{"id":4655,"date":"2025-03-31T18:12:15","date_gmt":"2025-03-31T18:12:15","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/remifentanil-txt\/"},"modified":"2025-03-31T18:12:15","modified_gmt":"2025-03-31T18:12:15","slug":"remifentanil-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/remifentanil-txt\/","title":{"rendered":"remifentanil.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nAnalgesic Induction of anaesthesia

DOSE IN NORMAL RENAL FUNCTION <\/H3>Induction: 0.5\u20131 microgram\/kg\/min Maintenance: Ventilated patients: 0.05\u20132 mcg\/kg\/min \u2014Spontaneous respiration: 25\u2013100 \u2014nanograms\/kg\/minAnalgesia and sedation in ventilated, intensive care patients: 6\u2013740 nanograms\/kg\/minuteAdditional analgesia during painful procedures in ventilated, intensive care patients: 100\u2013750 nanograms\/kg\/minute

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :412.9 (as hydrochloride)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :70<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 95 (as metabolites)<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.35<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :3\u201310 minutes (biological activity)\/unchangedTerminal elimination
  • 10 to 20 &nbsp &nbsp : minutes

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function
  • HDF\/high flux &nbsp :Unlikely to be dialysed. Dose as in normal renal function
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Anti-arrhythmics: delayed absorption of mexiletine\n
  • Antidepressants: possible CNS excitation or depression (hypertension or hypotension) in patients also receiving MAOIs (including moclobemide) \u2013 avoid concomitant use; possibly increased sedative effects with tricyclics\n
  • Antipsychotics: enhanced sedative and hypotensive effect\n
  • Antivirals: concentration possibly increased by ritonavir (risk of toxicity) \u2013 avoidSodium oxybate: enhanced effect of sodium oxybate \u2013 avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>To 1 mg\/mL with infusion fluid

    Route <\/H4>IV

    Rate of Administration <\/H4>Dependent on indication

    Comments<\/H4>Dilute to 20\u2013250 mcg\/mL with glucose 5%, sodium chloride 0.9% or water for injection; usually 50 micrograms\/mL for general anaesthesia

    OTHER INFORMATION <\/H4>Half-life of metabolite is increased to 30 hours in renal failure compared with 90 minutes in patients with normal renal functionMetabolite is essentially inactive Remifentanil would be expected to be metabolised before patient needs to be dialysed25\u201335% of metabolites are removed by dialysis.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Analgesic Induction of anaesthesia DOSE IN NORMAL RENAL<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4655","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4655","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4655"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4655\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4655"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4655"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4655"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}