Uses

Remifentanil is a short-acting opioid analgesic indicated for intravenous use as an analgesic during induction and maintenance of general anesthesia, continuation into the immediate postoperative period under direct anesthesia supervision, and as a component of monitored anesthesia care in adults.

Do not use if

Contraindicated for epidural or intrathecal administration due to glycine in the formulation. Contraindicated in patients with hypersensitivity to remifentanil or other fentanyl analogues.

Side effects

Common adverse effects include respiratory depression, apnea, hypotension, bradycardia, nausea, vomiting, muscle rigidity, and pruritus. Risk of opioid-induced hyperalgesia with prolonged infusion. Addiction, abuse, and misuse are potential risks.

Warnings

Carries a boxed warning for addiction, abuse, misuse, life-threatening respiratory depression, and risks from concurrent use with benzodiazepines or CNS depressants. Must only be administered in settings with full resuscitative equipment and by trained personnel. The profound respiratory depression requires continuous monitoring.

How it works

Remifentanil is a selective mu-opioid receptor agonist with ultrashort duration of action due to rapid hydrolysis by nonspecific tissue and plasma esterases. This esterase-based metabolism makes its clearance independent of hepatic and renal function, allowing precise titration during anesthesia.

Storage

Store unreconstituted vials at room temperature (20°C–25°C). After reconstitution, use within 4 hours and do not freeze.