Alfentanil

DEA Class; Rx

Common Brand Names; Alfenta, Rapifen

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.

Hypersensitivity

Increased intracranial pressure

Severe respiratory depresssion

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

The maximum dosage is dependent on indication for therapy.

The maximum dosage is dependent on indication for therapy.

The maximum dosage is dependent on indication for therapy.

Safe and effective use has not been established.