Details of Drug

Drug General Information (ID: D0855)
Drug Name	Isoflurane
Drug Type	Small molecule
Drug Synonymous	Aerrane; Forane; Forene; IsoFlo; Isoflurano; Isofluranum; AErrane (Veterinary); Forane (TN); Isoflurane [Anaesthetics, volatile]; Isoflurano [INN-Spanish]; Isofluranum [INN-Latin]; R-E 235dal; Isoflurane (JP15/USP/INN); Isoflurane [USAN:BAN:INN:JAN]; Isoflurane [USAN:INN:BAN:JAN]; Ether, 1-chloro-2,2,2-trifluoroethyl difluoromethyl; 1-Chloro-2,2,2-trifluoroethyl difluoromethyl ether; 2-Chloro-2-(difluoromethoxy)-1,1,1-trifluoroethane; 2-chloro-2-difluoromethoxy-1,1,1-trifluoroethane Click to Show/Hide
Disease Class	9A76-9A78: Corneal disease
Therapeutic Class	Anesthetics
Structure
Structure	3D Structure		2D Structure
Formula	C3H2ClF5O
InChI	1S/C3H2ClF5O/c4-1(3(7,8)9)10-2(5)6/h1-2H
InChIKey	PIWKPBJCKXDKJR-UHFFFAOYSA-N
Canonical SMILES	C(C(F)(F)F)(OC(F)F)Cl
External Link
	Pubchem ID	3763
	CAS Number	26675-46-7
	CHEBI ID	6015
	TTD ID	D0DP6L
	INTEDE ID	DR0885

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM004 Affected intra/extra-hepatic metabolism AM006 Pharmacodynamic additive effects BM017 CYP450 enzyme inhibition BM036 Additive cardiorespiratory depression effects BM038 Additive CNS depression effects BM041 Additive hypertensive effects BM042 Additive hypotensive effects BM045 Additive neuromuscular blocking effects BM052 Increased risk of cardiac depression BM072 Increased risk of nephrotoxicity BM076 Increased risk of prolong QT interval BM081 Increased risk of ventricular arrhythmias BM083 Potentiated the pharmacological effects (Unspecific) BM109 Increased risk of other adverse reactions (Unspecific)
Relation Graph

Full list of drugs interacting with Isoflurane
Affected intra/extra-hepatic metabolism
	CYP450 enzyme inhibition					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0302		Ceritinib	C28H36ClN5O3S	57379345	Moderate		Inter Info	[2], [3], [6]
Pharmacodynamic additive effects
	Additive cardiorespiratory depression effects					Drug Num: 25
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0226		Butorphanol	C21H29NO2	5361092	Moderate		Inter Info	[22], [7], [23]
D0379		Codeine	C18H21NO3	5284371	Moderate		Inter Info	[22], [7], [23]
D0467		Dextropropoxyphene	C22H29NO2	10100	Moderate		Inter Info	[22], [7], [23]
D0776		Hydromorphone	C17H19NO3	5284570	Moderate		Inter Info	[22], [7], [23]
D0035		Alfentanil	C21H32N6O3	51263	Moderate		Inter Info	[22], [7], [23]
D0219		Buprenorphine	C29H41NO4	644073	Moderate		Inter Info	[22], [7], [23]
D0470		Dezocine	C16H23NO	3033053	Moderate		Inter Info	[22], [7], [23]
D0471		Diamorphine	C21H23NO5	5462328	Moderate		Inter Info	[22], [7], [23]
D0493		Dihydrocodeine	C18H23NO3	5284543	Moderate		Inter Info	[22], [7], [23]
D0698		Fospropofol	C13H21O5P	3038498	Moderate		Inter Info	[32], [33], [34], [35], [36], [37]
