Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Opioid (Ultra-Short-Acting)

Remifentanil

Brand names: Ultiva

Remifentanil is an ultra-short-acting synthetic opioid used for analgesia during anaesthesia and for sedated, ventilated patients in intensive care.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a potent selective mu-opioid receptor agonist; its ester structure is rapidly broken down by non-specific blood and tissue esterases, giving a very short context-insensitive half-life.

Prescribing in practice

  • It causes dose-dependent respiratory depression and apnoea and must be given only by infusion with airway, ventilation and resuscitation support immediately available.
  • Because its effect dissipates within minutes of stopping, alternative analgesia must be planned before the infusion ends to avoid severe rebound pain.
  • It commonly causes bradycardia, hypotension and muscle rigidity, and its metabolism is independent of hepatic and renal function.

Monitoring

Continuous monitoring of respiration, oxygenation, heart rate and blood pressure is essential throughout the infusion.

Counselling the patient

  • This is a very short-acting opioid given by trained anaesthetic or critical-care staff.
  • Ensure ongoing pain relief is arranged before the infusion is discontinued.

Evidence & guidelines

Its pharmacology and use as an infusion-only opioid in anaesthesia and critical care are well established and described in the SPC.

Reference: Miller's Anesthesia; AAGBI TCI Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways