Remifentanil is a pain medication used to initiate and maintain anesthesia (anesthesia). As part of the anesthetic process, this drug will be used with other drugs, such as propofol, midazolam, or thiopenthal.

Remifentanil is an opioid class of pain medication that works by blocking the flow of pain signals in the brain which will then affect the body's response to pain. Remifentanil will be given by a doctor or medical officer at the hospital. This drug is available in injectable dosage forms of 1 mg, 2 mg, and 5 mg.

Remifentanil trademark: Remikaf

What is Remifentanil

class Prescription drug
Category Opioid painkillers
Benefit As an anti-pain drug in the process of anesthesia (anesthesia)
Used by Adults and seniors
Remifentanil for pregnant and lactating women Category C: Animal studies have shown an adverse effect on the fetus, but there have been no controlled studies in pregnant women.

Drugs should only be used if the expected benefit outweighs the risk to the fetus.

Remifentanil is not known to be absorbed into breast milk or not. If you are breastfeeding, do not use this medicine without consulting your doctor first.

Drug form Inject

Warning Before Using Remifentanil

Remifentanil should only be used in a hospital and will be given directly by a doctor. The following are some things that must be considered before using remifentanil:

  • Tell your doctor about any history of allergies you have. Remifentanil should not be given to patients who are allergic to this drug or to fentanyl.
  • Tell your doctor if you are taking or have recently been taking monoamine oxidase inhibitors ( MAOIs ), such as selegiline. Remifentanil should not be given to patients who are currently or have recently been treated with this drug.
  • Remifentanil will be given in the hospital, follow the doctor's recommendations before, during and after the injection. Monitoring of the patient's condition will be carried out periodically.
  • Tell your doctor if you have ever abused drugs or were addicted to alcohol .
  • Tell your doctor if you have chronic obstructive pulmonary disease ( COPD ), asthma, sleep apnea , heart disease, bradycardia , low blood pressure, benign enlargement of the prostate gland ( BPH ), inflammation of the pancreas, thyroid disease , seizures, liver disease , or kidney disease .
  • Tell your doctor if you have a condition that can increase intracranial pressure , such as a brain tumor or head injury .
  • Tell your doctor if you are taking certain medications, supplements or herbal products.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
  • Tell your doctor right away if you experience an allergic drug reaction , more serious side effects, or an overdose after injecting remifentanil.

Dosage and Rules for Using Remifentanil

Remifentanil will be given by a doctor. The dosage will be determined according to the condition and purpose of using the drug. In general, the following are the dosages of remifentanil as a pain medication for induction and maintenance of general anesthesia :

  • Initial dose before intubation 1 mcg/kg/BB. The dose for induction of anesthesia is 0.5–1 mcg/kgBW per minute.
  • The maintenance dose during general anesthesia is 0.25–0.5 mcg/kg per minute.
  • An additional dose to increase the pain relief effect during anesthesia can be given 0.5-1 mcg/kg every 2-5 minutes.

For elderly patients, remifentanil will be given starting at the lowest dose, then the dose can be added if needed.

How to Use Remifentanil Properly

Remifentanil injection will be given by a doctor or medical personnel under the supervision of a doctor at the hospital. Remifentanil will be injected directly through a vein (intravenous/IV).

The doctor will monitor the patient's breathing, blood pressure, oxygen levels, and kidney function while taking remifentanil. Follow all doctor's recommendations before, during, or after the remifentanil injection so that the effectiveness of the treatment is maximized.

Remifentanil Interactions with Other Drugs

The following are a number of interactions that may occur when using remifentanil together with other drugs:

  • Increased risk of developing hypotension , severe sedation, respiratory depression, coma, even death when used with benzodiazepines , sedatives, antipsychotics, neuromuscular blocking drugs, or antixiolytics
  • Increased risk of serotonin syndrome when used with antidepressant drugs, such as monoamine oxidase inhibitors (MAOIs) or selective serotonin reuptake inhibitors (SSRIs)
  • Reducing the effectiveness of remifentanil can even trigger withdrawal symptoms if used with other opioid painkillers, such as butorphanol , nalbuphine, or buprenorphine.

Remifentanil Side Effects and Dangers

Some of the side effects that can occur after using remifentanil are:

  • Breath slows down
  • Slow or irregular heartbeat
  • Nausea or vomiting
  • Low or even high blood pressure
  • Shiver
  • Dizziness or severe tiredness
  • Muscles feel stiff
  • Low blood pressure
  • Disorders of the bile ducts

Your doctor will monitor your condition before, during and after the remifentanil injection. Report to your doctor if side effects persist or an allergic drug reaction occurs after using remifentanil.

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