Dosing & Uses
Dosage Forms & Strengths
inhalation solution
- 100mL
- 250mL
Anesthesia Induction & Maintenance
Use calibrated vaporizer
Induction: 1.5-3% can produce surgical anesthesia in 7-10 minutes
Maintenance: 1-2.5% with nitrous oxide
Additional 0.5-1% may be needed if given with oxygen alone
Safety & efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (34)
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, isoflurane. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).
- dexfenfluramine
isoflurane increases toxicity of dexfenfluramine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- dexmethylphenidate
isoflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- dextroamphetamine
isoflurane increases toxicity of dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- diethylpropion
isoflurane increases toxicity of diethylpropion by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- dobutamine
isoflurane increases toxicity of dobutamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- dopamine
isoflurane increases toxicity of dopamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- ephedrine
isoflurane increases toxicity of ephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- epinephrine
isoflurane increases toxicity of epinephrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- fenfluramine
isoflurane increases toxicity of fenfluramine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- fentanyl
fentanyl, isoflurane. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl intranasal
fentanyl intranasal, isoflurane. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transdermal
fentanyl transdermal, isoflurane. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transmucosal
fentanyl transmucosal, isoflurane. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fexinidazole
fexinidazole and isoflurane both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- hydrocodone
hydrocodone, isoflurane. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).
- isoproterenol
isoflurane increases toxicity of isoproterenol by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- lefamulin
lefamulin and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- lisdexamfetamine
isoflurane increases toxicity of lisdexamfetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- mefloquine
mefloquine increases toxicity of isoflurane by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- methamphetamine
isoflurane increases toxicity of methamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- methylphenidate
isoflurane increases toxicity of methylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of acute hypertensive episode.
- metoclopramide intranasal
isoflurane, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- midodrine
isoflurane increases toxicity of midodrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- norepinephrine
isoflurane increases toxicity of norepinephrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- phendimetrazine
isoflurane increases toxicity of phendimetrazine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- phentermine
isoflurane increases toxicity of phentermine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- phenylephrine
isoflurane increases toxicity of phenylephrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- phenylephrine PO
isoflurane increases toxicity of phenylephrine PO by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- propylhexedrine
isoflurane increases toxicity of propylhexedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- pseudoephedrine
isoflurane increases toxicity of pseudoephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- sufentanil SL
sufentanil SL, isoflurane. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- xylometazoline
isoflurane increases toxicity of xylometazoline by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- yohimbine
isoflurane increases toxicity of yohimbine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
Monitor Closely (12)
- benazepril
isoflurane, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.
- brexanolone
brexanolone, isoflurane. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
isoflurane increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
- captopril
isoflurane, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.
- esketamine intranasal
esketamine intranasal, isoflurane. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- fostemsavir
isoflurane and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- lasmiditan
lasmiditan, isoflurane. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant, isoflurane. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- midazolam intranasal
midazolam intranasal, isoflurane. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- oliceridine
oliceridine, isoflurane. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).
- osilodrostat
osilodrostat and isoflurane both increase QTc interval. Use Caution/Monitor.
- stiripentol
stiripentol, isoflurane. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
Minor (0)
Adverse Effects
1-10%
Nausea
Vomiting
Shivering
<1%
Dose-dependent hypotension
Arrhythmias
Malignant hyperthermia (rare)
Elevations in white blood count
May decrease creatinine and increase BUN
Ileus, severe (fatal)
Hepatic dysfunction (postoperative period) (rare)
Respiratory depression may occur (rare)
Warnings
Contraindications
Hypersensitivity to isoflurane & halogenated agents
Genetic susceptibility to malignant hyperthermia
Cautions
Caution in coronary heart disease
May decrease renal and hepatic blood flow
Postoperative hepatic dysfunction and hepatitis reported
Rare risk of perioperative hyperkalemia & malignant hyperthermia
Adequate data have not been developed to establish its application in obstetrical anesthesia
Should not be used as a sole agent of induction in patients with ventricular dysfunction
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
General anesthetics and sedation drugs in young children and pregnant women
Brain development
- Prolonged or repeated exposure may result in negative effects on fetal or young children’s brain development
- Caution with use during surgeries or procedures in children younger than 3 yr or in pregnant women during their third trimester
- Assess the risk:benefit ratio in these populations, especially for prolonged procedures (ie, >3 hr) or multiple procedures
Pregnancy & Lactation
Pregnancy
There are no adequate and well-controlled studies in pregnant women; in animal reproduction studies, embryofetal toxicity was noted in pregnant mice exposed to 0.075% (increased post implantation losses) and 0.3% isoflurane (increased post implantation losses and decreased live- birth index) during organogenesis
Lactation
Use caution
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.Pharmacology
Mechanism of Action
Volatile liquid inhalation anesthetic
Pharmacokinetics
Onset: Rapid (7-10 min)
Duration: Short (depends on blood concentration)
Minimum Alveolar Conc: 1.3%
Metabolism: Liver (0.2%)
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)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| isoflurane inhalation - | 99.9 % liquid |  | |
| isoflurane inhalation - | 99.9 % liquid |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
isoflurane inhalation
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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