Annotation

The FDA-approved label warns that individuals with a genetic predisposition to malignant hyperthermia, or patients with Duchenne Muscular Dystrophy, are at greater risk of developing malignant hyperthermia, or hyperkaelemia, respectively, if administered desflurane.

Specific variants in the RYR1 and CACNA1S genes are associated with risk of malignant hyperthermia in individuals administered potent inhalational anesthetics, including desflurane. Although the desflurane (SUPRANE) drug label does not specifically mention genetic testing, the FDA-approved label for desflurane (SUPRANE) contraindicates it for individuals with known, or suspected, genetic predisposition to malignant hyperthermia.

Excerpts from the FDA-approved desflurane (SUPRANE) drug label

• The use of SUPRANE is contraindicated in the following conditions

• Known or suspected genetic susceptibility to malignant hyperthermia

• In susceptible individuals, potent inhalation anesthetic agents may trigger a skeletal muscle hypermetabolic state leading to high oxygen demand and the clinical syndrome known as malignant hyperthermia.

• Use of inhaled anesthetic agents has been associated with rare increases in serum potassium levels that have resulted in cardiac arrhythmias and death in pediatric patients during the postoperative period. Patients with latent as well as overt neuromuscular disease, particularly Duchenne muscular dystrophy, appear to be most vulnerable. Concomitant use of succinylcholine has been associated with most, but not all, of these cases.

For the complete drug label text with sections containing pharmacogenetic information highlighted, see the desflurane drug label

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