Select a medication above to begin.
Ultiva
remifentanil
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
Adult Dosing .
Dosage forms: INJ
general anesthesia adjunct
- [induction]
- Dose: 0.5-1 mcg/kg/min IV; Info: give with hypnotic or volatile agent; may give initial 1 mcg/kg/dose IV x1 if intubation occurs <8min after infusion start; decr. dose by 50% in patients >65 yo; use ideal body wt in obese patients
- [maintenance]
- Dose: 0.05-2 mcg/kg/min IV; Info: give with nitrous oxide, isoflurane, or propofol; may incr. dose by 25-100% q2-5min, or decr. dose by 25-50% q2-5min; may give supplemental bolus 1 mcg/kg/dose IV q2-5min; give 0.125-4 mcg/kg/min IV and 0.5-1 mcg/kg/dose IV q2-5min in patients undergoing CABG; decr. start dose by 50% in patients >65 yo; use ideal body wt in obese patients; taper dose gradually to D/C
postop anesthesia care adjunct
- [0.025-0.2 mcg/kg/min IV]
- Start: 0.1 mcg/kg/min IV; Info: for continuation of analgesia into the immediate postop period; may adjust dose by 0.025 mcg/kg/min IV q5min; give 0.05-1 mcg/kg/min IV in patients undergoing CABG; decr. start dose by 50% in patients >65 yo; use ideal body wt in obese patients; taper dose gradually to D/C
monitored anesthesia care adjunct
- [single dose]
- Dose: 0.5-1 mcg/kg/dose IV x1; Start: 90sec before local or regional anesthetic block; decr. dose by 50% in patients >65 yo; use ideal body wt in obese patients
- [continuous infusion]
- Dose: 0.05-0.2 mcg/kg/min IV; Start: 0.1 mcg/kg/min IV 5min before local or regional anesthetic block, then decr. to 0.05 mcg/kg/min IV after anesthetic block placement; Info: may adjust dose by 0.025 mcg/kg/min IV q5min; decr. start dose by 50% in patients >65 yo; use ideal body wt in obese patients; taper dose gradually to D/C
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ
general anesthesia adjunct
- [maintenance, 0-2 mo]
- Dose: 0.4-1 mcg/kg/min IV; Info: give with nitrous oxide; may incr. dose by up to 50% q2-5min, or decr. dose by 25-50% q2-5min; may give supplemental bolus 1 mcg/kg/dose IV q2-5min; use ideal body wt in obese patients; taper dose gradually to D/C
- [maintenance, 1-12 yo]
- Dose: 0.05-1.3 mcg/kg/min IV; Info: give with halothane, sevoflurane, or isoflurane; may incr. dose by up to 50% q2-5min, or decr. dose by 25-50% q2-5min; may give supplemental bolus 1 mcg/kg/dose IV q2-5min; use ideal body wt in obese patients; taper dose gradually to D/C
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]