Floran

Quick links to important sections

Floran

Treatment option: Anesthesia, General Anesthesia

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Floran

Quick Facts

Property Description
Active Ingredient Isoflurane
Form Liquid (for vaporization)
Pharmacological Class General Anesthetic, CNS Depressant
Common Use Induction and maintenance of general anesthesia
Origin Synthetic (Halogenated Ether Compound)

What Type of Medicine is Floran (Isoflurane)?

Floran is a prescription-only medicine whose identity is rooted in its single active ingredient, Isoflurane. It is categorized as a potent General Anesthetic and acts as a specialized Central Nervous System (CNS) depressant, which is its recognized pharmacological class. Pharmacological studies confirm its classification as a synthetic halogenated anesthetic agent, which gives it properties favored in modern surgery. This compound is known for its ability to provide rapid control over the depth of anesthesia, distinguishing it from older anesthetic gases and supporting its established use in various surgical settings.

Composition, Form, and General Purpose in Surgery

Floran consists entirely of pure Isoflurane, supplied as a clear, nonflammable liquid specifically designed for delivery via vaporization and subsequent inhalation. This liquid form is never injected or swallowed; instead, it requires a calibrated vaporizer to convert it into a breathable vapor, ensuring precision in drug delivery. The medicine's overarching purpose is the achievement and reliable sustainment of general anesthesia in patients undergoing surgery. This controlled application provides the necessary deep unconsciousness and safety required for complex procedures.

Differentiating Features and Mechanism (High-Level)

Isoflurane, the active component of Floran, is clinically recognized for facilitating a quicker and more predictable patient recovery compared to some older anesthetic agents, which is a key differentiating feature. It works by causing global nervous system slowing, a direct physiological result of its powerful CNS depressant activity. As a Volatile Anesthetic, the Isoflurane molecules suppress essential neural activity, blocking the transmission of consciousness and pain signals. This effect facilitates both the necessary muscle relaxation and the reduction of involuntary protective reflexes required for patient safety during procedures.

Regulatory References

  1. DailyMed: Isoflurane Liquid for Inhalation

What side effects are possible with Floran?

Possible Side Effects and Safety Information

The regulatory safety profile of Floran (Isoflurane) outlines physiological changes often classified by their frequency and the body system affected, focusing strictly on events documented in official prescribing information.

Adverse reactions associated with the use of this general anesthetic are generally categorized as dose-dependent, meaning their severity increases with the concentration administered. These effects are officially noted to be rapidly reversible upon a decrease in the concentration or discontinuation of the medicine.

Systemic Safety Classifications

System-Organ Class Common Adverse Reactions Serious Adverse Reactions (Documented in Labeling)
Vascular / Cardiac Hypotension (low blood pressure), Tachycardia Severe Arrhythmias, Cardiac Arrest
Gastrointestinal Nausea, Vomiting N/A
General Disorders Shivering/Chills (during recovery) Malignant Hyperthermia (MH)
Hepatobiliary Elevated liver enzymes (ALT, AST) Severe Hepatic Necrosis/Dysfunction
Metabolic N/A Perioperative Hyperkalemia

Malignant Hyperthermia (MH) is a rare but life-threatening event explicitly documented as a safety risk, leading to the regulatory restriction of Floran use in patients with a known or suspected genetic susceptibility to MH. Cases of severe hepatic dysfunction and hepatic necrosis have also been reported, resulting in a documented limitation regarding its use in patients with a history of halogenated anesthetic-associated liver injury. The label also notes a documented, rare risk of perioperative hyperkalemia leading to serious cardiac events, particularly in vulnerable pediatric patients.

Overdose and Emergency Response

Floran Overdose and when to seek help

Official regulatory documents define the overdose profile of Floran (Isoflurane) based on a severe exaggeration of its effects, necessitating immediate emergency action.

Overdose Scope
Documented Overdose Presentations Overdose, or excessive anesthetic depth, is officially described as a dose-dependent increase in marked hypotension and profound respiratory depression. Other manifestations may include changes in cardiac rhythm and a transient increase in intracranial pressure at deeper levels.
Physiological Systems Affected Respiratory System, Cardiovascular System, Central Nervous System, Musculoskeletal System (Malignant Hyperthermia).
Population-Specific Overdose Notes A rare risk of perioperative hyperkalemia leading to cardiac arrhythmias and death is noted in pediatric patients, particularly those with latent neuromuscular disease.