D0772		Hydrocodone	C18H21NO3	5284569	Moderate		Inter Info	[22], [7], [23]
D0909		Levacetylmethadol	C23H31NO2	15130	Moderate		Inter Info	[22], [7], [23]
D0923		Levorphanol	C17H23NO	5359272	Moderate		Inter Info	[22], [7], [23]
D1100		Nalbuphine	C21H27NO4	5311304	Moderate		Inter Info	[22], [7], [23]
D1169		Oliceridine	C22H30N2O2S	66553195	Moderate		Inter Info	[22], [7], [23]
D1183		Opium	NA	NA	Moderate		Inter Info	[22], [7], [23]
D1208		Oxymorphone	C17H19NO4	5284604	Moderate		Inter Info	[22], [7], [23]
D1356		Propofol	C12H18O	4943	Moderate		Inter Info	[32], [33], [34], [35], [36], [37]
D1390		Remifentanil	C20H28N2O5	60815	Moderate		Inter Info	[22], [7], [23]
D1001		Meperidine	C15H21NO2	4058	Moderate		Inter Info	[22], [7], [23]
D1017		Methadone	C21H27NO	4095	Moderate		Inter Info	[22], [7], [23]
D1089		Morphine	C17H19NO3	5288826	Moderate		Inter Info	[22], [7], [23]
D1203		Oxycodone	C18H21NO4	5284603	Moderate		Inter Info	[22], [7], [23]
D1247		Pentazocine	C19H27NO	441278	Moderate		Inter Info	[22], [7], [23]
D1512		Sufentanil	C22H30N2O2S	41693	Moderate		Inter Info	[22], [7], [23]
	Additive CNS depression effects					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1485		Sodium oxybate	C4H7NaO3	23663870	Major		Inter Info	[13], [14]
	Additive hypertensive effects					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D1039		Methylphenidate	C14H19NO2	4158	Moderate		Inter Info	[2], [3], [41]
	Additive hypotensive effects					Drug Num: 20
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0069		Amlodipine	C20H25ClN2O5	2162	Moderate		Inter Info	[18], [19], [20]
D0072		Amoxapine	C17H16ClN3O	2170	Moderate		Inter Info	[3]
D0497		Diltiazem	C22H26N2O4S	39186	Moderate		Inter Info	[18], [19], [20]
D0795		Imipramine	C19H24N2	3696	Moderate		Inter Info	[3]
D0170		Bepridil	C24H34N2O	2351	Moderate		Inter Info	[18], [19], [20]
D0361		Clomipramine	C19H23ClN2	2801	Moderate		Inter Info	[3]
D0444		Deserpidine	C32H38N2O8	8550	Moderate		Inter Info	[30], [31]
D0446		Desipramine	C18H22N2	2995	Moderate		Inter Info	[3]
D0525		Doxepin	C19H21NO	667477	Moderate		Inter Info	[3]
D0911		Levamlodipine	C20H25ClN2O5	9822750	Moderate		Inter Info	[18], [19], [20]
D1134		Nifedipine	C17H18N2O6	4485	Moderate		Inter Info	[18], [19], [20]
D0865		Isradipine	C19H21N3O5	3784	Moderate		Inter Info	[18], [19], [20]
D1130		Nicardipine	C26H29N3O6	4474	Moderate		Inter Info	[18], [19], [20]
D1138		Nimodipine	C21H26N2O7	4497	Moderate		Inter Info	[18], [19], [20]
D1141		Nisoldipine	C20H24N2O6	4499	Moderate		Inter Info	[18], [19], [20]
D1158		Nortriptyline	C19H21N	4543	Moderate		Inter Info	[3]
D1361		Protriptyline	C19H21N	4976	Moderate		Inter Info	[3]
D1393		Reserpine	C33H40N2O9	5770	Moderate		Inter Info	[30], [31]
D1647		Trimipramine	C20H26N2	5584	Moderate		Inter Info	[3]
D1690		Verapamil	C27H38N2O4	2520	Moderate		Inter Info	[18], [19], [20]
	Additive neuromuscular blocking effects					Drug Num: 11
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0343		Cisatracurium	C53H72N2O12+2	62887	Moderate		Inter Info	[24], [25], [26]
D0122		Atracurium	C53H72N2O12+2	47319	Moderate		Inter Info	[24], [25], [26]
D0522		Doxacurium	C56H78N2O16+2	60169	Moderate		Inter Info	[24], [25], [26]
D1047		Metocurine	C40H48N2O6+2	21233	Moderate		Inter Info	[24], [25], [26]
D1080		Mivacurium	C58H80N2O14+2	5281042	Moderate		Inter Info	[24], [25], [26]
D1219		Pancuronium	C35H60N2O4+2	441289	Moderate		Inter Info	[24], [25], [26]
D1295		Pipecuronium	C35H62N4O4+2	50192	Moderate		Inter Info	[24], [25], [26]
D1384		Rapacuronium	C37H61N2O4+	5311399	Moderate		Inter Info	[24], [25], [26]
D1659		Tubocurarine	C37H41N2O6+	6000	Moderate		Inter Info	[24], [25], [26]
D1684		Vecuronium	C34H57N2O4+	39765	Moderate		Inter Info	[24], [25], [26]
D1420		Rocuronium	C32H53N2O4+	441290	Moderate		Inter Info	[24], [25], [26]
	Increased risk of nephrotoxicity					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0858		Isoniazid	C6H7N3O	3767	Moderate		Inter Info	[38], [39], [40]
	Increased risk of prolong QT interval					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0535		Droperidol	C22H22FN3O2	3168	Major		Inter Info	[1], [2], [3], [4], [5], [6]
	Potentiated the pharmacological effects (Unspecific)					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0066		Amiodarone	C25H29I2NO3	2157	Moderate		Inter Info	[27], [28], [29]
	Increased risk of other adverse reactions (Unspecific)					Drug Num: 7
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0581		Epinephrine	C9H13NO3	5816	Major		Inter Info	[7], [8], [9]
D0853		Isocarboxazid	C12H13N3O2	3759	Major		Inter Info	[10], [11], [12]
D1263		Phenelzine	C8H12N2	3675	Major		Inter Info	[10], [11], [12]
D1455		Selegiline	C13H17N	26757	Major		Inter Info	[10], [11], [12]
D1153		Norepinephrine	C8H11NO3	439260	Major		Inter Info	[15], [16], [17]
D1620		Tranylcypromine	C9H11N	19493	Major		Inter Info	[10], [11], [12]
D0143		Baclofen	C10H12ClNO2	2284	Moderate		Inter Info	[2], [3], [21]

References
1	Canadian Pharmacists Association.
2	Cerner Multum, Inc. "Australian Product Information.".
3	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
4	Glassman AH, Bigger JT Jr "Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death." Am J Psychiatry 158 (2001): 1774-82. [PMID: 11691681]
5	Product Information. Inapsine (droperidol). Janssen Pharmaceutica, Titusville, NJ.
6	EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring.".
7	Product Information. Ultane (sevoflurane). Abbott Pharmaceutical, Abbott Park, IL.
8	Konchigeri HN, Shaker MH, Winnie AP "Effect of epinephrine during enflurane anesthesia." Anesth Analg 53 (1974): 894-7.[PMID: 4473933]
9	Karl HW, Swedlow DB, Lee KW, Downes JJ "Epinephrine-halothane interactions in children." Anesthesiology 58 (1983): 142-5.[PMID: 6337528]
