Desflurane (Inhalation)

Desflurane is part of the group of medicines called general anesthetics. Inhaled desflurane is used to induce general anesthesia (loss of consciousness) before and during surgery in adults. It is also used to maintain anesthesia in adults and children after they have received other anesthetics before and during surgery.

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

Your doctor will monitor you closely after you receive this medicine. This will help your doctor determine if the medicine is working correctly. Blood and urine tests may be needed to check for side effects.

Hyperkalemia may occur rarely after receiving this medicine. Contact your doctor immediately if you experience confusion, irregular heartbeat, nausea or vomiting, numbness or tingling in your hands, feet, or legs, or difficulty breathing after receiving this medicine.

This medicine may cause malignant hyperthermia (high body temperature). Contact your doctor right away if you or your child experience a fast heartbeat, high fever, or stiff muscles.

Contact your doctor immediately if you notice any changes in your heart rhythm. You may feel dizzy or faint, or you may experience a fast, pounding, or uneven heartbeat. Ensure your doctor knows if you have had a heart rhythm issue, including QT prolongation.

Contact your doctor immediately if you experience 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 blood, or yellowing of the eyes and skin. These may indicate a serious liver problem.

Before undergoing any medical tests, inform 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 issues with coordination and thinking. Therefore, for about 24 hours (or longer if needed) after receiving a general anesthetic, do not drive, operate machines, or engage in any activities that could be dangerous if you are not alert.

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

In deciding to use a medicine, the risks of taking the medicine must be weighed against the benefits it will provide. This is a decision you and your doctor will make together. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Current studies have not shown any pediatric-specific problems that would limit the usefulness of inhaled desflurane in children after they have received other anesthetics. However, children 6 years of age and younger are more likely to experience unwanted side effects, such as coughing, chest tightness, or trouble breathing, which may require caution when using this medicine.

Geriatric

Current studies have not shown any geriatric-specific problems that would limit the usefulness of inhaled desflurane in elderly patients. However, older adults are more likely to experience unwanted effects, which may require a dose adjustment when using this medicine.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

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

Using this medicine with any of the following medicines is generally not recommended, but may be necessary 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

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

Other medical problems may affect the use of this medicine. Be sure to tell your doctor if you have any other medical issues, especially:

• Asthma or
• Diseases that can cause muscle weakness (e.g., familial periodic paralysis, Duchenne muscular dystrophy, myasthenia gravis, Eaton-Lambert syndrome), or history of or
• Heart or blood vessel disease (e.g., coronary artery disease) or
• Heart rhythm problems or
• Hyperkalemia (high potassium in the blood) or
• Hypovolemia (low blood volume) or
• Recent upper airway infection—Use with caution. May worsen these conditions.

• Liver disease (e.g., cirrhosis, viral hepatitis)—The doctor may choose another anesthetic for patients with these conditions.

• Moderate or severe liver disease (caused by desflurane or similar medicines), history of or
• Known or suspected malignant hyperthermia—Should not be used in patients with these conditions.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may occur, but if they do, they might need medical attention.

Check with your doctor or nurse right away if any of the following side effects happen:

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 happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your healthcare professional may also be able to tell you ways to prevent or reduce some of these side effects. Check with your healthcare 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.

In the U.S.

• Suprane

Available Dosage Forms:

• Solution
• Liquid

Therapeutic Class: Volatile Liquid

Chemical Class: Haloalkane

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®.