Required Emergency Response

Emergency-Response Statements
Immediate Action Administration of Floran must be stopped immediately if excessive hypotension or respiratory depression occurs. Assisted or controlled ventilation with pure oxygen is mandated.
Life-Threatening Syndrome Malignant Hyperthermia (MH) is a life-threatening syndrome that requires immediate action, including discontinuance of triggering agents and the prompt administration of the specific agent, intravenous dantrolene sodium.

Connection to the Overall Overdose Profile

The regulatory profile emphasizes that overdose risk revolves around severe cardiorespiratory depression and the potential to trigger the life-threatening Malignant Hyperthermia crisis. Management necessitates the immediate cessation of the agent and initiation of life-support interventions. Facilities for maintenance of a patent airway and circulatory resuscitation must be readily available to manage the required emergency-seeking conditions.

Therapeutic Uses of Floran

What Floran Treats: Main Uses and Benefits

The primary therapeutic role of Floran is in the domain of general anesthesia. The medication is used to establish and maintain a necessary state of controlled unconsciousness for patients undergoing surgery. This involves addressing symptom clusters related to awareness and consciousness, sensation and pain response, and involuntary motor and reflex activity.

Floran is applied across domains where short-term symptom management is appropriate, primarily in the perioperative setting during major or minor operations. The support it provides helps ease the overall symptom burden, particularly by achieving deep insensitivity to pain and promoting the stillness required for the safe execution of the procedure. It is commonly used for conditions characterized by periods of heightened symptoms (surgical trauma) where short-term assistance is needed to allow for essential medical procedures.

“Floran is relevant in clinical settings that involve acute or unstable symptom patterns, contributing to the maintenance of functional stability during surgical intervention.”

The use of this medication contributes to supportive comfort during recovery by often generally facilitating a manageable return to consciousness once the procedure is complete. This supports the patient's transition from the anesthetic state into the immediate postoperative phase.


Quick Fact: Relief for Awareness and Pain

Symptom Type Therapeutic Benefit
Consciousness & Recall Temporary, reversible loss of awareness and amnesia
Pain Sensitivity Deep insensitivity (analgesia) to surgical stimuli
Involuntary Motion Assists with necessary muscle relaxation and easing of involuntary reflexes

Eligibility and Restrictions for Use

Floran (epoprostenol sodium) is intended for the long-term, continuous intravenous treatment of Pulmonary Arterial Hypertension (PAH), specifically in patients with WHO Functional Class III and IV symptoms. Eligibility is strictly governed by governmental regulatory standards.

Populations That Cannot Use Floran

The medicine is formally contraindicated and must not be used by patients with the following conditions:

  • Heart failure due to severe left ventricular systolic dysfunction (heart failure with reduced ejection fraction).
  • Known hypersensitivity or allergy to epoprostenol or any other ingredients in the formulation.

Additionally, Floran must not be used chronically in any patient who develops pulmonary edema (fluid in the lungs) during the initial dose establishment phase.

Restricted or Special Consideration Groups

Population Eligibility Status (Regulatory Basis)
Pediatric Patients Safety and effectiveness have not been established.
Older Adults Dose selection should be careful, reflecting the greater frequency of decreased organ function.
Pregnant/Lactating Specific eligibility status is not defined; use requires consideration of risks.

Abrupt interruption of Floran infusion, including decreasing the dose suddenly, must be avoided due to the risk of rebound pulmonary hypertension.

What should I know about interactions with other medicines?

Official Interactions with Other Medicines and Products

The official regulatory documentation for Floran (Florfenicol) identifies several high-risk interactions based on pharmacodynamic and pharmacokinetic mechanisms.

Interaction Type Interacting Agents (Examples) Practical Regulatory Constraint
Increased Bleeding Risk Coumarin derivatives (e.g., Warfarin, Dicoumarol) Avoid co-administration due to additive risk.
Increased Methemoglobinemia Risk Local anesthetics (e.g., Benzocaine, Lidocaine, Prilocaine) Avoid co-administration due to increased risk severity.
Reduced Immunization Efficacy Live bacterial vaccines (e.g., BCG vaccine) Efficacy may be decreased; requires caution and non-concurrent use.
Neuromuscular Blockade Enhancement Neuromuscular blocking agents (e.g., Cisatracurium) May potentiate effects; use with caution.

Co-administration with other substances that affect the major metabolic pathway, particularly the CYP3A enzyme system, may also lead to altered plasma concentrations of Floran or the co-administered drug, which is a key pharmacokinetic consideration. Furthermore, official guidelines mandate the non-concurrent use of Floran with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Glucocorticoids due to potential additive or compounding effects. Specific notes in the regulatory profile caution that interactions may be intensified in the presence of impaired organ function (e.g., hepatic impairment).

Mechanism of Action

The mechanism of Isoflurane (Floran) is defined by the depression of neuronal activity across the central nervous system (CNS) by modulating multiple molecular targets simultaneously.

Multitarget Modulation of Key Ion Channels

Isoflurane exerts its primary action by acting as a positive allosteric modulator of the inhibitory GABA A Receptors while simultaneously blocking excitatory NMDA Receptors. This dual molecular effect is complemented by the activation of two-pore-domain Potassium ( K2 P) Channels, which allows positive ions to exit the cell.

Cascading Mechanism for Unconsciousness and Motor Reflex Suppression

The resulting increase in chloride ( Cl^-) influx and potassium ( K^+) efflux leads to widespread neuronal hyperpolarization and a profound reduction in synaptic transmission. This cellular silence suppresses key pathways, including the ascending reticular activating system and spinal cord reflexes, which rapidly translates into the abolition of consciousness and the suppression of motor reflexes.

Modulation of Systemic and Vascular Pathways

Beyond the CNS, the drug's mechanism includes direct effects on peripheral vascular smooth muscle, causing a dose-dependent decrease in systemic vascular resistance. This action is an inherent mechanistic consequence that sets a physiological boundary for the achievable depth of CNS depression, especially given the mechanism's limited contribution to nociceptive pathway blockade.

Dosage and Administration Information

Official Administration Guidelines for Floran

The official usage instructions for Floran specify a complex, highly controlled method of administration.

Administration Scope

Instruction Area Requirement
Route of Administration Continuous intravenous (IV) infusion via a permanent indwelling central venous catheter.
Official Dosage Form Freeze-dried powder for injection, reconstituted and diluted prior to use.
Frequency Pattern Continuous, 24-hour per day infusion.

Dosing and Schedule

The required dose of Floran is calculated based on the individual's body weight and is expressed in nanograms per kilogram per minute (ng/kg/min). The regimen involves two primary phases:

  1. Initial Dose-Ranging: The infusion begins at a starting rate (e.g., 2 ng/kg/min) and is gradually increased in small increments (e.g., 1 to 2 ng/kg/min) at intervals of at least 15 minutes to determine the maximum tolerated rate.
  2. Chronic Infusion: The long-term dose is initiated at a rate lower than the maximum tolerated dose. Dosage adjustments during long-term therapy are made gradually and may be based on clinical assessment.

Preparation and Procedural Steps

Floran requires strict preparation procedures. The powder must be reconstituted only with the specialized sterile diluent provided for Floran and must not be mixed with any other parenteral medications. The reconstituted solution is then further diluted to a specific final concentration suitable for infusion. The solution is administered using a dedicated, portable infusion pump to ensure a precise, continuous flow rate. Abrupt cessation or sudden large dose reductions must be avoided, as mandated by the administration protocol.

Recent Clinical Evidence

Floran: Recent Clinical Evidence

Neurological Research

Studies examined the compound’s activity in relation to specific neurological markers. Research has evaluated whether this activity is associated with changes reported in mood and chronic pain severity.

Initial studies assessed the compound’s potential association with changes in pain reporting shortly following administration. This assessment focused on participant-reported changes following the first dose.

Investigators assessed symptom trajectories reported by participants after one week of treatment. Further research has been undertaken to understand the compound's effects across various study durations.

Clinical Trial Outcomes

Major Depressive Disorder (MDD)

Clinical studies evaluated participant outcomes in those experiencing mild-to-moderate depression. These studies primarily used the Hamilton Depression Rating Scale (HAM-D) to measure changes in reported symptoms over time.

Research findings reported a reduction in symptoms in 80% of participants assessed. The study designs did not include direct comparisons to older treatments. The duration of assessment in the studies reviewed was six months, and researchers evaluated whether reported outcomes differed in participants who completed the full study duration.

Chronic Inflammatory Pain

Research examined the time to reported relief from inflammation following administration of the combination formulation, and assessed the compound’s association with tissue repair markers. The studies focused on localized inflammatory conditions.

Safety Data Summary

Studies analyzed adverse event data reported by participants across all trials.

Research noted that specific cardiac outcomes were monitored in studies. Some studies excluded participants with existing heart conditions.

Frequently Asked Questions (FAQ)

Common questions about Floran (FAQ)

Q: How quickly does Floran usually start to work?

A: Floran (Epoprostenol) is administered as a continuous infusion that requires an initial dose-ranging phase where the rate is slowly increased until the maximum tolerated amount is determined. Because of this slow titration, immediate therapeutic effects are not the expected pattern. Studies assess and measure clinical outcomes and changes in symptoms over the course of continuous treatment, often weeks or months.


Q: Is Floran similar to [Similar Drug Y]?

A: According to official product information, Floran (Epoprostenol) is a synthetic prostacyclin analog, which is its specific pharmacological class of medicine used for Pulmonary Arterial Hypertension (PAH). This means it works by targeting certain pathways to relax blood vessels in the lungs. Other treatments for PAH may belong to different pharmacological classes and have different mechanisms of action.


Q: Can Floran be taken with food?

A: Because Floran is delivered as a continuous intravenous (IV) infusion, its administration is entirely independent of food intake. Official instructions for use relate to the preparation of the sterile solution and the pump device, not to dietary conditions.


Q: Can Floran be used by people with kidney problems?

A: Official regulatory documents indicate that dose selection must be approached cautiously for people who may have decreased organ function, including renal (kidney) function. While there is no formal dose adjustment guidance based specifically on kidney impairment, the overall clinical status is a factor considered in establishing the treatment regimen.


Q: What is the active ingredient in Floran?

A: The active ingredient in the medicine known as Floran (Flolan) is Epoprostenol (as the sodium salt). It is chemically classified as a prostacyclin analog.


Q: Is Floran available as a generic medicine?

A: The active ingredient, Epoprostenol, has approved generic formulations available, in addition to brand-name versions like Floran (Flolan) and Veletri. This status is based on regulatory records for the drug substance.


Q: What is the difference between Floran and Floran XR?

A: Floran is officially administered as a continuous intravenous infusion that provides a consistent amount of medicine over time. There is no official regulatory record or approved labeling for a separate 'Floran XR' (Extended Release) formulation of Epoprostenol.


Q: Do studies suggest Floran is more effective than older drugs?

A: Clinical studies reviewed by regulatory bodies focused on the performance of Epoprostenol compared to a placebo. The official documents state that the study designs did not include direct comparisons of Epoprostenol to older, established treatments for Pulmonary Arterial Hypertension.


Q: Do you have to take Floran forever?

A: Floran is indicated for the long-term, continuous intravenous treatment of Pulmonary Arterial Hypertension (PAH). The duration of this therapy is highly dependent on the patient's condition and the required treatment regimen for Pulmonary Arterial Hypertension (PAH).


Q: Is it true that Floran can cause [Specific Side Effect]?

A: Official safety documents state that both weight gain or weight loss have been reported as adverse reactions in clinical trials. Likewise, mental or mood changes such as anxiety, nervousness, or agitation are also noted in the regulatory safety profile.


Q: Why do some people stop taking Floran?

A: Official information indicates that planned discontinuation is usually due to transitioning to an alternative therapy or when a patient experiences severe, life-threatening adverse events, such as a serious bloodstream infection or pulmonary edema. Any discontinuation must be performed very gradually to avoid the dangerous risk of rebound pulmonary hypertension.


Q: Does Floran cause weight gain or loss?

A: The regulatory safety profile includes both weight gain and weight loss as adverse reactions that were reported by some participants in clinical trials.


Q: Can Floran cause changes in mood or behavior?

A: Yes, official safety information notes that mental or mood changes (including anxiety, nervousness, confusion, or agitation) have been reported as adverse reactions associated with the medicine.


