Description

Simple

A painkiller used in anesthesia.

Clinical

An opioid analgesic used in anesthesia.

Overview

Remifentanil (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. Remifentanil is a specific mu-type-opioid receptor agonist which means it reduces sympathetic nervous system tone, and causes respiratory depression and analgesia.

Pharmacology

Indication

For use during the induction and maintenance of general anesthesia.

Pharmacodynamic

Remifentanil 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... Read more

Mechanism of action

Remifentanil 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.

Absorption

Information currently not available.

Protein binding

70% (bound to plasma proteins)

Volume of distribution

350 mL/kg452 ± 144 mL/kg [neonates]223 ± 30.6 mL/kg [adolescents]

Clearance

40 mL/min/kg [young, healthy adults]

Half life

1-20 minutes

Route of elimination

Remifentanil 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.

Toxicity

Information currently not available.

Adverse Effects

Contraindications

  • Hypersensitivity:
    • true
  • Regions: US
  • Route:
    • Intravenous
  • Regions: US
  • Patient Conditions:
      • Name: Epidural administration
      • Drugbank Id: DBCOND0107485
  • Route:
    • Intravenous
  • Regions: US
  • Patient Conditions:
      • Name: Intrathecal administration
      • Drugbank Id: DBCOND0107822

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Remifentanil
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
1-benzylimidazole
The risk or severity of hypertension can be increased when Remifentanil is combined with 1-benzylimidazole.
2,5-Dimethoxy-4-ethylamphetamine
2,5-Dimethoxy-4-ethylamphetamine may increase the analgesic activities of Remifentanil.
2,5-Dimethoxy-4-ethylthioamphetamine
2,5-Dimethoxy-4-ethylthioamphetamine may increase the analgesic activities of Remifentanil.
4-Bromo-2,5-dimethoxyamphetamine
4-Bromo-2,5-dimethoxyamphetamine may increase the analgesic activities of Remifentanil.
4-Methoxyamphetamine
The risk or severity of adverse effects can be increased when Remifentanil is combined with 4-Methoxyamphetamine.
5-methoxy-N,N-dimethyltryptamine
The risk or severity of adverse effects can be increased when Remifentanil is combined with 5-methoxy-N,N-dimethyltryptamine.
7-Nitroindazole
The risk or severity of adverse effects can be increased when Remifentanil is combined with 7-Nitroindazole.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
The risk or severity of adverse effects can be increased when 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline is combined with Remifentanil.
Abediterol
The risk or severity of hypertension can be increased when Remifentanil is combined with Abediterol.
Acebutolol
The therapeutic efficacy of Acebutolol can be increased when used in combination with Remifentanil.
Aceclofenac
The risk or severity of hypertension can be increased when Remifentanil is combined with Aceclofenac.
Acemetacin
The risk or severity of hypertension can be increased when Remifentanil is combined with Acemetacin.
Acepromazine
The risk or severity of hypotension and CNS depression can be increased when Acepromazine is combined with Remifentanil.
Aceprometazine
The risk or severity of hypotension and CNS depression can be increased when Aceprometazine is combined with Remifentanil.
Acetazolamide
The risk or severity of adverse effects can be increased when Acetazolamide is combined with Remifentanil.
Acetophenazine
The risk or severity of hypotension and CNS depression can be increased when Acetophenazine is combined with Remifentanil.
Acetylglycinamide chloral hydrate
The risk or severity of adverse effects can be increased when Remifentanil is combined with Acetylglycinamide chloral hydrate.
Acetylsalicylic acid
The risk or severity of hypertension can be increased when Remifentanil is combined with Acetylsalicylic acid.
Aclidinium
The risk or severity of adverse effects can be increased when Remifentanil is combined with Aclidinium.
Adenosine
The risk or severity of Tachycardia can be increased when Adenosine is combined with Remifentanil.