Remifentanil

Remifentanil is an opioid medication that is used to manage or prevent pain during and after surgery or other medical procedures.

Remifentanil may also be used for reasons not mentioned in this medication guide.

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH.

You should not be treated with remifentanil if you are allergic to it.

Tell your doctor if you have ever had:

• breathing problems, sleep apnea;
• a head injury, brain tumor, or seizure;
• problems with your gallbladder or pancreas;
• alcoholism or drug addiction;
• if you have recently used alcohol, sedatives, tranquilizers, or other opioid medications; or
• if you have taken an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine.

Receiving remifentanil during late pregnancy may cause side effects in the newborn baby, including severe drowsiness and breathing problems. Your baby's breathing, blood pressure, oxygen levels, and other vital signs will be watched closely.

Ask a doctor before using opioid medicine if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue-colored lips, or if you are hard to wake up.

Your caregivers will watch for any side effects you have, such as:

• shallow breathing, breathing that stops during sleep;
• fast or slow heart rate;
• stiff muscles;
• low blood pressure (severe weakness, feeling light-headed); or
• serotonin syndrome—agitation, hallucinations, fever, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, diarrhea.

Serious breathing problems may be more likely in older adults and in those who are weak or have wasting syndrome or chronic breathing disorders.

Common side effects of remifentanil may include:

• slow breathing;
• slow heart rate;
• muscle stiffness; or
• low blood pressure.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH.

Remifentanil is injected into a vein by a healthcare provider.

Remifentanil is usually given through an infusion connected to pump that will release the correct dose of the medication to provide continuous pain relief during and after your surgery.

Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely.

You may be given other pain medications to use after your remifentanil treatment is discontinued. Keep using these medicines for as long as your doctor has prescribed.

In a medical setting, it is unlikely that you will miss a dose.

A remifentanil overdose can be fatal. Symptoms of an overdose may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.

In a medical setting, an overdose would be treated quickly.

Do not drink alcohol for at least 24 hours after your surgery. Dangerous side effects or death could occur.

Avoid driving or hazardous activities until you know how remifentanil will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Many other drugs can be dangerous when used with opioid medicine. Tell your doctor if you also use:

• other opioid medicines;
• a benzodiazepine sedative like Valium, Klonopin, or Xanax;
• sleep medicine, muscle relaxers, or other drugs that make you drowsy; or
• drugs that affect serotonin, such as antidepressants, stimulants, or medicine for migraines or Parkinson's disease.

This list is not complete. Many drugs may affect remifentanil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.