Sevoflurane
Fluoromethyl 2,2,2-trifluoro-1-(trifluoromethyl)ethyl ether (Isopropyl ether derivative)
Also known as: SevoFlo · Ultane · Petrem · Sojourn · Sevocris · Sevorane · Sevotek · BAX-3084 · MR-654 · Sevofluranum · Fluoromethyl 2,2,2-trifluoro-1-(trifluoromethyl)ethyl ether
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Audited v13 dosing evidence
Reviewed non-calculator evidenceReviewed non-calculator evidence (1)
Evidence only — not for automatic calculation
Most species/anesthesia; rapid induction and recovery when intubated
TABLE 127.5. Agent: Sevoflurane. Dosage: To effect15,279. Species/Comments: Most species/anesthesia; rapid induction and recovery when intubated.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Sevoflurane is a highly volatile, halogenated inhalational anesthetic widely used in veterinary medicine for the induction and maintenance of general anesthesia.
Key pharmacological characteristics include:
- Low Blood:Gas Partition Coefficient (0.6): This allows for exceptionally rapid alveolar-to-arterial equilibration, resulting in much faster induction and recovery times compared to isoflurane or halothane.
- Non-pungent Odor: Unlike isoflurane, sevoflurane is not irritating to the airway, making it the preferred agent for mask or chamber inductions in exotic species, fractious felines, and pediatric patients.
- Hemodynamic Stability: It tends to cause less profound hypotension than isoflurane, making it particularly useful in debilitated or geriatric patients.
Clinical Pearl: Because anesthetic depth can change very rapidly with sevoflurane, vigilant monitoring is required to prevent accidental anesthetic overdose during maintenance.
Mechanism of action
The precise mechanism of inhalant anesthetics remains incompletely elucidated, but they primarily act by disrupting synaptic transmission within the central nervous system.
- Lipid Matrix Interaction → Alters the function of neuronal membrane proteins.
- GABA_A Receptors → Potentiates inhibitory neurotransmission, leading to profound CNS depression.
- NMDA Receptors → Antagonizes excitatory glutamatergic signaling.
- Glycine Receptors → Enhances inhibitory signaling in the spinal cord, contributing to skeletal muscle relaxation.
Due to its low solubility in blood, minimal amounts of sevoflurane need to dissolve before alveolar partial pressures equilibrate with arterial partial pressures, driving its rapid onset and offset of action.
Safety & warnings
Contraindications
- Patients with a history or predilection towards malignant hyperthermia
- Known hypersensitivity to sevoflurane or other halogenated anaesthetics
- Known or suspected susceptibility to malignant hyperthermia
Adverse effects
- Dose-dependent hypotension
- Dose-dependent respiratory depression
- Gastrointestinal effects (nausea, vomiting, ileus)
- Myocardial depression and bradycardia (less than halothane)
- Malignant hyperthermia (rare but life-threatening)
- Temporary decreases in erythrocyte, white cell counts, and total protein in ferrets
- Agitation or excitement during rapid recovery
- Neonatal depression (crosses the placental barrier)
Precautions
WARNING: Compound A Formation Sevoflurane can react with desiccated (dried out) carbon dioxide absorbents to produce 'Compound A', a known nephrotoxin. Always ensure CO2 absorbents are fresh and avoid using extremely low oxygen flow rates (< 500 mL/min).
- Rapid Action: Because of its rapid onset, use extreme caution not to overdose during the induction phase.
- Rapid Recovery: Animals (especially large animals like horses) may wake up abruptly. Appropriate sedation during the recovery phase is critical to prevent injury.
- Neurologic/Renal Disease: Use with caution in patients with increased CSF pressure, head injury, or renal insufficiency.
- Species Specifics:
- Rabbits: Can cause breath holding and struggling; premedication and close observation are required.
- Guinea Pigs: May have a low margin of safety.
- Geriatric Patients: May require lower concentrations of inhalation anesthetic.
Drug interactions
May enhance neuromuscular blockade
May increase concentrations of inorganic fluoride
Additive neuromuscular blockade may occur
May increase concentrations of inorganic fluoride
May potentiate sevoflurane effects; decrease MAC
May potentiate sevoflurane effects; decrease MAC
Increased risk for anesthetic complications; recommend discontinuing 5 days in advance of surgery
Sevoflurane may enhance effects
Sensitizes the myocardium to sympathomimetics (less than halothane); arrhythmias may still result
May decrease MAC requirements
May cause cardiodepression
Reduces the concentration of sevoflurane required to achieve surgical anaesthesia (MAC reduction).
Reduces the dose requirement of sevoflurane.
Reduces the concentration of sevoflurane required to achieve surgical anaesthesia.
Sevoflurane potentiates the duration of action of these agents (greater potentiation compared with halothane).
Monitoring
- Respiratory rate, rhythm, and ventilatory status (capnography recommended)
- Cardiac rate and rhythm (ECG)
- Blood pressure (especially in 'at risk' or geriatric patients)
- Level of anesthetic depth (jaw tone, palpebral reflex, eye position)
- Body temperature (monitor for hypothermia or sudden spikes indicating malignant hyperthermia)
- Respiratory rate, rhythm, and depth (Capnography/ETCO2 highly recommended)
- Arterial blood pressure (hypotension is dose-dependent)
- Heart rate and rhythm (ECG)
- Anaesthetic depth (jaw tone, palpebral reflex, eye position)
- Pulse oximetry (SpO2)
Pharmacokinetics
Half-life
Absorption
Rapidly absorbed across the alveolar membrane due to a very low blood:gas partition coefficient (0.6).
Distribution
Rapidly distributes to the CNS and other highly perfused tissues. Plasma protein binding percentage is unknown.
Metabolism
Approximately 3% is metabolized in the liver via the cytochrome P450 2E1 isoenzyme system, producing inorganic fluoride.
Elimination
The vast majority is excreted rapidly and unchanged via the lungs.
Overdose
In the event of an overdosage, immediately discontinue sevoflurane administration.
- Maintain a patent airway.
- Flush the breathing circuit with 100% oxygen.
- Support respiratory function with positive pressure ventilation if necessary.
- Support cardiac function and treat severe hypotension with IV fluids and sympathomimetics as clinically indicated.
Available products
Formulations
- Inhalant liquid for vaporization (250 mL bottles)
- Inhalational liquid (250 ml bottle)
Veterinary
- Sevoflurane in 250 mL bottles: SevoFlo (Halocarbon Prod.)
- Petrem (Minrad)
- SevoFlo 250 ml liquid for inhalation
- Sevotek 250 ml liquid for inhalation
Human-labeled
- Sevoflurane in 250 mL bottles: Ultane (Abbott)
- Sojourn (Minrad)
- Sevoflurane 100% liquid for inhalation
Regulatory status
POM-V classification.
POM-V classification.
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store at room temperature. Sevoflurane does not react with metal and contains no stabilizers.
Client information
Sevoflurane is a specialized anesthetic gas administered by your veterinarian during surgical or diagnostic procedures.
- Fast Acting: It allows your pet to fall asleep very quickly and smoothly, which is especially helpful for pets that are stressed or difficult to handle.
- Rapid Recovery: Because the gas leaves the body rapidly once turned off, your pet will likely wake up, stand, and be alert much sooner than with older anesthetics.
- Safety: It is generally very safe and is often the anesthetic of choice for older pets, very young pets, or exotic animals because it is gentle on the cardiovascular system.
- Post-Anesthesia: Your pet may still be slightly groggy or uncoordinated for a short period after coming home. Keep them in a safe, quiet, and warm environment until they are fully back to normal.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.