Dosing & Uses
Dosage Forms & Strengths
inhalation solution
- 240mL (100%)
General Anesthesia
Induction: Initial 3% inhaled, increase by 0.5-1% increments q2-3Breaths
Maintenance: 2.5-8.5% with or without nitrous oxide
Dosage Forms & Strengths
inhalation solution
- 240mL (100%)
General Anesthesia Maintenance
Indicated for maintenance of anesthesia in infants and children who are tracheally intubated following induction with agents other than desflurane
Maintenance: 5.2-10% with or without nitrous oxide
Dosing Considerations
Contraindicated for induction in pediatric patients
Not indicated for maintenance of anesthesia in nonintubated children due to an increased incidence of moderate to severe respiratory adverse reactions, including coughing, laryngospasm and secretions
Concentration of desflurane used is age dependent
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- dronedarone
desflurane and dronedarone both increase QTc interval. Contraindicated.
Serious - Use Alternative (171)
- alfuzosin
desflurane and alfuzosin both increase QTc interval. Avoid or Use Alternate Drug.
- amiodarone
desflurane and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amisulpride
desflurane and amisulpride both increase QTc interval. Avoid or Use Alternate Drug.
amisulpride and desflurane both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered. - anagrelide
desflurane and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
- aripiprazole
desflurane and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- arsenic trioxide
desflurane and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
desflurane and artemether both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
desflurane and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
desflurane and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and desflurane both increase QTc interval. Avoid or Use Alternate Drug.
- atomoxetine
desflurane and atomoxetine both increase QTc interval. Avoid or Use Alternate Drug.
- azithromycin
desflurane and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- bedaquiline
desflurane and bedaquiline both increase QTc interval. Avoid or Use Alternate Drug.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, desflurane. 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).
benzhydrocodone/acetaminophen and desflurane both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate - benzphetamine
desflurane increases toxicity of benzphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- buprenorphine
desflurane and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and desflurane both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and desflurane both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine subdermal implant and desflurane both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate - buprenorphine transdermal
buprenorphine transdermal and desflurane both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine transdermal and desflurane both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate - buprenorphine, long-acting injection
buprenorphine, long-acting injection and desflurane both increase QTc interval. Avoid or Use Alternate Drug.
- calcium/magnesium/potassium/sodium oxybates
desflurane, calcium/magnesium/potassium/sodium oxybates. Either increases effects 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.
- ceritinib
desflurane and ceritinib both increase QTc interval. Avoid or Use Alternate Drug.
- chloroquine
desflurane and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- chlorpromazine
desflurane and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.
- ciprofloxacin
desflurane and ciprofloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
desflurane and citalopram both increase QTc interval. Avoid or Use Alternate Drug.
- clarithromycin
desflurane and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- clozapine
desflurane and clozapine both increase QTc interval. Avoid or Use Alternate Drug.
- crizotinib
desflurane and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- dasatinib
desflurane and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.
- degarelix
desflurane and degarelix both increase QTc interval. Avoid or Use Alternate Drug.
- dexfenfluramine
desflurane increases toxicity of dexfenfluramine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- dexmethylphenidate
desflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- dextroamphetamine
desflurane increases toxicity of dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- diethylpropion
desflurane increases toxicity of diethylpropion by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- disopyramide
desflurane and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.
- dobutamine
desflurane increases toxicity of dobutamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- dofetilide
desflurane and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.
- dolasetron
desflurane and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- dopamine
desflurane increases toxicity of dopamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- doxapram
doxapram, desflurane. Mechanism: unspecified interaction mechanism. Contraindicated. May result in V tach or V fib. Delay doxapram until anesthesia has been excreted.
- droperidol
desflurane and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
- eliglustat
desflurane and eliglustat both increase QTc interval. Avoid or Use Alternate Drug.
- encorafenib
desflurane and encorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
desflurane and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- ephedrine
desflurane increases toxicity of ephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- epinephrine
desflurane increases toxicity of epinephrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
desflurane increases levels of epinephrine by decreasing metabolism. Contraindicated. - epinephrine racemic
desflurane increases levels of epinephrine racemic by decreasing metabolism. Contraindicated.