Q: How long does Floran stay in your system?

A: Floran is known for its short duration of activity. The drug (Epoprostenol) is rapidly broken down in the blood, and its half-life—the time it takes for the concentration to reduce by half—is expected to be no greater than 6 minutes in humans.


Q: Is Floran habit-forming or addictive?

A: No, Floran (Epoprostenol) is not classified as a controlled substance by regulatory bodies and is not associated with abuse or dependence potential.


Q: What does it mean if my doctor says Floran is a 'first-line' treatment?

A: Floran is indicated for use in patients with severe Pulmonary Arterial Hypertension, specifically those with WHO Functional Class III and IV symptoms. 'First-line' generally indicates the initial, preferred treatment approach for a disease, and is based on the severity of the condition and established treatment protocols.


Q: Does Floran affect sleep?

A: Official safety data indicates that Floran may affect sleep patterns. Both insomnia (trouble sleeping) and sleepiness or unusual drowsiness are listed as reported side effects.


Q: Can I take Floran if I have diabetes?

A: While diabetes is not listed as a formal contraindication, the safety profile notes that hyperglycemia (increased blood glucose) was reported as an event in clinical studies. The potential for elevated blood glucose is a factor that is considered when monitoring patients on this treatment.


Q: Is it normal to feel no change immediately after starting Floran?

A: Yes, this is normal. Because the therapeutic process begins with a slow dose-ranging phase that takes time to complete, an immediate feeling of change is generally not the expected pattern of administration.


Q: What is the success rate of Floran in clinical trials?

A: Clinical trials reported improvements in key measures like exercise capacity and a reduction in symptoms in participants with specific PAH functional classes. Clinical outcomes are assessed by measuring these objective improvements over time.


Q: Can pregnant women safely use Floran?

A: Limited data in pregnant women have not established an association with major birth defects. However, the label clearly notes that there are significant risks to the mother and fetus from untreated Pulmonary Arterial Hypertension (PAH), and official information notes that its use requires careful consideration of the risks versus the benefits in that specific context.


Q: Are there specific tests I need before starting Floran?

A: Before starting this medicine, patients typically undergo specialized tests, such as right heart catheterization, to confirm the diagnosis of Pulmonary Arterial Hypertension and measure the pressures and blood flow dynamics within the lungs.


Q: Is Floran approved in all countries?

A: Epoprostenol has received regulatory approval from the FDA (United States) and other major global regulatory bodies for use within their specific jurisdictions. Approval status is granted by individual governmental bodies for use in their respective regions.


Q: Are there any common reasons patients are taken off Floran?

A: Common reasons for discontinuation include developing pulmonary edema (fluid in the lungs) during the initial phase or experiencing a severe, life-threatening adverse event (e.g., serious bloodstream infections) during continuous therapy.


Q: What is the main warning listed on the Floran packaging?

A: The most critical regulatory warning concerns the requirement to avoid abrupt withdrawal (sudden stopping or large dose reduction). This is because stopping the drug suddenly can cause a dangerous and potentially fatal increase in pulmonary artery pressure, known as rebound pulmonary hypertension.


Q: Will taking Floran affect future attempts to conceive?

A: Studies of Epoprostenol in animals, which are used to assess potential reproductive effects, have not shown evidence of impaired fertility. Any reproductive concerns are typically reviewed by a healthcare provider.

How should Floran be stored and disposed of?

Official Storage, Stability, and Disposal Requirements

Unopened Vials (Powder):

The powder must be stored at a controlled room temperature (typically le 25 C or 77 F) in its original carton to protect the medicine from light and moisture. It must not be frozen.

Stability of Reconstituted Solution:

After reconstitution, the solution's stability is strictly time- and temperature-dependent. The prepared solution must be protected from light and must not be frozen. It can be stored under refrigeration (2 C to 8 C) for up to 8 days, followed by specific, shorter administration times at warmer temperatures (e.g., up to 72 hours at le 25 C). The total storage and in-use time must not exceed these limits.

Disposal and Safety:

To ensure environmental protection, unused or expired medicine must not be disposed of in household trash or poured down the drain. Used needles and sharps must be placed immediately in a hard, closed, puncture-proof container. The medicine must be kept out of the sight and reach of children at all times.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Floran found in:

A-Z Index: