Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
SUPRANE vs ULTANE
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Suprane (desflurane) is a volatile general anesthetic that potentiates GABA-A receptor activity and inhibits NMDA receptor function, leading to neuronal hyperpolarization and depression of central nervous system activity.
Sevoflurane is a volatile general anesthetic that enhances inhibitory neurotransmission via GABA-A and glycine receptors, and inhibits excitatory neurotransmission via NMDA and nicotinic acetylcholine receptors, producing anesthesia, amnesia, and muscle relaxation.
Induction and maintenance of general anesthesia for inpatient and outpatient surgery in adults and children,Maintenance of anesthesia in pediatric patients
Induction and maintenance of general anesthesia in adult and pediatric patients for inpatient and outpatient surgery
Induction: 0.5-3% inspired concentration in oxygen or oxygen/nitrous oxide mixture; Maintenance: 0.5-2% inspired concentration. Administered via inhalation using a calibrated vaporizer.
Inhalation: Induction, 0.5-3% sevoflurane in oxygen or oxygen/nitrous oxide; maintenance, 1.5-3% sevoflurane with or without nitrous oxide.
Context-sensitive half-life: 2-5 minutes after brief administration; prolonged to 20-40 minutes after prolonged administration due to slow release from fat stores.
Terminal elimination half-life of inorganic fluoride is approximately 2-5 hours (mean 3.0 h) in adults; context: prolonged with obesity or renal impairment.
Minimal hepatic metabolism (less than 0.02%) via CYP2E1; primarily eliminated unchanged by the lungs.
Approximately 5% of sevoflurane is metabolized by cytochrome P450 (CYP2E1) to hexafluoroisopropanol (HFIP), carbon dioxide, and inorganic fluoride.
Primarily eliminated by the lungs with minimal metabolism (<5%). Less than 0.2% of the absorbed dose is excreted renally as unchanged drug.
Renal excretion of inorganic fluoride metabolites accounts for >95% of elimination; <5% excreted unchanged in urine.
~60% bound to serum proteins, primarily albumin and lipoproteins.
Minimal binding to plasma proteins; <5% bound.
Vd: 0.6-0.8 L/kg at steady state; large distribution into lipid-rich tissues.
Volume of distribution at steady state: 0.5-1.5 L/kg (mean 1.0 L/kg); large Vd indicates extensive tissue distribution.
Inhalation: ~100% due to complete absorption from the lungs; no oral bioavailability is clinically relevant.
Inhalation: ~100% bioavailable; no oral route.
No dose adjustment required for renal impairment; Suprane is minimally metabolized and renally excreted.
No dose adjustment required for GFR ≥30 m L/min; use with caution in GFR <30 m L/min due to potential for elevated fluoride concentrations, but no specific dose adjustment recommended.
No specific dose adjustment for Child-Pugh class A or B; caution in severe hepatic impairment (Child-Pugh C) due to potential decreased clearance, consider reduced maintenance concentrations.
No dose adjustment required for Child-Pugh A or B; use with caution in Child-Pugh C, but no specific dose adjustment recommended.
Induction: 3% inspired concentration in oxygen (or oxygen/nitrous oxide) for unpremedicated children, titrated to effect; Maintenance: 1-2% inspired concentration. Adjust based on age and response.
Induction: 2-4% sevoflurane in oxygen or oxygen/nitrous oxide, up to 8% for mask induction; maintenance: 1.5-3% with or without nitrous oxide.
Elderly patients (≥65 years): Reduce induction and maintenance concentrations by 20-50% due to increased sensitivity and slower recovery; typical maintenance 0.5-1.5% inspired.
Elderly patients are more sensitive to sevoflurane; use lower doses for induction and maintenance, typical maintenance 0.5-2% sevoflurane.
Suprane is contraindicated for induction of anesthesia in pediatric patients due to a high incidence of laryngospasm, coughing, breath-holding, and hypoxia.
None
Risk of malignant hyperthermia,Risk of perioperative hypersensitivity reactions including anaphylaxis,Risk of QT prolongation and torsades de pointes,Risk of hepatotoxicity in patients with previous exposure to halogenated anesthetics,May cause dose-dependent respiratory depression,Use caution in patients with increased intracranial pressure,May cause hypotension and bradycardia
Risk of malignant hyperthermia; may cause respiratory depression; caution in patients with preexisting respiratory or cardiovascular disease; monitor for hepatotoxicity; use with caution in patients with renal impairment (elevated fluoride levels); sevoflurane may cause QT prolongation
Known or suspected susceptibility to malignant hyperthermia,Known hypersensitivity to desflurane or other halogenated anesthetics,Induction of anesthesia in pediatric patients,Patients with a history of hepatitis or unexplained jaundice after previous halogenated anesthetic use
Known or suspected susceptibility to malignant hyperthermia,Known sensitivity to sevoflurane or other halogenated agents
No direct food interactions; fasting is required before anesthesia (typically NPO for 6-8 hours for solids, 2 hours for clear liquids) to reduce aspiration risk during induction.
No specific food interactions with sevoflurane. However, patients should adhere to preoperative fasting guidelines (typically 6-8 hours for solids, 2 hours for clear liquids) to reduce aspiration risk during anesthesia.
Sevoflurane (Suprane) is classified as FDA Pregnancy Category B. Animal studies have not demonstrated teratogenic effects, but there are no adequate and well-controlled studies in pregnant women. Use in the first trimester should be avoided unless essential. In the second and third trimesters, it is used for general anesthesia; however, it may produce uterine relaxation and fetal depression. Prolonged or repeated exposure should be avoided due to potential neurotoxicity in the developing fetus.
Sevoflurane (ULTANE) is classified as FDA Pregnancy Category B. Animal studies have not demonstrated teratogenic or fetotoxic effects at clinically relevant doses. In humans, limited data do not indicate an increased risk of major malformations with first-trimester exposure. However, use during the second and third trimesters may cause transient neonatal depression, including hypotonia and respiratory depression, due to placental transfer. Prolonged or repeated exposure should be avoided, especially during organogenesis, as with all volatile anesthetics.
Sevoflurane is rapidly eliminated; trace amounts may be excreted into breast milk. The M/P ratio is not established. Due to rapid clearance, the risk to the infant is low. The manufacturer recommends discontinuing breastfeeding for 24 hours after anesthesia to minimize exposure.
Sevoflurane is excreted into breast milk in low quantities. The milk-to-plasma (M/P) ratio has not been specifically determined for sevoflurane, but based on physicochemical properties, it is expected to be low. Due to rapid clearance and low oral bioavailability, the risk to a nursing infant is considered minimal after a single anesthetic dose. However, it is recommended to express and discard breast milk for 24 hours after anesthesia to minimize infant exposure.
No specific dose adjustments are recommended for sevoflurane during pregnancy. Pharmacokinetic changes in pregnancy (e.g., increased volume of distribution, decreased protein binding) may require higher induction doses and more rapid adjustments. Maintenance doses should be titrated to effect with careful monitoring of maternal vital signs and fetal heart rate.
During pregnancy, pharmacokinetic changes such as increased plasma volume, decreased protein binding, and increased cardiac output may necessitate dose adjustments. Sevoflurane requirements may be reduced by approximately 25-30% during pregnancy due to increased sensitivity to volatile anesthetics and decreased minimum alveolar concentration (MAC). Induction and maintenance doses should be titrated to effect, with close hemodynamic monitoring to avoid hypotension. No specific dose reduction is mandated, but careful titration is recommended.
Suprane (desflurane) has a low blood-gas partition coefficient (0.42) enabling rapid induction and emergence. It is a potent bronchodilator but can cause airway irritation and coughing during induction; avoid in pediatric mask inductions. Contraindicated in patients with known or suspected malignant hyperthermia susceptibility. Requires a calibrated vaporizer due to high vapor pressure (near-ambient). Can produce dose-dependent hypotension and respiratory depression.
ULTANE (sevoflurane) is a volatile anesthetic with low blood-gas solubility, facilitating rapid induction and emergence. It is associated with a risk of malignant hyperthermia; have dantrolene available. Sevoflurane can degrade in carbon dioxide absorbents to compound A, which may cause renal injury; use fresh gas flows ≥2 L/min to minimize this risk. Monitor end-tidal sevoflurane concentration closely, as hypotension and respiratory depression are dose-dependent.
You will be given this anesthetic gas through a mask or breathing tube to keep you asleep during surgery.,You may experience a temporary sore throat or cough after waking up.,Common side effects include nausea, vomiting, and shivering as you recover.,You should not drive or operate machinery for at least 24 hours after anesthesia.,Inform your doctor if you have any personal or family history of malignant hyperthermia.
You will receive this medication only under the supervision of an anesthesia professional,Do not eat or drink before surgery as instructed by your doctor,You may experience dizziness or drowsiness after waking; do not drive for 24 hours,Report any history of kidney disease or adverse reactions to anesthesia,Inform your doctor if you are pregnant or breastfeeding,You will be monitored throughout the procedure for vital signs and safety
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about SUPRANE vs ULTANE, answered by our medical review team.
SUPRANE is a Inhalational Anesthetic that works by Suprane (desflurane) is a volatile general anesthetic that potentiates GABA-A receptor activity and inhibits NMDA receptor function, leading to neuronal hyperpolarization and depression of central nervous system activity.. ULTANE is a Inhalational Anesthetic that works by Sevoflurane is a volatile general anesthetic that enhances inhibitory neurotransmission via GABA-A and glycine receptors, and inhibits excitatory neurotransmission via NMDA and nicotinic acetylcholine receptors, producing anesthesia, amnesia, and muscle relaxation.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between SUPRANE and ULTANE depend on the specific clinical indication. These are both Inhalational Anesthetic agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of SUPRANE is: Induction: 0.5-3% inspired concentration in oxygen or oxygen/nitrous oxide mixture; Maintenance: 0.5-2% inspired concentration. Administered via inhalation using a calibrated vaporizer.. The standard adult dose of ULTANE is: Inhalation: Induction, 0.5-3% sevoflurane in oxygen or oxygen/nitrous oxide; maintenance, 1.5-3% sevoflurane with or without nitrous oxide.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between SUPRANE and ULTANE in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. SUPRANE is classified as Category C. Sevoflurane (Suprane) is classified as FDA Pregnancy Category B. Animal studies have not demonstrated teratogenic effects, but there are no adequate and well-controlled studies in . ULTANE is classified as Category C. Sevoflurane (ULTANE) is classified as FDA Pregnancy Category B. Animal studies have not demonstrated teratogenic or fetotoxic effects at clinically relevant doses. In humans, limit. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.