Isoflurane
- isoflurane
- 26675-46-7
- 1-Chloro-2,2,2-trifluoroethyl difluoromethyl ether
- Forane
- 2-Chloro-2-(difluoromethoxy)-1,1,1-trifluoroethane
- Create:2005-03-25
- Modify:2025-01-18
- isoflurane
- 26675-46-7
- 1-Chloro-2,2,2-trifluoroethyl difluoromethyl ether
- Forane
- 2-Chloro-2-(difluoromethoxy)-1,1,1-trifluoroethane
- Aerrane
- Forene
- Isoflurano
- IsoFlo
- Isofluranum
- Compound 469
- Ethane, 2-chloro-2-(difluoromethoxy)-1,1,1-trifluoro-
- R-E 235dal
- Terrell
- MFCD00066609
- CYS9AKD70P
- COMPOUND-469
- Ether, 1-chloro-2,2,2-trifluoroethyl difluoromethyl
- CHEBI:6015
- DTXSID3020752
- 2-chloro-2-difluoromethoxy-1,1,1-trifluoroethane
- DTXCID30752
- difluoromethyl 1-chloro-2,2,2-trifluoroethyl ether
- Isofluranum [INN-Latin]
- NCGC00181037-01
- AErrane (Veterinary)
- ISOFLURANE (MART.)
- ISOFLURANE [MART.]
- ISOFLURANE (USP-RS)
- ISOFLURANE [USP-RS]
- Isoba; Isofor; Isoforine; Isorrane; R-E 235da1
- Isoflurano [INN-Spanish]
- 1-CHLORO-2,2,2-TRIFLUROETHYL DIFLUROMETHYL ETHER
- ISOFLURANE (EP MONOGRAPH)
- ISOFLURANE [EP MONOGRAPH]
- (2RS)-2-chloro-2-(difluoromethoxy)-1,1,1-trifluoroethane
- ISOFLURANE (USP MONOGRAPH)
- ISOFLURANE [USP MONOGRAPH]
- CAS-26675-46-7
- Forane (TN)
- CCRIS 3043
- Isoflurane [Anaesthetics, volatile]
- EINECS 247-897-7
- UNII-CYS9AKD70P
- BRN 1852087
- Pentafluoran
- Fluriso
- Isospire
- IsoSol
- HSDB 8057
- Isoflurane, USP
- (+-)-Isoflurane
- ATTANE
- (+/-)-Isoflurane
- Isoflurane [USAN:USP:INN:BAN:JAN]
- Compd 469
- Isoflurane, AldrichCPR
- ISOFLURANE [MI]
- ISOFLURANE [INN]
- ISOFLURANE [JAN]
- Difluoromethyl 1-chloro-2,2,2-trifluoroethyl ether (Isoflurane)
- ISOFLURANE [USAN]
- ISOFLURANE [VANDF]
- SCHEMBL1532
- CHEMBL1256
- ISOFLURANE [WHO-DD]
- GTPL2505
- Isoflurane (JP18/USP/INN)
- ISOFLURANE [GREEN BOOK]
- ISOFLURANE [ORANGE BOOK]
- N01AB06
- BDBM217353
- Tox21_112685
- Tox21_200831
- BBL100111
- s6917
- STL454337
- AKOS006228574
- DB00753
- KS-5166
- PB47772
- NCGC00181037-02
- NCGC00181037-03
- NCGC00258385-01
- SY050218
- AC-154802
- DB-046999
- DESFLURANE IMPURITY B [EP IMPURITY]
- C2485
- CS-0017450
- NS00014343
- C07518
- D00545
- EN300-123043
- P15338
- SBI-0653918.0001
- A818554
- Q413918
- SR-01000944965
- SR-01000944965-1
- W-107162
- 1-Chloro-1-(difluoromethoxy)-2,2,2-trifluoroethane
- 2-chloro-2-(difluoromethoxy)-1,1,1-trifluoro-ethane
- BRD-A31564021-001-01-8
- Ethane, 1-chloro-1-(difluoromethoxy)-2,2,2-trifluoro-
- Z1201618663
- 2-[bis(fluoranyl)methoxy]-2-chloranyl-1,1,1-tris(fluoranyl)ethane
- Cytoplasm
- Extracellular
- Membrane
Use (kg) in Switzerland (2009): >750
Use (kg; approx.) in Germany (2009): >10000
Consumption (g per capita) in Switzerland (2009): 0.096
Consumption (g per capita; approx.) in Germany (2009): 0.12
Excretion rate: 1
Calculated removal (%): 91.9
H336 (93.1%): May cause drowsiness or dizziness [Warning Specific target organ toxicity, single exposure; Narcotic effects]
H373 (41.2%): May causes damage to organs through prolonged or repeated exposure [Warning Specific target organ toxicity, repeated exposure]
P260, P261, P271, P304+P340, P319, P403+P233, P405, and P501
(The corresponding statement to each P-code can be found at the GHS Classification page.)
