Remifentanil (rem-i-FEN-ta-nil)

Relieves pain during and after surgery or other medical procedures.

Brand Name(s):

Ultiva, Ultiva Novaplus

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.
• Some medicines can affect how remifentanil works. Tell your doctor if you are using any of the following:
  • Benzodiazepine medicine
  • Medicine to treat anxiety, depression, or mental health problems (including mirtazapine, trazodone, SNRIs, SSRIs, TCAs)
  • Triptan medicine to treat migraine headaches
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. Tell your doctor if you are using buprenorphine, butorphanol, nalbuphine, pentazocine, tramadol, or a muscle relaxer (including cyclobenzaprine, metaxalone).

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have heart disease, breathing or lung problems, diabetes, gallbladder problems, pancreas problems, or a history of seizures, head injury, or brain tumor. Tell your doctor if you have been addicted to drugs or alcohol.
• This medicine may cause the following problems:
  • High risk of overdose, which can lead to death
  • Respiratory depression (serious breathing problem that can be life-threatening)
  • Worsening of pain
  • May increase risk for muscle rigidity or movement
  • Serotonin syndrome (when used with certain medicines)
• This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up carefully.
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blue lips, fingernails, or skin
• Extreme dizziness or weakness, shallow breathing, slow or uneven heartbeat, sweating, cold or clammy skin, seizures
• Severe confusion, lightheadedness, dizziness, fainting
• Shaking, fast or pounding heartbeat, trembling, hunger
• Stiffness in the muscles of your neck, chest, hands, or legs
• Trouble breathing
• Twitching or muscle movements you cannot control
• Worsening of pain, increased sensitivity to pain

If you notice these less serious side effects, talk with your doctor:

• Pain, itching, burning, swelling, or lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088