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    Chemistry

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    Also known as: Sulphur hexafluoride, 2551-62-4, Sulfur fluoride, Sonovue, Elegas, Sulfur fluoride (sf6)
    Molecular Formula
    F6S
    Molecular Weight
    146.06  g/mol
    InChI Key
    SFZCNBIFKDRMGX-UHFFFAOYSA-N
    FDA UNII
    WS7LR3I1D6
    Sulfur Hexafluoride
    Sulfur hexafluoride. An inert gas used mainly as a test gas in respiratory physiology. Other uses include its injection in vitreoretinal surgery to restore the vitreous chamber and as a tracer in monitoring the dispersion and deposition of air pollutants.
    Sulfur hexafluoride is a Contrast Agent for Ultrasound Imaging. The mechanism of action of sulfur hexafluoride is as an Ultrasound Contrast Activity.
    1 2D Structure

    Sulfur Hexafluoride

    2 Identification
    2.1 Computed Descriptors
    2.1.1 IUPAC Name
    hexafluoro-6-sulfane
    2.1.2 InChI
    InChI=1S/F6S/c1-7(2,3,4,5)6
    2.1.3 InChI Key
    SFZCNBIFKDRMGX-UHFFFAOYSA-N
    2.1.4 Canonical SMILES
    FS(F)(F)(F)(F)F
    2.2 Other Identifiers
    2.2.1 UNII
    WS7LR3I1D6
    2.3 Synonyms
    2.3.1 MeSH Synonyms

    1. Hexafluoride, Sulfur

    2.3.2 Depositor-Supplied Synonyms

    1. Sulphur Hexafluoride

    2. 2551-62-4

    3. Sulfur Fluoride

    4. Sonovue

    5. Elegas

    6. Sulfur Fluoride (sf6)

    7. Lumason

    8. Sulfur(vi) Fluoride

    9. Hexafluorure De Soufre

    10. Hexafluoridosulfur

    11. Sulfur Hexafluoride [usan]

    12. Sulfur Fluoride (sf6), (oc-6-11)-

    13. Sulfur(6+) Fluoride

    14. Ws7lr3i1d6

    15. Chebi:30496

    16. Bri

    17. Hexafluorosulfur

    18. Sulfur Hexafluoride (usan)

    19. Esaflon

    20. Elagas

    21. Sf6

    22. Hsdb 825

    23. Hexafluorure De Soufre [french]

    24. Einecs 219-854-2

    25. Sulfur Hexafluoride Lipid Microsphere

    26. Un1080

    27. Unii-ws7lr3i1d6

    28. Sf6 Microbubbles

    29. Sulfur Fluoride, (oc-6-11)-

    30. Lumason (tn)

    31. Sonovue (tn)

    32. Hexafluoro-l6-sulfane

    33. Hexafluoro-lambda6-sulfane

    34. Ec 219-854-2

    35. R 7146

    36. Hexafluoro-$l^{6}-sulfane

    37. Chembl1796998

    38. Dtxsid8029656

    39. Sulfur Hexafluoride [mi]

    40. [sf6]

    41. Sulfur Hexafluoride [hsdb]

    42. Sulfur Hexafluoride, >=99.75%

    43. Amy37163

    44. Hexakis(fluoranyl)-$l^{6}-sulfane

    45. Sulfur Hexafluoride [mart.]

    46. Mfcd00011447

    47. Sulfur Hexafluoride [who-dd]

    48. Zinc245224194

    49. Db11104

    50. Oc-6-11

    51. Sulphur Hexafluoride [ema Epar]

    52. Un 1080

    53. Sonovue (for The Microbubble Formulation)

    54. Stabilized Sulfur Hexafluoride Microbubbles

    55. Sulfur Hexafluoride, Phospholipid Microspheres

    56. D05962

    57. A817889

    58. Q279055

    59. Sulfur Hexafluoride [un1080] [nonflammable Gas]

    60. Sulfur Hexafluoride Lipid-type A Microspheres [orange Book]

    2.4 Create Date
    2004-09-16
    3 Chemical and Physical Properties
    Molecular Weight 146.06 g/mol
    Molecular Formula F6S
    XLogP34.2
    Hydrogen Bond Donor Count0
    Hydrogen Bond Acceptor Count6
    Rotatable Bond Count0
    Exact Mass145.96249015 g/mol
    Monoisotopic Mass145.96249015 g/mol
    Topological Polar Surface Area1 Ų
    Heavy Atom Count7
    Formal Charge0
    Complexity62.7
    Isotope Atom Count0
    Defined Atom Stereocenter Count0
    Undefined Atom Stereocenter Count0
    Defined Bond Stereocenter Count0
    Undefined Bond Stereocenter Count0
    Covalently Bonded Unit Count1
    4 Drug and Medication Information
    4.1 Drug Information
    1 of 2  
    Drug NameLumason
    Active IngredientSulfur hexafluoride lipid-type a microspheres
    Dosage FormFor suspension
    RouteIntravenous
    Strength60.7mg/25mg
    Market StatusPrescription
    CompanyBracco

    2 of 2  
    Drug NameLumason
    Active IngredientSulfur hexafluoride lipid-type a microspheres
    Dosage FormFor suspension
    RouteIntravenous
    Strength60.7mg/25mg
    Market StatusPrescription
    CompanyBracco

    4.2 Therapeutic Uses

    Lumason is indicated for use in patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    An inert gas used mainly as a test gas in respiratory physiology. Other uses include its injection in vitreoretinal surgery to restore the vitreous chamber ...

    National Library of Medicine - Medical Subject Headings (2007)

    The intraocular injection of sulfur hexafluoride appears to be useful contribution to the surgical treatment of superior bullous hemi-retinal detachment, allowing effective and durable internal tamponade, while avoiding prolonged bedrest.

    J Fr Ophtalmol 6 (11): 889-93 (1983)

    In this randomized clinical trial, 18 patients received treatment with silicone oil and 16 patients received SF6. The primary outcome was defined as successful anatomic attachment of the retina. Secondary outcomes included the time to retinal detachment, visual acuity, anatomic macular attachment, and any complications of surgery. RESULTS: The odds of successful reattachment with silicone oil were 50% greater than they were with SF6, but this difference was not statistically significant. There were no differences between the two groups in any of the secondary outcomes. ... This study did not have enough statistical power to detect a small but clinically important difference between the two treatment groups ...

    PMID:9387180 Hammer M et al; Ophthalmic Surg Lasers 28 (11): 926-31 (1997)

    For more Therapeutic Uses (Complete) data for SULFUR HEXAFLUORIDE (11 total), please visit the HSDB record page.

    4.3 Drug Warning

    /BOXED WARNING/ WARNING: SERIOUS CARDIOPULMONARY REACTIONS Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following the injection of ultrasound contrast agents, including sulfur hexafluoride lipid microspheres. Most serious reactions occur within 30 minutes of administration. Assess all patients for the presence of any condition that precludes administration. Always have resuscitation equipment and trained personnel readily available.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    Serious cardiopulmonary reactions, including fatalities have occurred uncommonly during or shortly following administration of ultrasound contrast agents, including Lumason. These reactions typically occurred within 30 minutes of administration. The risk for these reactions may be increased among patients with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias). Always have cardiopulmonary resuscitation personnel and equipment readily available prior to Lumason administration and monitor all patients for acute reactions. The reported reactions that may follow the administration of ultrasound contrast agents include: fatal cardiac or respiratory arrest, shock, syncope, symptomatic arrhythmias (atrial fibrillation, tachycardia, bradycardia, supraventricular tachycardia, ventricular fibrillation, and ventricular tachycardia), hypertension, hypotension, dyspnea, hypoxia, chest pain, respiratory distress, stridor, wheezing, loss of consciousness, and convulsions.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    Lumason is contraindicated in patients with: known or suspected right-to-left, bi-directional, or transient right-to-left cardiac shunts history of hypersensitivity reactions to sulfur hexafluoride lipid microsphere components or to any of the inactive ingredients in Lumason Do not administer by intra-arterial injection.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    In patients with right-to-left, bi-directional, or transient right-to-left cardiac shunts, some intravenously injected sulfur hexafluoride lipid containing microspheres may bypass filtering by the lung and directly enter the arterial circulation. Occlusion of the microcirculation by these microspheres may result in tissue ischemia. Lumason is only for intravenous administration; do not administer Lumason by intra-arterial injection.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    For more Drug Warnings (Complete) data for SULFUR HEXAFLUORIDE (19 total), please visit the HSDB record page.

    4.4 Drug Indication

    Echocardiography: Sulfur hexafluoride is indicated for use in adult patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricularendocardial border. Ultrasonography of the Liver: Sulfur hexafluoride is indicated for use with ultrasound of the liver in adult and pediatric patients to characterize focal liver lesions.

    This medicinal product is for diagnostic use only.

    SonoVue is for use with ultrasound imaging to enhance the echogenicity of the blood, or of fluids in the urinary tract which results in an improved signal to noise ratio.

    SonoVue should only be used in patients where study without contrast enhancement is inconclusive.

    Echocardiography

    SonoVue is a transpulmonary echocardiographic contrast agent for use in adult patients with suspected or established cardiovascular disease to provide opacification of cardiac chambers and enhance left ventricular endocardial border delineation.

    Doppler of macrovasculature

    SonoVue increases the accuracy in detection or exclusion of abnormalities in cerebral arteries and extracranial carotid or peripheral arteries in adult patients by improving the Doppler signal to noise ratio.

    SonoVue increases the quality of the Doppler flow image and the duration of clinically useful signal enhancement in portal vein assessment in adult patients.

    Doppler of microvasculature

    SonoVue improves display of the vascularity of liver and breast lesions during Doppler sonography in adult patients leading to more specific lesion characterisation.

    Ultrasonography of excretory urinary tract

    SonoVue is indicated for use in ultrasonography of the excretory tract in paediatric patients from newborn to 18 years to detect vesicoureteral reflux. For the limitation in the interpretation of a negative urosonography.

    5 Pharmacology and Biochemistry
    5.1 Pharmacology

    Sulfur hexafluoride provides useful echocardiographic signal intensity for two minutes after the injection. Sulfur hexafluoride microspheres are destroyed and contrast enhancement decreases as the mechanical index increases (values of 0.8 or less are recommended). For ultrasonography of the liver, Sulfur hexafluoride provides dynamic patterns of differential signal intensity enhancement between focal liver lesions and liver parenchyma during the arterial, portal venous, and late phase of signal intensity enhancement of the microvasculature.

    5.2 FDA Pharmacological Classification
    5.2.1 Active Moiety
    SULFUR HEXAFLUORIDE
    5.2.2 FDA UNII
    WS7LR3I1D6
    5.2.3 Pharmacological Classes
    Ultrasound Contrast Activity [MoA]; Contrast Agent for Ultrasound Imaging [EPC]
    5.3 ATC Code

    V08DA04

    V08DA05

    S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355

    V - Various

    V08 - Contrast media

    V08D - Ultrasound contrast media

    V08DA - Ultrasound contrast media

    V08DA05 - Sulfur hexafluoride, phospholipid microspheres

    5.4 Absorption, Distribution and Excretion

    Absorption

    The pharmacokinetic of the SF6 gas component of Lumason was evaluated in 12 healthy adult subjects (7 men and 5 women). After intravenous bolus injections of 0.03 mL/kg and 0.3 mL/kg of Lumason, corresponding to approximately 1 and 10 times the recommended doses, concentrations of SF6 in blood peaked within 1 to 2 minutes for both doses.

    Route of Elimination

    The SF6 component of Lumason is eliminated via the lungs.

    Volume of Distribution

    In a study of healthy subjects, the mean values for the apparent steady-state volume of distribution of SF6 were 341 L and 710 L for Lumason doses of 0.03 mL/kg and 0.3 mL/kg, respectively. Preferential distribution to the lung is likely responsible for these values.

    SonoVue, is a new echo contrast agent based on stabilized sulfur hexafluoride (SF6) microbubbles ... The blood kinetics and pulmonary elimination of SF6 after intravenous bolus injection of two dosage levels (0.03 and 0.3 mL/kg) of SonoVue were evaluated in 12 healthy subjects (7 men, 5 women). In addition, safety and tolerability were evaluated by monitoring vital signs, adverse effects, discomfort, and physical examination and laboratory parameters associated with the SonoVue injection. The blood kinetics of SF6 was not dose dependent. SF6 was rapidly removed from the blood by the pulmonary route, with 40% to 50% of the injected dose eliminated within the first minute after administration and 80% to 90% eliminated by 11 minutes after administration; the elimination was similar in men and women and independent of dose. Both dosages were well tolerated. No adverse effects were observed immediately or during the 24-hour follow-up period. ... The route of SF6 elimination was by means of the lungs in the expired air. ...

    PMID:10639039 Morel DR et al; Invest Radiol 35 (1): 80-5 (2000)

    Sonovue (trade mark) is a new echo contrast agent made of microbubbles stabilized by phospholipids and containing sulphur hexafluoride (SF6), an innocuous gas. ... With regard to the gas contained in the bubbles, its pharmacokinetics have been assessed during a study in human volunteers. Following intravenous administration of 0.3 mL/kg of SonoVue (trade mark) (i.e., approximately ten times the imaging dose), the blood level curve showed a distribution half-life of about 1 minute and an elimination half-life of about 6 minutes. More than 80% of the administered gas is exhaled via the lungs after 11 minutes. ...

    PMID:10639039 Schneider M; Echocardiography 16 (7, Pt 2): 743-746 (1999 Oct)

    The pharmacokinetic of the SF6 gas component of Lumason was evaluated in 12 healthy adult subjects (7 men and 5 women). After intravenous bolus injections of 0.03 mL/kg and 0.3 mL/kg of Lumason, corresponding to approximately 1 and 10 times the recommended doses, concentrations of SF6 in blood peaked within 1 to 2 minutes for both doses. The terminal half-life of SF6 in blood was approximately 10 minutes for the 0.3 mL/kg dose. (At the 0.03 mL/kg dose, terminal half-life could not be estimated.) The area-under-the-curve of SF6 was dose-proportional over the dose range studied.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    In a study of healthy subjects, the mean values for the apparent steady-state volume of distribution of SF6 were 341 L and 710 L for Lumason doses of 0.03 mL/kg and 0.3 mL/kg, respectively. Preferential distribution to the lung is likely responsible for these values.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    For more Absorption, Distribution and Excretion (Complete) data for SULFUR HEXAFLUORIDE (6 total), please visit the HSDB record page.

    5.5 Metabolism/Metabolites

    SF6 undergoes little or no biotransformation; 88% of an administered dose is recovered unchanged in expired air.

    SF6 undergoes little or no biotransformation; 88% of an administered dose is recovered unchanged in expired air.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    Under brief and prolonged exposures, sulfur hexafluoride was biologically inert and did not metabolize.

    PMID:7250729 Mel'nikova LV, Rozova TA; Gig Tr Prof Zabol 6: 48-9 (1981)

    5.6 Biological Half-Life

    The terminal half-life of SF6 in blood was approximately 10 minutes for the 0.3 mL/kg dose. (At the 0.03 mL/kg dose, terminal half-life could not be estimated.)

    The pharmacokinetic of the SF6 gas component of Lumason was evaluated in 12 healthy adult subjects (7 men and 5 women). After intravenous bolus injections of 0.03 mL/kg and 0.3 mL/kg of Lumason... The terminal half-life of SF6 in blood was approximately 10 minutes for the 0.3 mL/kg dose. (At the 0.03 mL/kg dose, terminal half-life could not be estimated.) The area-under-the-curve of SF6 was dose-proportional over the dose range studied.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    ... Following intravenous administration of 0.3 mL/kg of SonoVue (trade mark) (i.e., approximately ten times the imaging dose), the blood level curve showed a distribution half-life of about 1 minute and an elimination half-life of about 6 minutes. ...

    PMID:10639039 Schneider M; Echocardiography 16 (7, Pt 2): 743-746 (1999 Oct)

    In a study of patients with pulmonary impairment, blood concentrations of SF6 peaked at 1 to 4 minutes following Lumason administration. The cumulative recovery of SF6 in expired air was 102 +/- 18% (mean +/- standard deviation), and the terminal half-life of SF6 in blood was similar to that measured in healthy subjects.

    NIH; DailyMed. Current Medication Information for LUMASON- sulfur hexafluoride (Revised: October 2014). Available from, as of August 2, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c679424-c3f7-ed02-892f-20ca0d775089

    5.7 Mechanism of Action

    Within the blood, the acoustic impedance of Lumason microspheres is lower than that of the surrounding non-aqueous tissue. Therefore, an ultrasound beam is reflected from the interface between the microspheres and the surrounding tissue. The reflected ultrasound signal provides a visual image that shows a contrast between the blood and the surrounding tissues.

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