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sufentanil
generic
Black Box Warnings .
Addiction, Abuse, and Misuse
opioid agonist Schedule II controlled substance w/ risk of addiction, abuse, and misuse, which can lead to overdose and death; assess opioid abuse or addiction risk prior to prescribing; regularly reassess all pts for misuse, abuse, and addiction
Respiratory Depression
serious, life-threatening, or fatal cases may occur even w/ recommended use, esp. during tx start or after dose incr; to decr. risk, initiate and titrate dose appropriately
Risks from Concomitant Use w/ Benzodiazepines, CNS Depressants
concomitant opioid use w/ benzodiazepines or other CNS depressants, incl. alcohol, may result in profound sedation, resp. depression, coma, and death; reserve concomitant use for pts w/ inadequate alternative tx options
CYP450 3A4 Interaction
concomitant use w/ CYP450 3A4 inhibitors or D/C of concomitant CYP450 3A4 inducers may incr. opioid conc. which may incr. or prolong adverse effects incl. potentially fatal resp. depression; monitor pts receiving any concomitant CYP450 3A4 inhibitor or inducer
Adult Dosing .
Dosage forms: INJ
general anesthesia induction
- [8-30 mcg/kg/dose IV x1]
- Info: for ventilated pts undergoing complicated/prolonged major surgery; use w/ neuromuscular blocker
general anesthesia maintenance
- [0.5-10 mcg/kg/dose IV prn]
- Max: 30 mcg/kg/procedure; Info: for ventilated pts; use w/ neuromuscular blocker
general anesthesia, analgesia adjunct
- [complic. major surgery]
- Dose: 10-50 mcg IV prn; Start: 2-8 mcg/kg/dose IV x1; Max: 1 mcg/kg/h surgical time; Info: for ventilated pts
- [general surgery]
- Dose: 10-25 mcg IV prn; Start: 1-2 mcg/kg/dose IV x1; Max: 1 mcg/kg/h surgical time; Info: for ventilated pts
analgesia, obstetric
- [10-15 mcg epidural q1h]
- Max: 3 doses; Info: admin. w/ 10 mL bupivacaine 0.125% w/ or w/o epinephrine
renal dosing
- [see below]
- renal impairment: consider decr. usual dose
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: INJ
general anesthesia induction
- [<12 yo]
- Dose: 10-25 mcg/kg/dose IV x1; Info: for pts undergoing cardiovascular surgery
general anesthesia maintenance
- [<12 yo]
- Dose: 25-50 mcg IV prn; Info: for pts undergoing cardiovascular surgery
renal dosing
- [see below]
- renal impairment: consider decr. usual dose
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised