[News Terms] Preventing Abuse of 'Narcotics Designated' Etomidate and Lemborexant

The Ministry of Food and Drug Safety has designated 'Etomidate,' an induction agent for general anesthesia, and 'Lemborexant,' used for patients with insomnia, as narcotics.

Etomidate, known as the "second Propofol," is officially named Etomidate Lipuro Injection and was developed by Paul Janssen. It is mainly used as a general anesthetic in procedures such as sedation endoscopy. Etomidate is often used for hemodynamically unstable patients because it has less respiratory depressive effects compared to other intravenous anesthetics. However, the incidence of nausea and vomiting after awakening from anesthesia is as high as 40%, and it may cause side effects such as muscle spasms.

Propofol was designated as a narcotic psychotropic drug in 2011. Etomidate had only been managed as a prescription drug because strong dependency, like Propofol, had not yet been proven. However, Etomidate has been abused in blind spots of regulation, causing ongoing controversy. According to data received by the office of Seo Young-seok, a member of the Democratic Party of Korea, from the Ministry of Health and Welfare and the Health Insurance Review and Assessment Service (HIRA), the quantity of Etomidate supplied to medical institutions last year was 336,000 units, a 44% increase from 232,900 units in 2020. However, the usage (prescription) from 2020 to 2023 accounted for only 17.4% of the total supply (184,688 units out of 1,060,583 units). The fact that usage is lower than supply suggests that a significant portion is used off-label and not captured in HIRA statistics. In fact, Doctor A was indicted by the prosecution last July on charges of illegally selling Etomidate to 75 Propofol addicts 5,071 times over about four years from September 2019 to last June, receiving 1.2 billion KRW. In 2022, plastic surgeon Doctor C was tried on charges of sexual crimes after injecting patients with Etomidate.

The Ministry of Food and Drug Safety has required companies with product approval to prepare and report sales plans to prevent misuse or illegal distribution of Etomidate until the legal amendment to designate it as a narcotic is enacted.

Lemborexant is an insomnia treatment drug from Japan's Eisai Pharmaceutical. Lemborexant induces sleep by blocking the action of orexin A and orexin B, major neurotransmitters that maintain wakefulness. This drug is effective in reducing sleep onset time and improving sleep maintenance in adults with insomnia. Headache and dizziness may occur as side effects. It is recommended to take Lemborexant orally before bedtime. Alcohol consumption should be avoided while taking this medication.

The Ministry of Food and Drug Safety expects that this new narcotics designation will help prevent drug misuse and illegal distribution.

This content was produced with the assistance of AI translation services.