Remifentanil

Trade name

Remifentanil (AFT), Remifentanil (Viatris)

Presentation and preparation

Vial size (powder volume)	Fluid to add	Volume to add	Resulting concentration
1 mg (negligible)	Water for injections	1 mL	1 mg/mL
2 mg (negligible)	Water for injections	2 mL	1 mg/mL
5 mg (negligible)	Water for injections	5 mL	1 mg/mL

Reconstitute to 1 mg/mL for IV administration. Shake well.

IV administration

Give undiluted or dilute to 20 to 250 microgram/mL and give over at least 1 minute.

Continuous infusions should be diluted to 20 to 250 microgram/mL.

IV doses should be administered into tubing as close to the venous cannula site as possible. After a dose is given or at the end of an infusion, the line should be removed or cleared using a compatible fluid administered at the same rate.

Do not flush line after administration; a sufficient amount of remifentanil may be present in the dead space of the IV line and/or cannula to cause respiratory depression, apnoea and muscle rigidity if the line is flushed.

Other routes of administration

IM: Not recommended.

SC: Not recommended.

Compatible IV fluids

Remifentanil 250 microgram/mL or weaker:

Glucose 5%

Glucose 5% and sodium chloride 0.9%

Sodium chloride 0.9%

Y-site only and remifentanil 250 microgram/mL or weaker:

Hartmann’s

Potassium chloride 20 mmol/L

Additional information

For use in theatre or intensive care settings only.

Use only when facilities for cardiac monitoring and cardio-respiratory resuscitation exist.

Rapid administration may cause skeletal muscle and chest wall rigidity. Use with caution in patients less than 1 year of age.

Monitor respiratory rate, sedation and blood pressure.

Concomitant use of CNS depressants (e.g. parenteral benzodiazepines, IM olanzapine) increases the risk of respiratory depression, sedation, coma and death.

Taper the infusion slowly when discontinuing treatment; abrupt discontinuation may increase risk of withdrawal effects.