Remifentanil
Also known as: Ultiva, Remicit
**Remifentanil** is an advanced, highly potent pain medication and anesthesia adjunct used exclusively in the veterinary hospital setting. * **Why it is used**: It provides profound pain relief during surgical procedures and allows the veterinarian to use lower doses of other anesthetic gases or drugs. * **Fast Acting**: Its most unique feature is how quickly it leaves the body. Once the infusion is stopped, the drug wears off in just a few minutes. This allows your pet to wake up from anesthesia much faster and smoother. * **Organ Safe**: Because it is broken down by enzymes in the blood and tissues rather than the liver or kidneys, it is exceptionally safe for pets with pre-existing liver or kidney disease. * **Post-Op Pain**: Since remifentanil wears off so quickly, your veterinarian will administer longer-acting pain medications before your pet wakes up to ensure they remain comfortable after surgery.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- Analgesic adjunct to general anesthesia
- Analgesic adjunct to general anesthesia
- Analgesic adjunct to general anesthesia
How it is given
Possible side effects
- Respiratory depression
- Apnea
- Bradyarrhythmias
- Hypotension
- Hyperthermia (noted in cats)
- Anaphylaxis (rare)
Cautions & contraindications
- Hypersensitivity to remifentanil or other fentanyl analogs
- Epidural or intrathecal administration (contraindicated due to the presence of glycine in the formulation)
- Because of the high risk of significant **respiratory depression** (including apnea) and **bradycardia**, remifentanil must ONLY be administered in a closely monitored anesthesia care setting with intubation and mechanical ventilation capabilities. * **Administration**: Continuous infusions should strictly be administered via a calibrated syringe pump or infusion device. * **Obesity**: In morbidly obese patients, the dosage should be calculated based on ideal body weight rather than actual body weight. * **Pregnancy**: Weigh potential risks versus benefits. FDA Category C for humans. No teratogenic effects observed in limited animal studies, but fetal respiratory depression is possible.
Drug interactions
- CNS Depressants (e.g., propofol, isoflurane, thiopental): Additive CNS and respiratory depression; remifentanil significantly reduces MAC and induction agent requirements.
- Diuretics: Opiates may decrease diuretic efficacy in patients with congestive heart failure.
- Monoamine Oxidase Inhibitors (e.g., amitraz, selegiline): Severe and unpredictable opiate potentiation may occur; use is generally not recommended if an MAOI has been used within 14 days.
- Skeletal Muscle Relaxants: Remifentanil may enhance neuromuscular blockade.
- Nitrous Oxide: High doses of remifentanil combined with nitrous oxide may cause cardiovascular depression.
- Tricyclic Antidepressants (e.g., clomipramine, amitriptyline): May exacerbate the effects of tricyclic antidepressants.
- Warfarin: Opiates may potentiate anticoagulant activity.
Frequently asked questions
What is Remifentanil used for in pets?
**Remifentanil** is an advanced, highly potent pain medication and anesthesia adjunct used exclusively in the veterinary hospital setting. * **Why it is used**: It provides profound pain relief during surgical procedures and allows the veterinarian to use lower doses of other anesthetic gases or drugs. * **Fast Acting**: Its most unique feature is how quickly it leaves the body. Once the infusion is stopped, the drug wears off in just a few minutes. This allows your pet to wake up from anesthesia much faster and smoother. * **Organ Safe**: Because it is broken down by enzymes in the blood and tissues rather than the liver or kidneys, it is exceptionally safe for pets with pre-existing liver or kidney disease. * **Post-Op Pain**: Since remifentanil wears off so quickly, your veterinarian will administer longer-acting pain medications before your pet wakes up to ensure they remain comfortable after surgery.
Is Remifentanil safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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