- eribulin
desflurane and eribulin both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin base
desflurane and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
desflurane and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
desflurane and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
desflurane and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
- escitalopram
desflurane and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.
- fenfluramine
desflurane increases toxicity of fenfluramine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- fentanyl
fentanyl, desflurane. 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, desflurane. 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, desflurane. 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, desflurane. 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 desflurane both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- flecainide
desflurane and flecainide both increase QTc interval. Avoid or Use Alternate Drug.
- fluconazole
desflurane and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- fluoxetine
desflurane and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.
- fluvoxamine
desflurane and fluvoxamine both increase QTc interval. Avoid or Use Alternate Drug.
- foscarnet
desflurane and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
- gemifloxacin
desflurane and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- gemtuzumab
desflurane and gemtuzumab both increase QTc interval. Avoid or Use Alternate Drug.
- gilteritinib
desflurane and gilteritinib both increase QTc interval. Avoid or Use Alternate Drug.
gilteritinib and desflurane both increase QTc interval. Avoid or Use Alternate Drug. - glasdegib
desflurane and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.
- goserelin
desflurane and goserelin both increase QTc interval. Avoid or Use Alternate Drug.
- granisetron
desflurane and granisetron both increase QTc interval. Avoid or Use Alternate Drug.
- haloperidol
desflurane and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.
- histrelin
desflurane and histrelin both increase QTc interval. Avoid or Use Alternate Drug.
- hydrocodone
hydrocodone, desflurane. 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).
- hydroxychloroquine sulfate
desflurane and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxyzine
desflurane and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
desflurane and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- iloperidone
desflurane and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.
- inotuzumab
desflurane and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.
- isocarboxazid
isocarboxazid increases levels of desflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- isoproterenol
desflurane increases toxicity of isoproterenol by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- itraconazole
desflurane and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
desflurane and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug.
- lapatinib
desflurane and lapatinib both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and desflurane both increase QTc interval. Avoid or Use Alternate Drug.
- lenvatinib
desflurane and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.
- leuprolide
desflurane and leuprolide both increase QTc interval. Avoid or Use Alternate Drug.
- levofloxacin
desflurane and levofloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- lisdexamfetamine
desflurane increases toxicity of lisdexamfetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- lithium
desflurane and lithium both increase QTc interval. Avoid or Use Alternate Drug.
- lofexidine
desflurane and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
- loperamide
desflurane and loperamide both increase QTc interval. Avoid or Use Alternate Drug.
- lopinavir
desflurane and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
desflurane and macimorelin both increase QTc interval. Avoid or Use Alternate Drug.
- maprotiline
desflurane and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- mefloquine
mefloquine increases toxicity of desflurane by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- methamphetamine
desflurane increases toxicity of methamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- methylphenidate
desflurane increases toxicity of methylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of acute hypertensive episode.
- metoclopramide intranasal
desflurane, 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
desflurane increases toxicity of midodrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- midostaurin
desflurane and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mifepristone
desflurane and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.
- mirtazapine
desflurane and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
desflurane and mobocertinib both increase QTc interval. Avoid or Use Alternate Drug.
- moxifloxacin
desflurane and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- nilotinib
desflurane and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- norepinephrine
desflurane increases toxicity of norepinephrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
desflurane increases levels of norepinephrine by decreasing metabolism. Contraindicated. - octreotide
desflurane and octreotide both increase QTc interval. Avoid or Use Alternate Drug.
- ofloxacin
desflurane and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- olanzapine
desflurane and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- olopatadine intranasal
desflurane and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ondansetron
desflurane and ondansetron both increase QTc interval. Avoid or Use Alternate Drug.
- osimertinib
desflurane and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
desflurane and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- ozanimod
desflurane and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.
- paliperidone
desflurane and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.
- panobinostat
desflurane and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.
- pasireotide
desflurane and pasireotide both increase QTc interval. Avoid or Use Alternate Drug.
- pazopanib
desflurane and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
- pentamidine
desflurane and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- phendimetrazine
desflurane increases toxicity of phendimetrazine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- phenelzine
phenelzine increases levels of desflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- phentermine
desflurane increases toxicity of phentermine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- phenylephrine
desflurane increases toxicity of phenylephrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
desflurane increases levels of phenylephrine by decreasing metabolism. Contraindicated. - phenylephrine PO
desflurane increases levels of phenylephrine PO by decreasing metabolism. Contraindicated.
desflurane increases toxicity of phenylephrine PO by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN. - pimavanserin
desflurane and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pitolisant
desflurane and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- ponesimod
desflurane and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
- posaconazole
desflurane and posaconazole both increase QTc interval. Avoid or Use Alternate Drug.
- primaquine
desflurane and primaquine both increase QTc interval. Avoid or Use Alternate Drug.
- procainamide
desflurane and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- propafenone
desflurane and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
- propylhexedrine
desflurane increases toxicity of propylhexedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- quetiapine
desflurane and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.
- quinine
desflurane and quinine both increase QTc interval. Avoid or Use Alternate Drug.
- ranolazine
desflurane and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.
- rasagiline
rasagiline increases levels of desflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- ribociclib
desflurane and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.
- rilpivirine
desflurane and rilpivirine both increase QTc interval. Avoid or Use Alternate Drug.
- risperidone
desflurane and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- romidepsin
desflurane and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b and desflurane both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- saquinavir
desflurane and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.
- selegiline
selegiline increases levels of desflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- selpercatinib
desflurane and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.
- serdexmethylphenidate/dexmethylphenidate
desflurane increases toxicity of serdexmethylphenidate/dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- sertraline
desflurane and sertraline both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
desflurane and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
- sodium oxybate
desflurane, sodium oxybate. Either increases effects 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.
- solifenacin
desflurane and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.
- sorafenib
desflurane and sorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- sotalol
desflurane and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- sufentanil SL
sufentanil SL, desflurane. 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.
- sunitinib
desflurane and sunitinib both increase QTc interval. Avoid or Use Alternate Drug.
- tacrolimus
desflurane and tacrolimus both increase QTc interval. Avoid or Use Alternate Drug.
- telavancin
desflurane and telavancin both increase QTc interval. Avoid or Use Alternate Drug.
- tetrabenazine
desflurane and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.
- toremifene
desflurane and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
- tranylcypromine
tranylcypromine increases levels of desflurane by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- trazodone
desflurane and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- triclabendazole
desflurane and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- triptorelin
desflurane and triptorelin both increase QTc interval. Avoid or Use Alternate Drug.
- vandetanib
desflurane and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.
- vardenafil
desflurane and vardenafil both increase QTc interval. Avoid or Use Alternate Drug.
- vemurafenib
desflurane and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.
- venlafaxine
desflurane and venlafaxine both decrease QTc interval. Avoid or Use Alternate Drug.
- voclosporin
desflurane and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- voriconazole
desflurane and voriconazole both increase QTc interval. Avoid or Use Alternate Drug.
- vorinostat
desflurane and vorinostat both increase QTc interval. Avoid or Use Alternate Drug.
- xylometazoline
desflurane increases toxicity of xylometazoline by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- yohimbine
desflurane increases toxicity of yohimbine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
Monitor Closely (151)
- acebutolol
desflurane, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- acrivastine
acrivastine and desflurane both increase sedation. Use Caution/Monitor.
- alfentanil
desflurane and alfentanil both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- alprazolam
desflurane and alprazolam both increase sedation. Use Caution/Monitor.
- amisulpride
amisulpride and desflurane both increase sedation. Use Caution/Monitor.
- amitriptyline
desflurane and amitriptyline both increase sedation. Use Caution/Monitor.
desflurane and amitriptyline both increase QTc interval. Use Caution/Monitor. - amoxapine
desflurane and amoxapine both increase sedation. Use Caution/Monitor.
- apomorphine
desflurane and apomorphine both increase sedation. Use Caution/Monitor.
- asenapine
asenapine and desflurane both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and desflurane both increase sedation. Use Caution/Monitor.
- atenolol
desflurane, atenolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- avapritinib
avapritinib and desflurane both increase sedation. Use Caution/Monitor.
- baclofen
desflurane and baclofen both increase sedation. Use Caution/Monitor.
- belladonna and opium
desflurane and belladonna and opium both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- benperidol
desflurane and benperidol both increase sedation. Use Caution/Monitor.
