REMIFENTANIL HYDROCHLORIDE

Manufacturer: Hikma Pharmaceuticals USA Inc.

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