographic reference

Authors: Pfizer Laboratories Div Pfizer Inc

Year: 2026

Source type: Current published human-use SPL / product information

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[CA_P_42810868] Cannabis use and anaesthetic agent dosing in patients undergoing surgery or interventional procedures: a single-centre retrospective cohort study.

Original source / bibliographic reference

Authors: Ratajczak N, Ahrens E, Wachtendorf LJ, Munoz-Acuna R, Redaelli S, Suleiman A, Seibold EL, Hentges M, Tenge T, von Wedel D, Ashrafian S, Paschold BS, Chen G, Hill KP, Schaefer MS.

Year: 2026

Source type: Journal Article

DOI: 10.1016/j.bja.2026.09.001

PMID: 42810868

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_41713495] Do Cannabis Users Require More Anesthesia During Third Molar Removal Under Intravenous General Anesthesia When Compared to Nonusers?

Original source / bibliographic reference

Authors: Panesar KS, Smith C, Zhang Z, Dodson TB, Burke A.

Year: 2026

Source type: Comparative Study; Journal Article

DOI: 10.1016/j.joms.2026.01.020

PMID: 41713495

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_39087994] Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures: A Replication Study.

Original source / bibliographic reference

Authors: Smith LD, Pelton W, Morgan MK.

Year: 2024

Source type: Journal Article

DOI: 10.1097/sga.0000000000000834

PMID: 39087994

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_33661987] High quantities: Evaluating the association between cannabis use and propofol anesthesia during endoscopy.

Original source / bibliographic reference

Authors: Imasogie N, Rose RV, Wilson A.

Year: 2021

Source type: research-article; Journal Article

DOI: 10.1371/journal.pone.0248062

PMID: 33661987

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

[CA_P_34042571] Anesthesia for Patients Who Self-Report Cannabis (Marijuana) Use Before Esophagogastroduodenoscopy: A Retrospective Review.

Original source / bibliographic reference

Authors: King DD, Stewart SA, Collins-Yoder A, Fleckner T, Price LL.

Year: 2021

Source type: research-article; Journal Article

PMID: 34042571

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

Unresolved access questions / further review: No new complete methodological assessment; original direct PubMed retrieval incomplete.

PubMed Central – freely accessible full text

[CA_P_19237981] Induction dose of propofol in patients using cannabis.

Original source / bibliographic reference

Authors: Flisberg P, Paech MJ, Shah T, Ledowski T, Kurowski I, Parsons R.

Year: 2009

Source type: Research Support, Non-U.S. Gov't; Randomized Controlled Trial; Journal Article

DOI: 10.1097/eja.0b013e328319be59

PMID: 19237981

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_41123263] Effect of patient marijuana use on perioperative opioid requirements.

Original source / bibliographic reference

Authors: Pitts J, Henry M, Zhao H, Rajkumar KP, Hauck E, Livelsberger J.

Year: 2025

Source type: Journal Article; Observational Study

DOI: 10.5055/jom.0935

PMID: 41123263

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_32931961] Nurse-Administered Propofol Continuous Infusion Sedation for Gastrointestinal Endoscopy in Patients Who Are Difficult to Sedate.

Original source / bibliographic reference

Authors: Lee HS, Nagra N, La Selva D, Kozarek RA, Ross A, Weigel W, Beecher R, Chiorean M, Gluck M, Boden E, Venu N, Krishnamoorthi R, Larsen M, Lin OS.

Year: 2021

Source type: Journal Article

DOI: 10.1016/j.cgh.2020.09.018

PMID: 32931961

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_36746375] Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation?

Original source / bibliographic reference

Authors: Gangwani P, Lillian D, Dobbins J, Feng C, Vorrasi J, Kolokythas A.

Year: 2023

Source type: Journal Article

DOI: 10.1016/j.joms.2023.01.007

PMID: 36746375

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_37783364] Cannabis Users Require More Anesthetic Agents for General Anesthesia in Ambulatory Oral and Maxillofacial Surgery Procedures.

Original source / bibliographic reference

Authors: Ripperger D, Atte A, Ritto F.

Year: 2023

Source type: Journal Article

DOI: 10.1016/j.joms.2023.09.008

PMID: 37783364

Source access – 23 October 2026: Direct retrieval could not be fully verified; availability remains unresolved.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_38215858] Marijuana and endoscopy: the effects of marijuana on sedation.

Original source / bibliographic reference

Authors: Kosirog J, Bouvette C, Pannu J, Gondal J, Madhoun M.

Year: 2024

Source type: Journal Article

DOI: 10.1016/j.gie.2024.01.013

PMID: 38215858

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_39199820] Perioperative Analgesic and Sedative Effects of Cannabidiol in Cats Undergoing Ovariohysterectomy.

Original source / bibliographic reference

Authors: Zanelli GR, Vieira GBM, Souza RVM, Aguiar AJA, Cassu RN.

Year: 2024

Source type: research-article; Journal Article

DOI: 10.3390/ani14162286

PMID: 39199820

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

Drug search and explanation of the evidence · Guide: cannabinoids and medicines · Author and responsibility