Select a medication above to begin.
remifentanil
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
Adult Dosing .
Dosage forms: INJ
analgesia, anesthesia induction adjunct
- [0.5-1 mcg/kg/min IV]
- Start: may give initial 1 mcg/kg over 30-60sec; Info: give w/ muscle relaxant to avoid chest wall rigidity; decr. start dose 50% in pts >65 yo; use IBW for start dose in obese pts
analgesia, anesthesia maint. adjunct
- [0.05-2 mcg/kg/min IV]
- Info: may give supplemental bolus 1 mcg/kg/dose; not recommended as sole agent
analgesia, postop anesthesia care adjunct
- [0.025-0.2 mcg/kg/min IV]
- Info: for continuation of analgesia into the immediate postop period
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ
analgesia, anesthesia maint. adjunct
- [0-2 mo]
- Dose: 0.4-1 mcg/kg/min IV; Start: 0.4 mcg/kg/min IV, incr. dose up to 50% or decr. dose 25-50% q2-5min to desired effect; Info: may give up to 1 mcg/kg/dose IV supplemental bolus over 30-60 sec q2-5min; given w/ nitrous oxide
- [1-12 yo]
- Dose: 0.05-1.3 mcg/kg/min IV; Start: 0.25 mcg/kg/min IV, incr dose up to 50% or decr. dose 25-50% q2-5min to desired effect; Info: may give up to 1 mcg/kg/dose IV initial or supplemental bolus over 30-60 sec q2-5min
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]