Classifications: analgesic; narcotic (opiate) agonist; general anesthesia; Therapeutic: narcotic (opiate) analgesic; general anesthesia
Pregnancy Category: C
Controlled Substance: Schedule II
1 mg/mL, 2 mg/mL, 5 mg/mL injection
Synthetic, potent narcotic agonist analgesic similar to fentanyl. Rapidly metabolized; therefore respiratory depression
is of shorter duration than fentanyl analogs when discontinued.
Used as the analgesic component of an anesthesia regime.
Analgesic during induction and maintenance of general anesthesia, as the analgesic component of monitored anesthesia care.
Hypersensitivity to fentanyl analogs, epidural or intrathecal administration; pregnancy (category C).
Head injuries, increased intracranial pressure; older adults, debilitated, morbid obesity, poor-risk patients; COPD, other
respiratory problems, bradyarrhythmia; lactation. Safety in labor and delivery has not been demonstrated.
Route & Dosage
|Adjunct to Anesthesia
Adult: IV 0.51 mcg/kg/min or 1 mcg/kg bolus
Child: IV Birth2 mo, 0.41 mcg/kg/min; 112 y, 0.51 mcg/kg/min or 1 mcg/kg bolus
Dose based on IBW.
Note: See manufacturer's guidelines for reconstitution information and infusion rates.
PREPARE: Direct/Continuous Infusion: ??Reconstitute by adding 1 mL of sterile water for injection, D5W, NS, D5NS, ?NS, or D5RL to each 1 mg of remifentanil to
yield 1 mg/mL. Shake well to dissolve. ??Further dilute to a final concentration of 20, 25, 50, or 250 mcg/mL by adding the required dose to the appropriate amount
of IV solution.
ADMINISTER: Direct/Continuous Infusion: Give at the ordered rate according to patient's weight.
INCOMPATIBILITIES Solution/additive: Unknown. Y-site: Amphotericin B, amphotericin B cholesteryl, cefoperazone, chlorpromazine, diazepam.
- Clear IV tubing completely of the drug following discontinuation of remifentanil infusion to ensure that inadvertent administration
of the drug will not occur at a later time.
- Reconstituted solution is stable for 24 h at room temperature. Store vials of powder at 2°25° C (36°77°
Adverse Effects (≥1%)Body as a Whole:
Muscle rigidity, shivering. CNS:
Dizziness, headache. CV:
Hypotension, hypertension, bradycardia. GI: Nausea,
, apnea. Skin:
and other cns depressants
potentiate effects; mao inhibitors
may precipitate hypertensive crisis.
12 min. Distribution:
70% protein bound. Metabolism:
Hydrolyzed by nonspecific esterases in the blood and tissues. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Monitor vital signs during postoperative period; observe for and immediately report any S&S of respiratory distress or respiratory
depression, or skeletal and thoracic muscle rigidity and weakness.
- Monitor for adequate postoperative analgesia.