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Ultiva

REMIFENTANIL HYDROCHLORIDE

Manufacturer: Mylan Institutional LLC

Score: 144.0

Quick Summary

Remifentanil Hydrochloride is an opioid agonist used for analgesia during the induction and maintenance of general anesthesia, as well as for continuation as an analgesic into the immediate postoperative period. It has a rapid onset and short duration of action, and is metabolized by nonspecific blood and tissue esterases. The drug is contraindicated for epidural or intrathecal administration and in patients with hypersensitivity to remifentanil. Adverse reactions include respiratory depression, bradycardia, hypotension, and skeletal muscle rigidity. Dosage recommendations vary based on the patient population and medical procedure, and special considerations are necessary for pediatric, geriatric, and pregnant patients.

Key Clinical Findings and Indications

  • Analgesia during induction and maintenance of general anesthesia
  • Continuation as an analgesic into the immediate postoperative period
  • Rapid onset and short duration of action

Important Safety Information

Warning

Addiction, Abuse, and Misuse: Remifentanil Hydrochloride exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death.

Contraindications

  • Epidural or intrathecal administration
  • Hypersensitivity to remifentanil

Adverse Reactions

  • Respiratory depression
  • Bradycardia
  • Hypotension
  • Skeletal muscle rigidity

Dosing Recommendations

General Guidance

Titrate dosage slowly in geriatric patients and those with renal or hepatic impairment.

General anesthesia

Adult Dose

0.5 to 1 mcg/kg/min

Pediatric Dose

0.25 to 1.3 mcg/kg/min (for patients 1 to 12 years old)

Postoperative analgesia

Adult Dose

0.1 mcg/kg/min

Pediatric Dose

Not recommended

Special Population Considerations

Pregnancy

  • Prolonged use may cause neonatal opioid withdrawal syndrome
  • Insufficient data to inform drug-associated risk for major birth defects and miscarriage

Nursing Mothers

  • Not specified in the provided text

Pediatric Use

  • Efficacy and safety established in pediatric patients from birth to 12 years for maintenance of general anesthesia
  • Not recommended for postoperative analgesia or monitored anesthesia care in pediatric patients

Geriatric Use

  • Starting dose should be decreased by 50% in patients over 65 years old
  • Titrate dosage slowly in geriatric patients

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