10	Product Information. Azilect (rasagiline). Teva Pharmaceuticals USA, North Wales, PA.
11	Product Information. Marplan (isocarboxazid) Roche Laboratories, Nutley, NJ.
12	Product Information. Nardil (phenelzine). Parke-Dvis, Morris Plains, NJ.
13	Product Information. Xywav (calcium/magnesium/potass/sodium oxybates). Jazz Pharmaceuticals, Palo Alto, CA.
14	Product Information. Xyrem (sodium oxybate). Orphan Medical, Minnetonka, MN.
15	Cooke JE "Drug interactions in anesthesia." Clin Plast Surg 12 (1985): 83-9.[PMID: 2858281]
16	Smith RB "Drug interactions and drug reactions." Otolaryngol Clin North Am 14 (1981): 615-29.[PMID: 7029414]
17	Product Information. Fluothane (halothane). Wyeth-Ayerst Laboratories, Philadelphia, PA.
18	Product Information. Cardizem (diltiazem). Hoechst Marion-Roussel Inc, Kansas City, MO.
19	Product Information. Covera-HS (verapamil). Searle, Skokie, IL.
20	Hantler CB, Wilton N, Learned DM, et al "Impaired myocardial conduction in patients receiving diltiazem therapy during enflurane anesthesia." Anesthesiology 67 (1987): 94-6
21	Product Information. Fycompa (perampanel). Eisai Inc, Teaneck, NJ.
22	Product Information. Orlaam (levomethadyl acetate) Roxanne Laboratories Inc, Columbus, OH.
23	Inagaki Y, Kuzukawa A "Effects of epidural and intravenous buprenorphine on halothane minimum alveolar anesthetic concentration and hemodynamic responses." Anesth Analg 84 (1997): 100-5
24	Kronenfeld MA, Thomas SJ, Turndorf H "Recurrence of neuromuscular blockade after reversal of vecuronium in a patient receiving polymyxin/amikacin sternal irrigation." Anesthesiology 65 (1986): 93-4. [PMID: 2873764]
25	Mirakhur RK, Ferres CJ, Clarke RS, Bali IM, Dundee JW. Clinical evaluation of Org NC 45. Br J Anaesth. 1983 Feb;55(2):119-24.
26	Withington DE, Donati F, Bevan DR, Varin F "Potentiation of atracurium neuromuscular blockade by enflurane: time-course of effect." Anesth Analg 72 (1991): 469-73
27	Gallagher JD, Lieberman RW, Meranze J, Spielman SR, Ellison N "Amiodarone-induced complications during coronary artery surgery." Anesthesiology 55 (1981): 186-8. [PMID: 6973297]
28	Kerin NZ, Aragon E, Faitel K, Frumin H, Rubenfire M "Long-term efficacy and toxicity of high- and low-dose amiodarone regimens." J Clin Pharmacol 29 (1989): 418-23. [PMID: 2661600]
29	Liberman BA, Teasdale SJ "Anaesthesia and amiodarone." Can Anaesth Soc J 32 (1985): 629-38. [PMID: 4075214]
30	Ziegler CH, Lovette JB "Operative complications after therapy with reserpine and reserpine compounds." JAMA 176 (1961): 114-7
31	Jahr JS, Weber S "Ventricular dysrhythmias following an alfentanil anesthetic in a patient on reserpine for hypertension." Acta Anaesthesiol Scand 35 (1991): 788-9
32	Gill SS, Wright EM, Reilly CS "Pharmacokinetic interaction of propofol and fentanyl: single bolus injection study." Br J Anaesth 65 (1990): 760-5. [PMID: 2265045]
33	Hamaoka N, Oda Y, Hase I, Mizutani K, Nakamoto T, Ishizaki T, Asada A "Propofol decreases the clearance of midazolam by inhibiting CYP3A4: An in vivo and in vitro study." Clin Pharmacol Ther 66 (1999): 110-7. [PMID: 10460064]
34	McClune S, McKay AC, Wright PM, et al "Synergistic interaction between midazolam and propofol." Br J Anaesth 69 (1992): 240-5. [PMID: 1389840]
35	Pavlin DJ, Coda B, Shen DD, et al "Effects of combining propofol and alfentanil on ventilation, analgesia, sedation, and emesis in human volunteers." Anesthesiology 84 (1996): 23-37. [PMID: 8572340]
36	Product Information. Diprivan (propofol). Zeneca Pharmaceuticals, Wilmington, DE.
37	Product Information. Lusedra (fospropofol). Eisai Inc, Teaneck, NJ.
38	Dale O, Brown BR "Clinical pharmacokinetics of the inhalational anaesthetics." Clin Pharmacokinet 12 (1987): 145-67
39	Mazze RI, Woodruff RE, Heerdt ME "Isoniazid-induced enflurane defluorination in humans." Anesthesiology 57 (1982): 5-8
40	Gauntlett IS, Koblin DD, Fahey MR, et al. "Metabolism of isoflurane in patients receiving isoniazid." Anesth Analg 69 (1989): 245-9
41	Product Information. Metadate CD Capsules (methylphenidate) Celltech Pharmaceuticals, Inc, Applegate, WI.

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