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Alfentanil

    Brands

    DEA Class; Rx

    Common Brand Names; Alfenta, Rapifen

    • Synthetic, Opioids; 
    • Opioids, Anilidopiperidine

    Alfentanil is a synthetic opiate agonist primarily used in anesthesia, especially in settings where hemodynamic stability is critical (e.g., cardiovascular surgery). Fentanyl is 5-8 times more potent than alfentanil, but alfentanil has a faster onset and shorter duration of action.

    Indicated for use during general anesthesia induction and general anesthesia maintenance.

    For procedural sedation or monitored anesthesia care sedation in the sedated, responsive, and spontaneously breathing patient.

    Hypersensitivity

    Increased intracranial pressure

    Severe respiratory depresssion

    Arrhythmia (14%)

    Bradycardia (14%)

    Chest wall rigidity (17%)

    Hypertension (18%)

    Nausea (28%)

    Vomiting (18%)

    Tachycardia (12%)

    Apnea (3-9%)

    Blurred vision (1-3%)

    Dizziness (3-9%)

    Hypotension (10%)

    Post-op respiratory depression (1-3%)

    Skeletal muscle movements (3-9%)

    Postoperative sedation (1-3%)

    Sweating, flushing

    Warmness of the face/neck/upper thorax

    Pruritus

    urticaria

    Respiratory (undefined)

    Respiratory/circulatory depression

    Respiratory arrest

    Shock

    Cardiac arrest

    Nervous System (undefined)

    Dizziness

    Visual disturbances

    Mental clouding/depression

    Sedation

    Coma

    Euphoria

    Dysphoria

    Weakness

    Faintness

    Agitation

    Restlessness

    Nervousness

    Seizures

    GI (undefined)

    Nausea

    Vomiting

    Constipation

    Cardiovascular (undefined)

    QT-interval prolongation

    Severe cardiac arrhythmias

    Cardiac arrest

    ST segment elevation

    VTach

    MI

    Angina pectoris

    Syncope

    Genitourinary (undefined)

    Urinary retention

    Oliguria

    Cholinergic (undefined)

    Bradycardia

    Dry mouth

    Palpitation

    Tachycardia

    Use caution in bradycardia, compromised cardiac reserve, head injury, hypothyroidism, increased ICP, intracranial lesions, renal impairment, respiratory impairment, obesicty, history of drug abuse

    Concurrent administration of benzodiazepine or neuromuscular blocker will decrease chest wall rigidity

    Should be administered by trained individuals

    In patients who may be susceptible to intracranial effects of CO2 retention (e.g., those with evidence of increased intracranial pressure or brain tumors), therapy may reduce respiratory drive, and resultant CO2 retention can further increase intracranial pressure; monitor such patients for signs of sedation and respiratory depression, particularly when initiating therapy; opioids may obscure clinical course in a patient with a head injury; avoid the use in patients with impaired consciousness or coma

    May cause spasm of sphincter of Oddi; opioids may cause increases in serum amylase; monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms

    Therapy may increase frequency of seizures in patients with seizure disorders and in other clinical settings associated with seizures; monitor patients for worsened seizure control during therapy

    Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome; available data in pregnant women are insufficient to inform a drug-associated risk for major birth defects and miscarriage

    Lactation: use with caution

    Adults

    The maximum dosage is dependent on indication for therapy.

    Elderly

    The maximum dosage is dependent on indication for therapy.

    Adolescents

    The maximum dosage is dependent on indication for therapy.

    Children

    Safe and effective use has not been established.

    Alfentanil hydrochloride

    injectable solution: Schedule II

    • 0.5mg/mL

    Dose should be calculated based on ideal body weight