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NERVOUS SYSTEM › ANESTHETICS › ANESTHETICS, GENERAL › Opioid anesthetics
remifentanil
N01AH06
Forms & Strengths
- Lyophilized powder for injection: 1mg, 2mg, 5mg
- Solution for injection: 1mg/mL, 2mg/mL, 5mg/mL
- Generic and brand name formulations available
Adult Dosing
- Anesthesia: 0.5-1 mcg/kg/min IV
- Sedation for ICU: 0.05-0.2 mcg/kg/min IV
- Titrate to effect, not to exceed 2 mcg/kg/min IV
Pediatric Dosing
- Neonates and infants: 0.1-0.4 mcg/kg/min IV
- Children: 0.25-1 mcg/kg/min IV
- Titrate to effect and monitor respiratory function
Indications
- Anesthesia for inpatient and outpatient procedures
- Intensive care unit (ICU) sedation
- Induction and maintenance of general anesthesia
Mechanism of Action
- Selective mu-opioid receptor agonist
- Rapid onset and short duration of action due to ester linkages
- Metabolized by nonspecific blood and tissue esterases
Contraindications
- Hypersensitivity to remifentanil or other opioids
- Respiratory depression in the absence of resuscitative equipment
- Intramuscular or subcutaneous use
Adverse Reactions
- Respiratory depression or arrest
- Hypotension, bradycardia, or hypoxia
- Muscle rigidity, nausea, vomiting, or pruritus
Drug Interactions
- Benzodiazepines: increased sedative effect
- Other opioids: additive risk of respiratory depression
- MAOIs: risk of serotonin syndrome or other adverse effects
Curated Content: Needs Vetting Before Put to Clinical Use