Desflurane (inhalation route)


    Brand Name

    US Brand Name

    Suprane


    Description

    Desflurane belongs to the group of medicines known as general anesthetics. Inhaled desflurane is used to cause general anesthesia (loss of consciousness) before and during surgery in adults. It is also used as a maintenance anesthesia in adults and children after receiving other anesthetics before and during surgery.

    This medicine is to be given only by or under the direct supervision of a trained doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of inhaled desflurane in children after receiving other anesthetics. However, children 6 years of age and younger are more likely to have unwanted side effects, such as coughing, chest tightness, or trouble breathing, which may require caution in patients receiving this medicine.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of inhaled desflurane in the elderly. However, elderly patients are more likely to have unwanted effects, which may require a dose adjustment in patients receiving this medicine.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Alfentanil
    • Cisatracurium
    • Dexmethylphenidate
    • Methylphenidate
    • Nitrous Oxide
    • Norepinephrine
    • Serdexmethylphenidate
    • St John's Wort

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Asthma or
    • Diseases that can cause muscle weakness (eg, familial periodic paralysis, Duchenne muscular dystrophy, myasthenia gravis, Eaton-Lambert syndrome), or history of or
    • Heart or blood vessel disease (eg, coronary artery disease) or
    • Heart rhythm problems or
    • Hyperkalemia (high potassium in the blood) or
    • Hypovolemia (low blood volume) or
    • Upper airway infection, recent—Use with caution. May make these conditions worse.
    • Liver disease (eg, cirrhosis, viral hepatitis)—The doctor may want to use another anesthetic in patients with these conditions.
    • Liver disease (caused by desflurane or similar medicines), moderate or severe, history of or
    • Malignant hyperthermia, known or suspected—Should not be used in patients with these conditions.

    Proper Use

    A doctor or other trained health professional will give you this medicine in a hospital. You will inhale the medicine through a mask placed over your mouth and nose.

    Your doctor will give you some medicines before receiving Suprane®.


    Precautions

    Your doctor will check you closely after receiving this medicine. This will allow your doctor to see if the medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

    Hyperkalemia may occur rarely after receiving this medicine. Tell your doctor right away if you have confusion, irregular heartbeat, nausea or vomiting, numbness or tingling in the hands, feet, or legs, or trouble breathing after receiving this medicine.

    This medicine may cause malignant hyperthermia (high body temperature). Check with your doctor right away if you or your child have a fast heartbeat, high fever, or rigid muscles.

    Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you had a heart rhythm problem, including QT prolongation.

    Check with your doctor right away if you have black, tarry stools, chills, dark urine, dizziness, fever, general tiredness or weakness, headache, itching, light-colored stools, loss of appetite, nausea and vomiting, upper right stomach pain, vomiting of blood, or yellow eyes and skin. These may be symptoms of a serious liver problem.

    Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

    General anesthetics may cause some people to feel drowsy, tired, or weak. They may also cause problems with coordination and one's ability to think. Therefore, for about 24 hours (or longer if necessary) after receiving a general anesthetic, do not drive, use machines, or do anything else that could be dangerous if you are not alert.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Bluish lips or skin
    • body aches or pain
    • chest tightness
    • congestion
    • cough
    • dryness or soreness of the throat
    • fever
    • hoarseness
    • not breathing
    • runny nose
    • tender, swollen glands in the neck
    • trouble breathing
    • trouble swallowing
    • voice changes

    Less common

    • Blurred vision
    • chest pain or discomfort
    • dizziness
    • fast, pounding, or irregular heartbeat or pulse
    • headache
    • lightheadedness, dizziness, or fainting
    • nervousness
    • pounding in the ears
    • slow or irregular heartbeat
    • unusual tiredness

    Rare

    • Dark urine
    • difficulty with moving
    • feeling of warmth or heat
    • flushing or redness of the skin, especially on the face and neck
    • general tiredness and weakness
    • joint pain
    • light-colored stools
    • muscle aching or cramping
    • muscle pains or stiffness
    • nausea and vomiting
    • noisy breathing
    • pain or discomfort in the arms, jaw, back, or neck
    • sweating
    • swollen joints
    • upper right abdominal or stomach pain
    • yellow eyes and skin

    Incidence not known

    • Confusion
    • decreased urine
    • dry mouth
    • increased thirst
    • loss of appetite
    • no blood pressure or pulse
    • numbness or tingling in the hands, feet, or lips
    • seizures
    • stomach pain
    • stopping of heart
    • unconsciousness
    • weakness or heaviness of the legs

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Increased watering of the mouth
    • redness of the white part of the eyes or inside of the eyelids

    Rare

    • Anxiety
    • irritability
    • itching skin
    • restlessness
    • shaking
    • trouble sleeping

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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