Alfentanil (intravenous route)


    Description

    Alfentanil injection is given together with other medicines to relieve pain during surgery. It is also used as a primary anesthesia (numbing medicine) for patients undergoing general surgery.

    This medicine is to be given only by or under the direct supervision of a doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of alfentanil injection in children 12 years of age and older. However, safety and efficacy have not been established in children younger than 12 years of age.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of alfentanil injection in the elderly. However, elderly patients may be more sensitive to the effects of alfentanil injection than younger adults, and are more likely to have age-related kidney, liver, heart, or lung problems, which may require caution and an adjustment in the dose for patients receiving alfentanil injection.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Levoketoconazole
    • Naltrexone
    • Safinamide
    • Samidorphan

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Acepromazine
    • Adagrasib
    • Alefacept
    • Almotriptan
    • Alprazolam
    • Amifampridine
    • Amineptine
    • Amiodarone
    • Amitriptyline
    • Amitriptylinoxide
    • Amobarbital
    • Amoxapine
    • Amphetamine
    • Amprenavir
    • Anileridine
    • Aprepitant
    • Aripiprazole
    • Armodafinil
    • Asciminib
    • Asenapine
    • Atazanavir
    • Avacopan
    • Baclofen
    • Belzutifan
    • Benperidol
    • Benzhydrocodone
    • Benzphetamine
    • Berotralstat
    • Boceprevir
    • Bosentan
    • Bromazepam
    • Bromopride
    • Brompheniramine
    • Buprenorphine
    • Bupropion
    • Buspirone
    • Butalbital
    • Butorphanol
    • Calcium Oxybate
    • Cannabidiol

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Propofol

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Alcohol abuse, or history of or
    • Brain tumor or
    • Breathing or lung problems (eg, apnea, COPD, cor pulmonale, respiratory depression, sleep apnea) or
    • Drug dependence, especially with narcotics, or history of or
    • Head injury, history of—May increase risk for more serious side effects.
    • Gallbladder problems or
    • Heart disease or
    • Hypotension (low blood pressure) or
    • Pancreatitis (inflammation of the pancreas) or
    • Seizures, history of or
    • Slow heartbeat—Use with caution. May make these conditions worse.
    • Kidney disease or
    • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins.


    Precautions

    Your doctor will check your progress closely while you or your child are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it.

    This medicine may cause allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

    Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with alfentanil may worsen the side effects of this medicine, such as dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

    This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). Your doctor may decrease your dose if you have sleep apnea (stop breathing for short periods during sleep) while using this medicine.

    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.

    Tell your doctor if you or your child have stiffness in the muscles of your neck, chest, hands, or legs after receiving this medicine.

    Call your doctor right away if you have worsening of pain, increased sensitivity to pain, or new pain after taking this medicine. These may be symptoms of opioid-induced hyperalgesia and allodynia.

    Check with your doctor right away if you or your child have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

    This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

    Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

    Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Blurred vision
    • chest pain or discomfort
    • confusion
    • difficult or trouble breathing
    • dizziness
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • fainting
    • fast, slow, pounding, or irregular heartbeat or pulse
    • headache
    • irregular, fast or slow, or shallow breathing
    • lightheadedness, dizziness, or fainting
    • nervousness
    • not breathing
    • pale or blue lips, fingernails, or skin
    • pounding in the ears
    • sweating
    • unusual tiredness or weakness

    Rare

    • Chest tightness
    • cough
    • noisy breathing
    • rigid muscles of the neck, arms, and legs

    Incidence not known

    • Agitation
    • cough
    • darkening of the skin
    • diarrhea
    • difficulty with swallowing
    • fainting
    • fever
    • hives, itching, or skin rash
    • increased sensitivity to pain
    • loss of appetite
    • nausea
    • overactive reflexes
    • poor coordination
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • restlessness
    • shivering
    • sweating
    • talking or acting with excitement you cannot control
    • trembling or shaking
    • twitching
    • vomiting
    • worsening of pain

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Drowsiness
    • sleepiness

    Rare

    • False or unusual sense of well-being

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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






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