Aggregated GHS information provided per 102 reports by companies from 11 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.
Reported as not meeting GHS hazard criteria per 3 of 102 reports by companies. For more detailed information, please visit ECHA C&L website.
There are 10 notifications provided by 99 of 102 reports by companies with hazard statement code(s).
Information may vary between notifications depending on impurities, additives, and other factors. The percentage value in parenthesis indicates the notified classification ratio from companies that provide hazard codes. Only hazard codes with percentage values above 10% are shown.
STOT SE 3 (93.1%)
STOT RE 2 (41.2%)
Prospective, serial blood testing often demonstrates minor transient elevations in serum aminotransferase levels in the 1 to 2 weeks after major surgery and halogenated anesthetic agents. Appearance of ALT levels above 10 times the upper limit of normal, however, is distinctly unusual and points to significant hepatotoxicity. Clinically apparent, severe hepatic injury from isoflurane is very rare, only isolated case reports and small case series having been published. The injury is marked by acute elevations in serum aminotransferase levels (5- to 50-fold) and appearance of jaundice within 2 to 21 days of surgery. There are usually minimal increases in alkaline phosphatase and gammaglutamyl transpeptidase levels. Jaundice is usually preceded by a day or two of fever and may be accompanied by rash and eosinophilia. The acute liver injury may be self-limited and resolve within 4 to 8 weeks, but can be severe and associated with acute liver failure. A strong risk factor is previous exposure to any of the halogenated anesthetics and particularly a history of halothane hepatitis or unexplained fever and rash after anesthesia with one of these agents. The differential diagnosis of acute liver injury after surgery and anesthesia is sometimes difficult, and a clinical picture similar to isoflurane hepatitis can be caused by shock or ischemia, other idiosyncratic forms of drug induced liver injury and acute viral or herpes hepatitis.
Likelihood score: B (highly likely cause of clinically apparent liver injury).
◉ Summary of Use during Lactation
There is no published experience with isoflurane during breastfeeding. Because the serum half-life of isoflurane in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required. Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure. In one study, breastfeeding before general anesthesia induction reduced requirements of sevoflurane and propofol compared to those of nursing mothers whose breastfeeding was withheld or nonnursing women. It is possible that requirements for other anesthetic agents would be affected similarly.
◉ Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
◉ Effects on Lactation and Breastmilk
A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia's effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants.
A randomized study compared the effects of cesarean section using general anesthesia, spinal anesthesia, or epidural anesthesia, to normal vaginal delivery on serum prolactin and oxytocin as well as time to initiation of lactation. General anesthesia was performed using propofol 2 mg/kg and rocuronium 0.6 mg/kg for induction, followed by sevoflurane and rocuronium 0.15 mg/kg as needed. After delivery, patients in all groups received an infusion of oxytocin 30 international units in 1 L of saline, and 0.2 mg of methylergonovine if they were not hypertensive. Fentanyl 1 to 1.5 mcg/kg was administered after delivery to the general anesthesia group. Patients in the general anesthesia group (n = 21) had higher post-procedure prolactin levels and a longer mean time to lactation initiation (25 hours) than in the other groups (10.8 to 11.8 hours). Postpartum oxytocin levels in the nonmedicated vaginal delivery group were higher than in the general and spinal anesthesia groups.
A retrospective study of women in a Turkish hospital who underwent elective cesarean section deliveries compared women who received bupivacaine spinal anesthesia (n = 170) to women who received general anesthesia (n = 78) with propofol for induction, sevoflurane for maintenance and fentanyl after delivery. No differences in breastfeeding rates were seen between the groups at 1 hour and 24 hours postpartum. However, at 6 months postpartum, 67% of women in the general anesthesia group were still breastfeeding compared to 81% in the spinal anesthesia group, which was a statistically significant difference.
Neurotoxin - Acute solvent syndrome
Reproductive Toxin - A chemical that is toxic to the reproductive system, including defects in the progeny and injury to male or female reproductive function. Reproductive toxicity includes developmental effects. See Guidelines for Reproductive Toxicity Risk Assessment.
Asthma - Reversible bronchoconstriction (narrowing of bronchioles) initiated by the inhalation of irritating or allergenic agents.
ACGIH Carcinogen - Not Classifiable.
Asthma, occupational [Category: Airway Disease]
Solvents, acute toxic effect [Category: Acute Poisoning]
Patents are available for this chemical structure:
https://patentscope.wipo.int/search/en/result.jsf?inchikey=PIWKPBJCKXDKJR-UHFFFAOYSA-N
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