sevoflurane (Rx)

  • Print
Brand and Other Names:Ultane

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

liquid

  • 100%
more...

Anesthesia

12-25 years

  • 2.6% in oxygen or 1.4% with 65% N2O/35% oxygen

25-40 years

  • 2.1% in oxygen or 1.1% with 65% N2O/35% oxygen

40-60 years

  • 1.7% in oxygen or 0.9% with 65% N2O/35% oxygen

60-80 years

  • 1.4% in oxygen or 0.7% with 65% N2O/35% oxygen

Dosage Forms & Strengths

liquid

  • 100%
more...

Anesthesia

0-1 month full term neonate

  • 3.3% in oxygen

1-6 months

  • 3% in oxygen

6 months to <3 years

  • 2.8% in oxygen or 2 % with 65% N2O/35% oxygen

3-12 years

  • 2.5% in oxygen or 2.5 % with 65% N2O/35% oxygen

12-25 years

  • 2.6% in oxygen or 1.4% with 65% N2O/35% oxygen
Next:

Interactions

Interaction Checker

and sevoflurane

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            Malignant hyperthermia

            Dose-dependent hypotension

            Bradycardia

            Tachycardia

            Hypotension

            Hypertension

            Nausea/vomiting

            Cough

            Agitation

            Increased salivation

            Airway obstruction

            Laryngospasm

            Apnea

            Increased BUN

            Increased ALT

            Respiratory irritation

            Nephrotoxicity

            Glycosuria

            Proteinuria

            Postmarketing Reports

            Seizures (majority of cases in children and young adults, most had no medical history of seizures)

            Cardiac arrest

            Cases of mild, moderate and severe post-operative hepatic dysfunction or hepatitis with or without jaundice

            Malignant hyperthermia

            Allergic reactions (eg, rash, urticaria, pruritus, bronchospasm, anaphylactic or anaphylactoid reactions)

            Transient elevations in glucose, liver function tests, and WBC count

            Previous
            Next:

            Warnings

            Contraindications

            Susceptibility to malignant hyperthermia

            Hypersensitivity, lack of ventilatory support

            Cautions

            Volatile liquid; use appropriate vaporizer for inhalation

            Agitation/delirium may occur

            Postoperative hepatitis reported

            Closely monitor patients with anemia, hepatic impairment, myxedema, renal impairment

            Can induce malignant hyperthermia in genetically susceptible individuals

            Reports of QT prolongation, associated with torsade de pointes (in exceptional cases, fatalities reported); exercise caution when administering to susceptible patients (eg, congenital long QT syndrome, coadministration with drugs that prolong QT interval)

            Should not be used as a sole agent of induction in patients with ventricular dysfunction

            Risk of perioperative hyperkalemia in pediatric patients reported (rare); some resulting in cardiac arrhythmia and death

            Perioperative hyperkalemia

            • Inhaled anesthetics associated with rare increases in serum potassium levels that have resulted in cardiac arrhythmias and death in pediatric patients postoperatively  
            • Patients with latent as well as overt neuromuscular disease, particularly Duchenne muscular dystrophy, appear to be most vulnerable
            • Concomitant use of succinylcholine has been associated with most, but not all, of these cases
            • Elevated serum creatinine kinase levels and, in some cases, changes in urine consistent with myoglobinuria observed  
            • Despite similar presentation to malignant hyperthermia, none of affected patients exhibited signs or symptoms of muscle rigidity or hypermetabolic state  
            • Early and aggressive intervention to treat hyperkalemia and resistant arrhythmias recommended  
            • Evaluation for latent neuromuscular disease recomended
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excreted in breast milk; no adverse effect on nursing infant

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Volatile liquid general anesthetic; may alter activity of neuronal ion channels, especially the fast synaptic neurotransmitter receptors including nicotinic acetylcholine, GABA, and glutamate receptors.

            Pharmacokinetics

            Onset: 2-3 min

            Duration: Depends on blood concentration

            Metabolism: Liver (3-5%); CYP2E1

            Excretion: Respiratory exhaled gases

            Pharmacogenomics

            Increased incidence of malignant hyperthermia with use of volatile anesthetics or depolarizing neuromuscular blockers in patients with gene mutations in ryanodine receptor (RYR1) or calcium channel alpha (1S)- subunit gene (CACNA1S)

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous