Generic Name: remifentanil (rem i FEN ta nil)
Brand Names: Ultiva
What is remifentanil?
Remifentanil is a narcotic (opioid) pain medicine.
Remifentanil is used to treat or prevent acute pain after surgery.
Remifentanil may be used for other purposes not listed in this medication guide.
What is the most important information I should know about remifentanil?
You should not receive this medication if you are allergic to remifentanil.
Before you receive remifentanil, tell your doctor about all of your medical conditions. You may need a dose adjustment or special tests to safely receive this medication.
Tell your doctor if you are pregnant or breast-feeding before you are treated with remifentanil. Your breathing and other vital signs will be constantly monitored while you are being treated with remifentanil. Remifentanil can cause side effects that may impair your thinking or reactions. You should not plan on driving or doing anything that requires you to be awake and alert right after you are treated with this medication.
Follow your doctor's instructions about any other restrictions on food, beverages, or activity after you are treated with remifentanil.
What should I discuss with my health care provider before I receive remifentanil?
You should not receive this medication if you are allergic to remifentanil.
Before you receive remifentanil, tell your doctor about all of your medical conditions. You may need a dose adjustment or special tests to safely receive this medication.
FDA pregnancy category C. Remifentanil may be harmful to an unborn baby. Before you receive this medication, tell your doctor if you are pregnant. It is not known whether remifentanil passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.
How should I take remifentanil?
Remifentanil is given as an injection through a needle placed into a vein. You will receive this injection in a hospital or surgery center.
Remifentanil is usually given slowly through an IV infusion connected to pump that will release the correct dose of the medication to provide continuous pain relief during and after your surgery.
Your breathing and other vital signs will be constantly monitored while you are being treated with remifentanil.
You may be given other pain medications to use after your remifentanil treatment is discontinued.
See also: Remifentanil dosage (in more detail)
What happens if I miss a dose?
Since remifentanil is given as needed by a healthcare professional for only a short time, it is not likely that you will miss a dose.
What happens if I overdose?
Seek emergency medical attention if you think you have received too much of this medicine. Overdose symptoms may include slow breathing, chest tightness, slow heart rate, extreme weakness or dizziness, seizure, or fainting.
What should I avoid after receiving remifentanil?
Remifentanil can cause side effects that may impair your thinking or reactions. You should not plan on driving or doing anything that requires you to be awake and alert right after you are treated with this medication.
Follow your doctor's instructions about any other restrictions on food, beverages, or activity after you are treated with remifentanil.
Remifentanil side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Your caregivers will monitor you for any of these serious side effects, which may clear up within minutes after stopping the remifentanil infusion or decreasing the dose:
weak, shallow breathing, or breathing that stops;
fast or slow heart rate;
stiff muscles; or
severe weakness, feeling light-headed or fainting.
Less serious side effects may include:
nausea, vomiting, constipation, dry mouth;
shivering;
itching or sweating;
headache;
muscle pain;
cough, sore throat;
dizziness, confusion, agitation;
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Remifentanil Dosing Information
Usual Adult Dose for Anesthesia:
Induction of Anesthesia: Continuous IV infusion: 0.5 to 1 mcg/kg/min. If endotracheal intubation is to occur in less than 8 minutes, an initial dose of 1 mcg/kg may be administered over 30 to 60 seconds.
Maintenance of Anesthesia: With Nitrous Oxide, 0.4 mg/kg/min by continuous IV infusion.
Infusion dose range: 0.1 to 2 mcg/kg/min.
Supplemental IV bolus: 1 mcg/kg every 2 to 5 minutes.
With Isoflurane or Propofol: 0.25 mg/kg/min by continuous IV infusion.
Infusion dose range. 0.05 to 2 mcg/kg/min.
Supplemental IV bolus: 1 mcg/kg dose.
Continuation into Postoperative Period: Continuous IV infusion: 0.1 mcg/kg/min.
Infusion dose range: 0.025 to 0.2 mcg/kg/min.
Monitored Anesthesia Care: Single IV dose: 1 mcg/kg over 30 to 60 seconds, given 90 seconds before local anesthetic or 0.5 mcg/kg with midazolam 2 mg.
Continuous IV infusion: 0.1 mcg/kg/min beginning 5 minutes before local anesthetic. Then, decrease to 0.05 mcg/kg/min (range 0.025 to 0.2 mcg/kg/min) after local anesthetic or
0.05 mcg/kg/min given with midazolam 2 mg, beginning 5 minutes before local anesthetic . Then, decrease to 0.025 mcg/kg/min (range 0.025 to 0.2 mcg/kg/min) after local anesthetic.
Usual Pediatric Dose for Anesthesia:
Neonatal:
Maintenance of anesthesia with nitrous oxide (70%):
IV continuous infusion: 0.4 mcg/kg/minute (range: 0.4 to 1 mcg/kg/minute)
Supplemental bolus dose of 1 mcg/kg may be administered; smaller bolus dose may be required with potent inhalation agents, potent neuraxial anesthesia, significant comorbidities, significant fluid shifts, or without atropine pretreatment.
Clearance in neonates is highly variable. Dose should be carefully titrated.
Endotracheal intubation (nonemergent): IV: 1 to 3 mcg/kg/dose; may repeat dose in 2 to 3 minutes if needed.
IV continuous infusion: Dose should be based on ideal body weight (IBW) in obese patients (greater than 30% over IBW).
Infants 1 to 2 months: Maintenance of anesthesia with nitrous oxide (70%): 0.4 mcg/kg/minute (range: 0.4 to 1 mcg/kg/minute).
Supplemental bolus dose of 1 mcg/kg may be administered, smaller bolus dose may be required with potent inhalation agents, potent neuraxial anesthesia, significant comorbidities, significant fluid shifts, or without atropine pretreatment.
Children 1 to 12 years: Maintenance of anesthesia with halothane, sevoflurane, or isoflurane: 0.25 mcg/kg/minute (range: 0.05 to 1.3 mcg/kg/minute)
Supplemental bolus dose of 1 mcg/kg may be administered every 2 to 5 minutes. Consider increasing concomitant anesthetics with infusion rate greater than 1 mcg/kg/minute. Infusion rate can be titrated upward in increments up to 50% or titrated downward in decrements of 25 to 50%. May titrate every 2 to 5 minutes.
What other drugs will affect remifentanil?
There may be other drugs that can interact with remifentanil. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
More remifentanil resources
- Remifentanil Side Effects (in more detail)
- Remifentanil Dosage
- Remifentanil Use in Pregnancy & Breastfeeding
- Remifentanil Drug Interactions
- Remifentanil Support Group
- 0 Reviews for Remifentanil - Add your own review/rating
- remifentanil Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information
- Remifentanil MedFacts Consumer Leaflet (Wolters Kluwer)
- Remifentanil Hydrochloride Monograph (AHFS DI)
- Ultiva Prescribing Information (FDA)
Compare remifentanil with other medications
- Anesthesia
Where can I get more information?
- Your doctor or pharmacist can provide more information about remifentanil.
See also: remifentanil side effects (in more detail)
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