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sufentanil
generic
Black Box Warnings .
Addiction, Abuse, and Misuse
opioid agonist Schedule II controlled substance with 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 patients for misuse, abuse, and addiction
Respiratory Depression
serious, life-threatening, or fatal cases may occur even with recommended use, especially during tx start or after dose incr; to decr. risk, initiate and titrate dose appropriately
Risks from Concomitant Use with Benzodiazepines, CNS Depressants
concomitant opioid use with benzodiazepines or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death; reserve concomitant use for patients with inadequate alternative tx options
CYP450 3A4 Interaction
concomitant use with CYP450 3A4 inhibitors or D/C of concomitant CYP450 3A4 inducers may incr. opioid concentration which may incr. or prolong adverse effects including potentially fatal respiratory depression; monitor patients receiving any concomitant CYP450 3A4 inhibitor or inducer
Adult Dosing .
Dosage forms: INJ
general anesthesia
- [8-30 mcg/kg/total dose IV x1]
- Max: 30 mcg/kg/procedure; Info: for intubated and ventilated patients; may give supplemental dose 0.5-10 mcg/kg/dose IV prn
general anesthesia adjunct
- [anesthesia duration 1-2h]
- Dose: 1-2 mcg/kg/total dose IV x1; Info: for intubated and ventilated patients; may give 75% or more of total dose prior to intubation, then 10-25 mcg IV prn; may give as continuous infusion up to 1 mcg/kg/h
- [anesthesia duration 2-8h]
- Dose: 2-8 mcg/kg/total dose IV x1; Info: for intubated and ventilated patients; may give 75% or more of total dose prior to intubation, then 10-50 mcg IV prn; may give as continuous infusion up to 1 mcg/kg/h
analgesia, obstetric
- [10-15 mcg epidurally x1]
- Max: 3 doses; Info: may repeat dose x2 no more frequently than q1h; give with 10 mL bupivacaine 0.125% with or without 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
- [<12 yo]
- Dose: 10-25 mcg/kg/dose IV x1; Info: for intubated and ventilated patients undergoing cardiovascular surgery; may give supplemental dose up to 25-50 mcg IV prn
renal dosing
- [see below]
- renal impairment: consider decr. usual dose
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised