Drug reference

Isoflurane

General Anesthetic · Anaesthetic

Also known as AErrane

General AnestheticAnaesthetic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

8 major

SEVERE in our sources

PREGNANCY

May depress neonatal respiration if used during delivery.

FDA category + note

Top interactionssee all 12 →

DroperidolSevereDatabaseDDInter
EpinephrineSevereDatabaseDDInter
IsocarboxazidSevereDatabaseDDInter
NorepinephrineSevereDatabaseDDInter

Mechanism

Isoflurane is a halogenated methyl ethyl ether volatile anesthetic with a MAC of 1.15% that potentiates GABA-A receptor-mediated inhibition and attenuates glutamate-mediated excitation. It produces dose-dependent decreases in mean arterial pressure primarily through peripheral vasodilation, with relatively preserved cardiac output compared to halothane. Isoflurane undergoes minimal hepatic metabolism (0.2%), producing negligible fluoride ion release and making it the least hepatotoxic of the halogenated agents.

Indications

Induction of anaesthesiaMaintenance of anaesthesiaMaintenance of anaesthesia in caesarean sectionmaintenance of anesthesia

Dosing

Adult: For induction of anaesthesia (in oxygen or nitrous oxide–oxygen): Initially 0.5 %, increased to 3 %, adjusted according to response, administered using specifically calibrated vaporiser. For maintenance of anaesthesia (in nitrous oxide–oxygen): 1–2.5 %, to be administered using specifically calibrated vaporiser; an additional 0.5–1% may be required when given with oxygen alone.…

Pharmacokinetics

Excretion

more than 99% excreted unchanged by the lungs

Side effects

Common

Carboxyhaemoglobinaemiachest discomfortcognitive impairmentdeliriumdyspnoeaileusmood altered (that can last several days)myoglobinuriaskin reactionshypotensionconcentration-dependent decrease in arterial blood pressurevasodilation (especially in skin and muscle)transient tachycardia and hypertension (with rapid changes in concentration due to sympathetic stimulation)concentration-dependent depression of ventilationairway irritant (coughing, laryngospasm)relaxation of skeletal musclerelaxation of uterine smooth musclereduces renal blood flow and glomerular filtration rate (GFR)

Serious