Drug reference

Alfentanil

Opioid Analgesic · Analgesic

Also known as Alfentanil hydrochloride, Rapifen

Opioid AnalgesicAnalgesic

CDSCO approvedSchedule X

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

AcetaminophenSevereTextbookHarrison 22e · p98-99
AzolesSevereTextbookHarrison 22e · p1742
BarbituratesSevereTextbookKDT 7e · p401
BenzodiazepinesSevereTextbookKDT 7e · p383

Mechanism

Alfentanil is an opioid analgesic. It exerts its effects by acting as an agonist primarily at mu-opioid receptors in the central nervous system, which modulates pain perception and emotional response to pain.

Indications

Intra-operative analgesiaEnhancement of anaesthesia at inductionanalgesia during perioperative period

Dosing

Adult: Initial bolus intravenous injection for analgesia and enhancement of anaesthesia at induction: Initially 0.25–1 microgram/kg, dose to be administered over at least 30 seconds. If patient is to be intubated more than 8 minutes after start of intravenous infusion, initial bolus intravenous injection dose is not necessary.
Renal adjustment: Avoid use or reduce dose; opioid effects are increased and prolonged, and increased cerebral sensitivity occurs.
Hepatic adjustment: Manufacturer advises caution; dose reduction and cautious titration are advised.

Pharmacokinetics

Bioavailability

—

Protein binding

92 ± 2%

Excretion

<1%

Side effects

Common

Apnoeachillsfatiguehypertensionmovement disordersmuscle rigidityprocedural complicationsnauseavomitingpruritus

Serious

Coma
hiccups
hypercapnia
pain
post procedural complications
respiratory disorders
Agitation
crying
epistaxis
vascular pain
Cardiac arrest
cough
fever
loss of consciousness
seizure
Potentially fatal respiratory depression

Pregnancy & lactation

Lactation

Present in milk—withhold breastfeeding for 24 hours.

Drug interactions

Acetaminophen

Severe

Textbook

Acetaminophen-related hepatotoxicity, a significant cause for liver failure.

Many practitioners have moved away from opioid-acetaminophen combination analgesics to avoid the risk of excessive acetaminophen exposure.

Source: Harrison 22e · p98-99

Azoles

Severe

Textbook

Increased plasma levels of alfentanil.

Source: Harrison 22e · p1742

Barbiturates

Severe

Textbook

Exaggerated CNS depression.

Source: KDT 7e · p401

Benzodiazepines

Severe

Textbook

Marked depression of respiration, cardiac contractility, and blood pressure.

Carefully monitor respiratory and cardiovascular functions when co-administering benzodiazepines with opioids due to increased risk of severe depression of vital signs.

Source: KDT 7e · p383

Chlordiazepoxide Hydrochloride

Severe

Textbook

Increased rates of accidental overdose and death.

Caution is advised, especially for patients with a history of drug abuse.

Source: G&G 14e

Clomethiazole

Severe

Textbook

Increased rates of accidental overdose and death.

Caution is advised, especially for patients with a history of drug abuse.