- betaxolol
desflurane, betaxolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- bisoprolol
desflurane, bisoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- brexanolone
brexanolone, desflurane. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and desflurane both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and desflurane both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and desflurane both increase sedation. Use Caution/Monitor.
- brompheniramine
desflurane and brompheniramine both increase sedation. Use Caution/Monitor.
- buprenorphine
desflurane and buprenorphine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- buprenorphine buccal
desflurane and buprenorphine buccal both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- buprenorphine, long-acting injection
desflurane 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.
- butorphanol
desflurane and butorphanol both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- carbinoxamine
desflurane and carbinoxamine both increase sedation. Use Caution/Monitor.
- carvedilol
desflurane, carvedilol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- celiprolol
desflurane, celiprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- cenobamate
cenobamate, desflurane. Either increases effects of the other by sedation. Use Caution/Monitor.
- chlordiazepoxide
desflurane and chlordiazepoxide both increase sedation. Use Caution/Monitor.
- chlorpheniramine
desflurane and chlorpheniramine both increase sedation. Use Caution/Monitor.
- chlorpromazine
desflurane and chlorpromazine both increase sedation. Use Caution/Monitor.
- cinnarizine
desflurane and cinnarizine both increase sedation. Use Caution/Monitor.
- cisapride
desflurane and cisapride both increase QTc interval. Use Caution/Monitor.
- clemastine
desflurane and clemastine both increase sedation. Use Caution/Monitor.
- clomipramine
desflurane and clomipramine both increase sedation. Use Caution/Monitor.
desflurane and clomipramine both increase QTc interval. Use Caution/Monitor. - clonazepam
desflurane and clonazepam both increase sedation. Use Caution/Monitor.
- clorazepate
desflurane and clorazepate both increase sedation. Use Caution/Monitor.
- clozapine
desflurane and clozapine both increase sedation. Use Caution/Monitor.
- codeine
desflurane and codeine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- cyclizine
desflurane and cyclizine both increase sedation. Use Caution/Monitor.
- cyproheptadine
desflurane and cyproheptadine both increase sedation. Use Caution/Monitor.
- daridorexant
desflurane and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- desipramine
desflurane and desipramine both increase sedation. Use Caution/Monitor.
desflurane and desipramine both increase QTc interval. Use Caution/Monitor. - deutetrabenazine
desflurane and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dexchlorpheniramine
desflurane and dexchlorpheniramine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
desflurane increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
desflurane and dexmedetomidine both increase sedation. Use Caution/Monitor.
- dextromoramide
desflurane and dextromoramide both increase sedation. Use Caution/Monitor.
- diamorphine
desflurane and diamorphine both increase sedation. Use Caution/Monitor.
- diazepam
desflurane and diazepam both increase sedation. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and desflurane both decrease serum potassium. Use Caution/Monitor.
dichlorphenamide, desflurane. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis. - difelikefalin
difelikefalin and desflurane both increase sedation. Use Caution/Monitor.
- dimenhydrinate
desflurane and dimenhydrinate both increase sedation. Use Caution/Monitor.
- diphenhydramine
desflurane and diphenhydramine both increase sedation. Use Caution/Monitor.
- dipipanone
desflurane and dipipanone both increase sedation. Use Caution/Monitor.
- dopexamine
desflurane increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
desflurane and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
desflurane and doxepin both increase sedation. Use Caution/Monitor.
desflurane and doxepin both increase QTc interval. Use Caution/Monitor. - droperidol
desflurane and droperidol both increase sedation. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, desflurane. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- esmolol
desflurane, esmolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- estazolam
desflurane and estazolam both increase sedation. Use Caution/Monitor.
- etomidate
desflurane and etomidate both increase sedation. Use Caution/Monitor.
- fenfluramine
desflurane increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fluphenazine
desflurane and fluphenazine both increase sedation. Use Caution/Monitor.
desflurane and fluphenazine both increase QTc interval. Use Caution/Monitor. - flurazepam
desflurane and flurazepam both increase sedation. Use Caution/Monitor.
- fostemsavir
desflurane and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- ganaxolone
desflurane and ganaxolone both increase sedation. Use Caution/Monitor.
- haloperidol
desflurane and haloperidol both increase sedation. Use Caution/Monitor.
- hydromorphone
desflurane and hydromorphone both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- hydroxyzine
desflurane and hydroxyzine both increase sedation. Use Caution/Monitor.
- iloperidone
desflurane and iloperidone both increase sedation. Use Caution/Monitor.
- imipramine
desflurane and imipramine both increase sedation. Use Caution/Monitor.
desflurane and imipramine both increase QTc interval. Use Caution/Monitor. - ketamine
desflurane and ketamine both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
desflurane and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- labetalol
desflurane, labetalol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- lasmiditan
lasmiditan, desflurane. 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, desflurane. 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.
- levalbuterol
desflurane increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levorphanol
desflurane and levorphanol both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- linezolid
linezolid increases levels of desflurane by pharmacodynamic synergism. Use Caution/Monitor.
- lofepramine
desflurane and lofepramine both increase sedation. Use Caution/Monitor.
- lofexidine
desflurane and lofexidine both increase sedation. Use Caution/Monitor.
- loprazolam
desflurane and loprazolam both increase sedation. Use Caution/Monitor.
- lorazepam
desflurane and lorazepam both increase sedation. Use Caution/Monitor.
- lormetazepam
desflurane and lormetazepam both increase sedation. Use Caution/Monitor.
- loxapine
desflurane and loxapine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
desflurane and loxapine inhaled both increase sedation. Use Caution/Monitor.
- maprotiline
desflurane and maprotiline both increase sedation. Use Caution/Monitor.
- meperidine
desflurane and meperidine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- methadone
desflurane and methadone both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- metoprolol
desflurane, metoprolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- midazolam
desflurane and midazolam both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, desflurane. Either increases effects 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.
- mirtazapine
desflurane and mirtazapine both increase sedation. Use Caution/Monitor.
- morphine
desflurane and morphine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- moxonidine
desflurane and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
desflurane and nabilone both increase sedation. Use Caution/Monitor.
- nadolol
desflurane, nadolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- nalbuphine
desflurane and nalbuphine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- nebivolol
desflurane, nebivolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- nortriptyline
desflurane and nortriptyline both increase sedation. Use Caution/Monitor.
desflurane and nortriptyline both increase QTc interval. Use Caution/Monitor. - oliceridine
oliceridine, desflurane. 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).
- opium tincture
desflurane and opium tincture both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- osilodrostat
osilodrostat and desflurane both increase QTc interval. Use Caution/Monitor.
- oxazepam
desflurane and oxazepam both increase sedation. Use Caution/Monitor.
- oxycodone
desflurane and oxycodone both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- oxymorphone
desflurane and oxymorphone both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- paliperidone
desflurane and paliperidone both increase sedation. Use Caution/Monitor.
- papaveretum
desflurane and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
desflurane and papaverine both increase sedation. Use Caution/Monitor.
- penbutolol
desflurane, penbutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- pentazocine
desflurane and pentazocine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- perphenazine
desflurane and perphenazine both increase sedation. Use Caution/Monitor.
desflurane and perphenazine both increase QTc interval. Use Caution/Monitor. - phenylephrine PO
desflurane increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
desflurane and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
desflurane and pimozide both increase sedation. Use Caution/Monitor.
- pindolol
desflurane, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- procarbazine
procarbazine increases levels of desflurane by pharmacodynamic synergism. Use Caution/Monitor.
- prochlorperazine
desflurane and prochlorperazine both increase sedation. Use Caution/Monitor.
desflurane and prochlorperazine both decrease QTc interval. Use Caution/Monitor. - promethazine
desflurane and promethazine both increase sedation. Use Caution/Monitor.
desflurane and promethazine both decrease QTc interval. Use Caution/Monitor. - propofol
desflurane and propofol both increase sedation. Use Caution/Monitor.
- propranolol
desflurane, propranolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- protriptyline
desflurane and protriptyline both increase sedation. Use Caution/Monitor.
desflurane and protriptyline both increase QTc interval. Use Caution/Monitor. - quazepam
desflurane and quazepam both increase sedation. Use Caution/Monitor.
- quetiapine
desflurane and quetiapine both increase sedation. Use Caution/Monitor.
- quinidine
desflurane and quinidine both increase QTc interval. Use Caution/Monitor.
- risperidone
desflurane and risperidone both increase sedation. Use Caution/Monitor.
- selegiline transdermal
selegiline transdermal increases levels of desflurane by pharmacodynamic synergism. Use Caution/Monitor.
- sevoflurane
desflurane and sevoflurane both increase sedation. Use Caution/Monitor.
- sotalol
desflurane, sotalol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- stiripentol
stiripentol, desflurane. 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.
- sufentanil
desflurane and sufentanil both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- tapentadol
desflurane and tapentadol both increase sedation. Use Caution/Monitor.
- temazepam
desflurane and temazepam both increase sedation. Use Caution/Monitor.
- thioridazine
desflurane and thioridazine both increase sedation. Use Caution/Monitor.
- thiothixene
desflurane and thiothixene both increase sedation. Use Caution/Monitor.
- timolol
desflurane, timolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- topiramate
desflurane and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
desflurane and tramadol both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- trazodone
desflurane and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
desflurane and triazolam both increase sedation. Use Caution/Monitor.
- triclofos
desflurane and triclofos both increase sedation. Use Caution/Monitor.
- trifluoperazine
desflurane and trifluoperazine both increase sedation. Use Caution/Monitor.
desflurane and trifluoperazine both decrease QTc interval. Use Caution/Monitor. - trimipramine
desflurane and trimipramine both increase sedation. Use Caution/Monitor.
desflurane and trimipramine both increase QTc interval. Use Caution/Monitor. - triprolidine
desflurane and triprolidine both increase sedation. Use Caution/Monitor.
- valbenazine
valbenazine and desflurane both increase QTc interval. Use Caution/Monitor.
- ziprasidone
desflurane and ziprasidone both increase QTc interval. Use Caution/Monitor.
- zotepine
desflurane and zotepine both increase sedation. Use Caution/Monitor.
Minor (15)
- amitriptyline
desflurane, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- amoxapine
desflurane, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- benazepril
desflurane, benazepril. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May increase risk of hypotension.
- captopril
desflurane, captopril. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May increase risk of hypotension.
- clomipramine
desflurane, clomipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- desipramine
desflurane, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- dosulepin
desflurane, dosulepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- doxepin
desflurane, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- imipramine
desflurane, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- lofepramine
desflurane, lofepramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- maprotiline
desflurane, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- nortriptyline
desflurane, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- protriptyline
desflurane, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- trazodone
desflurane, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- trimipramine
desflurane, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
Adverse Effects
>10%
Cough (3% to 34% adult induction; 26% pediatric maintenance and 72% pediatric induction )
Apnea (3% to 15% )
Interrupted breathing (30% adult induction; 3% pediatric maintenance and 68% pediatric induction )
Laryngeal spasm (3% to 10% adult induction; 13% pediatric maintenance and 50% pediatric induction )
Nausea (27% )
Desaturation of blood (3% to 10% adult induction; 2% pediatric maintenance and 26% pediatric induction )
Vomiting (16% )
Cardiovascular: Alteration in heart rate (greater than 1% ); hypotension (8% geriatric patients)
1-10%
Hypotension (8% geriatric patients)
Alteration in heart rate (>1% )
Bradyarrhythmia (>1% )
Heart failure, Hypertension (>1% )
Malignant hypertension, Shock, Sinus arrhythmia (>1% )
Tachycardia (>1% )
Excessive salivation (>1% )
Headache (>1% )
Delirium (>1%)
Pharyngitis (>1% )
<1%
Cardiac arrest, Cardiac dysrhythmia
Torsades de pointes
Hyperkalemia, Perioperative (rare )
Malignant hyperthermia
Pancreatitis, acute
Hepatic necrosis, Hepatitis, Liver failure
Rhabdomyolysis
Seizure
Nephrotoxicity
Respiratory failure
Complication of anesthesia, During induction
Postmarketing reports
Atrial fibrillation
Post-operative agitation in children
Cardiac arrest, QTc prolongation
Warnings
Contraindications
Sensitivity to halogenated agents
Genetic susceptibility to malignant hyperthermia
Patients in whom general anesthesia is contraindicated
Induction of anesthesia in pediatric patients
History of moderate to severe hepatic dysfunction following anesthesia with desflurane or other halogenated agents
Cautions
Volatile liquid; use appropriate vaporizer for inhalation
Not approved for maintenance of anesthesia in nonintubated children due to an increased incidence of respiratory adverse reactions, including coughing (26%), laryngospasm (13%), and secretions (12%)
Decrease in hepatic and renal blood flow reported
Risk of hyperkalemia increased in pediatric patients with underlying neuromuscular disease (eg, Duchenne muscular dystrophy)
Increase in intracranial pressure reported with use
Emergence from anesthesia in children may evoke a brief state of agitation that may hinder cooperation
Should not be used as sole agent of induction in patients with CAD, heart failure, or patients where increase in heart rate or BP are undesirable
Children, particularly if 6 years old or younger, under an anesthetic maintenance of desflurane delivered via laryngeal mask airway (LMA™ mask) are at increased risk for adverse respiratory reactions, including coughing and laryngospasm, especially with removal of the laryngeal mask airway under deep anesthesia; closely monitor these patients for signs and symptoms associated with laryngospasm and treat accordingly
When used for maintenance of anesthesia in children with asthma or history of recent upper airway infection, there is increased risk for airway narrowing and increases in airway resistance; closely monitor these patients for signs and symptoms associated with airway narrowing and treat accordingly
QTc prolongation, associated with torsade de pointes, reported; carefully monitor cardiac rhythm when administering drug to susceptible patients (e.g., patients with congenital Long QT Syndrome or patients taking drugs that can prolong the QT interval)
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
Malignant hyperthermia
- In susceptible individuals, volatile anesthetic agents, including desflurane, may trigger malignant hyperthermia, a skeletal muscle hypermetabolic state leading to high oxygen demand; fatal outcomes of malignant hyperthermia reported
- Risk of developing malignant hyperthermia increases with concomitant administration of succinylcholine and volatile anesthetic agents; therapy can induce malignant hyperthermia in patients with known or suspected susceptibility based on genetic factors or family history, including those with certain inherited ryanodine receptor (RYR1) or dihydropyridine receptor (CACNA1S) variants
- Signs consistent with malignant hyperthermia may include hyperthermia, hypoxia, hypercapnia, muscle rigidity (eg, jaw muscle spasm), tachycardia (eg, particularly that unresponsive to deepening anesthesia or analgesic medication administration), tachypnea, cyanosis, arrhythmias, hypovolemia, and hemodynamic instability; skin mottling, coagulopathies, and renal failure may occur later in the course of the hypermetabolic process
- Successful treatment of malignant hyperthermia depends on early recognition of the clinical signs
- If malignant hyperthermia suspected, discontinue all triggering agents (eg, volatile anesthetic agents and succinylcholine), administer intravenous dantrolene sodium, and initiate supportive therapies; consult prescribing information for intravenous dantrolene sodium for additional information on patient management
- Supportive therapies include administration of supplemental oxygen and respiratory support based on clinical need, maintenance of hemodynamic stability and adequate urinary output, management of fluid and electrolyte balance, correction of acid-base derangements, and institution of measures to control rising temperature
Pregnancy & Lactation
Pregnancy
There are no adequate and well-controlled studies in pregnant women; in animal reproduction studies, embryo-fetal toxicity (reduced viable fetuses and/or increased post-implantation loss) was noted in pregnant rats and rabbits administered 1 MAC desflurane for 4 hours a day (4 MAC-hours/day) during organogenesis; there are no data on pregnancy exposures in primates corresponding to periods prior to the third trimester in humans
Lactation
It is not known whether drug is excreted in human milk; because many drugs are excreted in human milk, caution should be exercised when administering therapy to a nursing woman
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; may enhance inhibitory postsynaptic channel activity and may inhibit excitatory synaptic activity
Pharmacokinetics
Onset: 1-2 min
Absorption: <0.02% (systemic)
Metabolism: Liver (minimal)
Elimination: Via the lungs (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)
Images
Patient Handout
desflurane 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) 2023 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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