Remifentanyl Uses, Dosage, Side Effects and more
Remifentanyl (marketed by Abbott as Ultiva) is a potent ultra short-acting synthetic opioid given to patients during surgery for pain relief and adjunctive to an anaesthetic. Remifentanyl is a specific mu-type-opioid receptor agonist which means it reduces sympathetic nervous system tone, and causes respiratory depression and analgesia.
Remifentanyl is an opioid agonist with rapid onset and peak effect and ultra-short duration of action. The opioid activity of remifentanil is antagonized by opioid antagonists such as naloxone. The analgesic effects of remifentanil are rapid in onset and offset. Its effects and side effects are dose dependent and similar to other opioids. Remifentanyl in humans has a rapid blood-brain equilibration half-time of 1 ± 1 minutes (mean ± SD) and a rapid onset of action.
| Trade Name | Remifentanyl |
| Availability | Prescription only |
| Generic | Remifentanil |
| Remifentanil Other Names | Remifentanil, Remifentanilo, Remifentanyl |
| Related Drugs | fentanyl, lidocaine, ketamine, hyoscyamine, propofol, glycopyrrolate |
| Type | |
| Formula | C20H28N2O5 |
| Weight | Average: 376.4467 Monoisotopic: 376.199822016 |
| Protein binding | 70% (bound to plasma proteins) |
| Groups | Approved |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | |
| Last Updated: | January 7, 2025 at 1:49 am |
Uses
Remifentanyl is an opioid analgesic used in anesthesia.
For use during the induction and maintenance of general anesthesia.
Remifentanyl is also used to associated treatment for these conditions: Immediate postoperative analgesia therapy, Induction and Maintenance of General Anesthesia, Monitored anesthesia care sedation
How Remifentanyl works
Remifentanyl is a µ-opioid agonist with rapid onset and peak effect, and short duration of action. The µ-opioid activity of remifentanil is antagonized by opioid antagonists such as naloxone.
Food Interaction
- Avoid alcohol. Ingesting alcohol may increase the sedative and CNS depressant effects of remifentanil.
Remifentanyl Alcohol interaction
[Moderate] GENERALLY AVOID:
Ethanol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics.
Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills.
In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.
Concomitant use of opioid analgesics with ethanol should be avoided.
Drug Interaction
Major: dantrolene, ondansetronModerate: alfentanil, diphenhydramine, meperidine, hydromorphone, chlorpheniramine / hydrocodone, midazolamUnknown: charcoal, epinephrine, amoxicillin / clavulanate, sulfamethoxazole / trimethoprim, heparin, furosemide, levothyroxine, atorvastatin, acetaminophen, vitamin a topical, bioflavonoids, sotalol
Disease Interaction
Major: prematurity, acute alcohol intoxication, gastrointestinal obstruction, hypotension, intracranial pressure, respiratory depressionModerate: adrenal insufficiency, hypothyroidism, seizure disorders, urinary retention, arrhythmias
Volume of Distribution
- 350 mL/kg
- 452 ± 144 mL/kg [neonates]
- 223 ± 30.6 mL/kg [adolescents]
Half Life
1-20 minutes
Clearance
- 40 mL/min/kg [young, healthy adults]
Elimination Route
Remifentanyl is an esterase-metabolized opioid. The carboxylic acid metabolite is essentially inactive (1/4600 as potent as remifentanil in dogs) and is excreted by the kidneys with an elimination half-life of approximately 90 minutes.
