Delving into the Latest Updates on Remifentanil Hydrochloride with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Afentanil, Aruchiba, Remifentanil

+ [16]

Target

μ opioid receptor

Action

agonists

Mechanism

μ opioid receptor agonists(Mu opioid receptor agonists)

Therapeutic Areas

Nervous System DiseasesOther Diseases

Active Indication

PainAnesthesia

Inactive Indication

AnalgesiaHyperalgesiaSedation

Originator Organization

Abbott Laboratories

Active Organization

GSK PlcAbbott Laboratories (Philippines), Inc.Janssen Pharmaceutical KK

+ [2]

Inactive Organization

Air Liquide Santé (International) SA

License Organization-

Drug Highest PhaseApproved

First Approval Date

United States (12 Jul 1996),

Anesthesia

Regulation-

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Structure/Sequence

Molecular FormulaC20H29ClN2O5

InChIKeyWFBMIPUMYUHANP-UHFFFAOYSA-N

CAS Registry132539-07-2

JOURNAL/mgres/04.03/01612956-202606000-00005/figure1/v/2025-08-20T112310Z/r/image-tiff Low-flow anesthesia aims to minimize anesthetic gas consumption while maintaining adequate anesthesia. To examine the effects of minimal-flow anesthesia on perioperative lung dynamics and postoperative pulmonary function tests, a prospective, randomized controlled study was conducted between October 2023 and March 2024 at Atatürk University. A total of 66 patients (15 males, 45 females) with confirmed American Society of Anesthesiologists (ASA) grade I–II, aged 18–65 years, and scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomized into two groups: MeFA (medium flow anesthesia, 2 L/min fresh gas flow) and MiFA (minimal flow anesthesia, 0.5 L/min fresh gas flow). In both groups, dynamic compliance values, peak inspiratory pressure (PIP) values, total inhalation anesthetic drug consumption, total remifentanil drug consumption, duration of anesthesia, duration of surgery, and spirometry test results were recorded. Respiratory measurements were recorded at the 5th minute after intubation (T1), 5th (T2), 10th (T3), 30th (T4), and 60th (T5) minutes after surgical incision and immediately after the surgical suturing (T6) pulse. There was no significant difference in compliance or PIP values between the groups from T1 to T5 (P > 0.05). However, at T6, the MeFA group exhibited a significant decrease in compliance and an increase in PIP compared with the MiFA group (P < 0.05). Additionally, significant differences in compliance and PIP values were found across all time intervals compared with those at T1, except for the T5–6 compliance values in the MiFA group (P < 0.001). No significant difference in respiratory function test values was noted between the groups (P > 0.05). The MiFA group exhibited a relatively milder reduction in compliance values and a lesser elevation in PIP values. Compared with medium-flow anesthesia, minimal-flow anesthesia may help mitigate perioperative lung function deterioration. These findings suggest potential benefits in preserving lung mechanics, warranting further research. This trial was registered at clinicaltrials.gov (identifier No. NCT06055335, registered March 25, 2023).

01 Apr 2026·JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL ANALYSIS

Integrated metabolomics and transcriptomics reveal biomarkers for detecting fentanyl analog abuse through machine learning

Article

Author: Hu, Meng ; Wang, Tao ; Kai, Zixiang ; Gao, Rui ; Wei, Zhiwen ; Cui, Haiyan ; Zhou, Xiaoxue ; Yun, Keming ; Su, Hongliang ; Yang, Rongyu ; Chen, Zhe ; Hao, Bo ; Qu, Tingli

Fentanyl analogs' (FA) rampant proliferation causes widespread abuse, fatalities, and severe social issues globally. Their high toxicity, rapid metabolism, and poor detectability make them a major anti-drug challenge. This study aimed to establish an accurate method for identifying their abuse. Firstly, a rat model of FA (fentanyl, remifentanil, and sufentanil) abuse was constructed using the conditioned place preference (CPP) paradigm. Subsequently, dual-platform (Liquid and Gas Chromatography - High Resolution Mass Spectrometry) based metabolomic and transcriptomic data were used for weighted gene co-expression network analysis (WGCNA) and trait-module correlation analysis, key genes and metabolites associated with overall FA abuse were identified. Thirdly, we established a FA abuse identification model (100 % accuracy, AUC=1) based on 31 metabolites and 12 hub genes. Finally, we established an accurate classification model of different FA (77.27 % accuracy; AUCs: 1, 1, 0.981, 0.979 for control/fentanyl/remifentanil/sufentanil groups) using ten genes and five metabolites. The identified biomarkers and computational models offer valuable tools for clinical diagnosis and drug regulation, which are critical for addressing the ongoing opioid crisis.

01 Mar 2026·JOURNAL OF CLINICAL ANESTHESIA

From fast track to enhanced recovery after Cardiac surgery: 15 years of experience with the Leipzig concept in a specialized post-anesthesia care unit

Article

Author: Zakhary, Waseem ; Flo Forner, Anna ; Holzhey, David ; Otto, Wolfgang ; Borger, Michael A ; Meineri, Massimiliano ; Ender, Joerg Karl

BACKGROUND:

Enhanced Recovery After Cardiac Surgery (ERACS) has become the standard of care for selected patients. This study evaluated the evolution of the Leipzig concept in a specialized postanaesthesia care unit (PACU) over 15 years, with a focus on temporal trends and clinical outcomes.

METHODS:

A retrospective cohort study was conducted on patients admitted to PACU after cardiac surgery at the Heart Center Leipzig between November 2005 and December 2020. Postoperative outcomes, including postprocedural complications, hospital length of stay, delirium, and mortality, were recorded. The outcomes were analyzed via multivariable models, and the adjusted results are reported.

RESULTS:

Among 56,371 cardiac surgery patients, 42% (n = 23,724) were admitted to the PACU and managed according to the ERACS protocol. After excluding incomplete datasets, 20,773 patients were analyzed. Utilization increased from 19% in 2006 to 60% in 2020. Despite a rising proportion of moderate- and high-complexity surgeries, in-hospital mortality has remained stable. Improved adherence to the ERACS components, including the integration of a delirium prevention bundle, was associated with significant reductions in postoperative delirium (p = 0.02) and in-hospital mortality (p = 0.007). Patients treated with sufentanil exhibited significantly lower in-hospital mortality than did those receiving remifentanil (p = 0.005). Subgroup analyses revealed higher in-hospital mortality in patients with EuroSCORE II ≥6%, complex procedures, and age ≥ 75 years (p < 0.001, p = 0.04, and p < 0.001, respectively).

CONCLUSIONS:

This study presents the largest collection of consecutive ERACS patients ever collected and demonstrates the safety and efficacy of ERACS management with a specialized PACU, highlighting the benefits of continuous protocol optimization.

20

News (Medical) associated with Remifentanil Hydrochloride

11 Sep 2025

·www.drugs.com

No Adverse Neurodevelopmental Effects Seen From Inhaled Anesthesia in Children Under 2

THURSDAY, Sept. 11, 2025 -- For children younger than 2 years undergoing surgery , no adverse neurodevelopmental effects are seen with the addition of dexmedetomidine and remifentanil to sevoflurane anesthesia versus sevoflurane alone, according to a study published online Sept. 9 in Anesthesiology . Sang-Hwan Ji, M.D., Ph.D., from Seoul National University Hospital in the Republic of Korea, and colleagues conducted a prospective, double-blind, randomized clinical trial including children younger than 2 years undergoing nonstaged, nonrepetitive surgeries to examine whether the combination of dexmedetomidine and remifentanil had any differential effect on neurodevelopmental outcomes compared to sevoflurane alone. Participants received dexmedetomidine and remifentanil as adjuncts to sevoflurane (DEX-R group; 176 children) or sevoflurane alone (control group; 169 children). Using the Korean Leiter International Performance Scale and the Child Behavior Checklist, neurodevelopmental status was examined at 28 to 30 months. The researchers found that the groups had no difference in the mean anesthesia duration. Compared with the control group, the DEX-R group had a significantly lower mean end-tidal sevoflurane concentration (1.8 versus 2.6 percent; P < 0.001). The mean full-scale IQ score was 102.5 ± 11.5 and 103.6 ± 11.5 in the DEX-R and control groups, respectively (P = 0.442). The Child Behavior Checklist total score did not differ significantly between the groups. "These findings support existing evidence suggesting that brief anesthetic exposure is unlikely to result in clinically significant neurodevelopmental impairment," the authors write. Abstract/Full Text

Clinical ResultClinical Study

09 Apr 2025

·www.echemi.com

Viatris to Pay Up to $335 Million Over Nine Years to Settle Opioid Claims

Viatris has agreed to pay up to $335 million over a nine-year period as part of a nationwide settlement addressing claims from U.S. state and local governments regarding the company’s alleged role in the opioid crisis. The Pennsylvania-based pharmaceutical firm, established through the 2020 merger of Mylan and Pfizer’s Upjohn division, has not admitted to any wrongdoing in connection with this agreement. Under the terms of the settlement, Viatris will contribute between $27.5 million and $40 million annually to support state and local opioid initiatives. New York Attorney General Letitia James, a key figure in the negotiation process, emphasized the importance of this settlement, stating, “While no settlement can fully repair the damage caused by dangerous opioids, these funds will help New York and other states fight the opioid crisis.” Viatris markets opioid products, including the painkiller Ultiva and the Fentanyl Transdermal System, a generic version of Johnson & Johnson’s Duragesic patch. The company is among several pharmaceutical manufacturers accused by state and local governments of downplaying the risks associated with opioid medications. This settlement contributes to the more than $50 billion already secured from various drugmakers, distributors, and pharmacies implicated in the opioid epidemic. Notably, in January, Purdue Pharma and its owners, the Sackler family, reached a $7.4 billion settlement to resolve numerous lawsuits related to their pain medication OxyContin, which has been widely blamed for initiating the crisis. According to the Centers for Disease Control and Prevention, opioid-related overdoses claimed over 80,000 lives in 2023, contributing to a total of 700,000 deaths over the past two decades. This settlement underscores the ongoing efforts to address the devastating impact of the opioid epidemic and hold pharmaceutical companies accountable for their roles in the crisis.

Patent Infringement

14 Mar 2025

·www.echemi.com

5 Key Updates on China's Fentanyl Control Amid US Tariffs

On February 1st, the United States announced a 10% tariff on products imported from China, citing concerns over the fentanyl crisis. In response, a spokesperson from the Ministry of Public Security emphasized that China maintains one of the strictest drug control policies in the world. As a signatory to the three UN drug control conventions, China has consistently upheld its international obligations and actively collaborates with countries, including the US, on drug enforcement efforts. In 2019, China took a humanitarian step by becoming the first country to classify all fentanyl-related substances under stringent controls, responding to US requests. Since this classification, China has not received reports of these substances being seized in the US. On March 12th, the National Medical Products Administration (NMPA) shared insights regarding China's management of fentanyl substances through a recently released white paper. The spokesperson addressed concerns about the production and export of fentanyl-related pharmaceuticals. Currently, four fentanyl-related drugs are approved for clinical use in China: fentanyl, sufentanil, remifentanil, and alfentanil. Three companies have been authorized to produce raw materials, while five are permitted to manufacture formulations. In 2024, China produced 100 kilograms of fentanyl raw materials, primarily for domestic medical use and export, with only 12.3 kilograms exported to countries like South Korea, Vietnam, and the Philippines. Notably, China has never exported fentanyl products to North America. All fentanyl-related drugs in China are classified as controlled narcotics, subjected to stringent regulations. The production and distribution of these drugs are closely monitored, with specific companies designated for manufacturing and fixed sales channels established. Export controls require permits, and international verification ensures the legality of trade before issuing export licenses. The NMPA will continue to enhance the supervision of fentanyl-related drug production and strictly regulate exports to prevent illegal channels and misuse, ensuring that medical needs are met responsibly.

Drug Approval

100 Deals associated with Remifentanil Hydrochloride

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External Link

KEGG	Wiki	ATC	Drug Bank
D01177	Remifentanil Hydrochloride	N01AH06	DB00899

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Pain	Switzerland	GSK Plc	28 Jan 1997
Anesthesia	United States	Mylan Institutional LLC	12 Jul 1996

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Analgesia	Phase 3	Germany	GSK Plc	01 Nov 2006
Sedation	Phase 3	Germany	GSK Plc	01 Nov 2006
Hyperalgesia	Phase 1	Germany	Air Liquide Santé (International) SA	01 Jan 2012

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Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT02527083 (CTgov)	Phase 4	Anesthesia \| Hernia \| Acute Pain ... View more	10	Propofol+Ketamine (TIVA-K)	ysphlvvhai(kbhoqjaxgt) = rkcugbudnz fqfecsdowl (fiarsnsqkn, 2.1) View more	-	31 Dec 2025
				Propofol+Remifentanil (TIVA-R)	ysphlvvhai(kbhoqjaxgt) = spnxykdcie fqfecsdowl (fiarsnsqkn, 0) View more
NCT02703090 (CTgov)	Not Applicable	Pain \| Anesthesia	44	Normal saline (Placebo)	xaxrvzlzdv(fkjytgkiql) = eidsawulnb jzuegzuucd (crztrsaopu, 0.032) View more	-	15 Dec 2025
				Remifentanil (Drug lower dose)	xaxrvzlzdv(fkjytgkiql) = xkzjnmsaem jzuegzuucd (crztrsaopu, 0.021) View more
NCT05279898 (PATHFINDERII, CTgov)	Not Applicable	Cognitive Dysfunction \| Pain \| Emergence Delirium	70	dexmedetomidine+EEG Monitoring+Ropivacaine+Propofol+Rocuronium+Ketamine+Remifentanil (Multimodal General Anesthesia (MMGA Bundle) - EEG Guided)	xgcggaucku(qrbthqcwdj) = nvevotgpyl hztvjsxcjx (sdghjnbhoa, 28.5) View more	-	26 Nov 2025
				Dexmedetomidine+fentanyl+Hydromorphone+Acetaminophen+Oxycodone+Propofol+Sevoflurane+Lidocaine (Standard of Care/Control)	xgcggaucku(qrbthqcwdj) = gesfpyftdp hztvjsxcjx (sdghjnbhoa, 79.9) View more
NCT06096181 (CTgov)	Phase 2	Analgesia \| Idiopathic scoliosis \| Spinal fusion ... View more	13	Propofol TIVA+Remifentanil TIVA (Propofol + Remifentanil)	xrwjdlnjsz(tyqkpgskyo) = vsfwiwcvqm brhlfzbqyp (aakojdaigd, yaatrmlcff - lfhcygvenk) View more	-	10 Nov 2025
				Dexmedetomidine TIVA+Propofol TIVA (Propofol + Dexmedetomidine)	xrwjdlnjsz(tyqkpgskyo) = ufjcicdbns brhlfzbqyp (aakojdaigd, hizsnfmvnj - cwxejcsynq) View more
NCT05026125 (OBEREM, Pubmed \| Anaesth Crit Care Pain Med)	Phase 4	Obesity	50	Remifentanil 3 μg kg-1 + Remifentanil 3 μg kg-1	zeetkxppzq(qhszibcrzh) = hhypwwoska dblslbtheg (tgtvgwwvlb )	Positive	01 Nov 2025
NCT04364945 (Pubmed \| Anesthesiology)	Not Applicable	-	343	Dexmedetomidine and Remifentanil as adjuncts to Sevoflurane	sthpwlazqm(uxqlunzuqk) = No significant difference was observed between groups zvrwmhiadv (xydwvwoown )	Positive	01 Oct 2025
				Sevoflurane alone
NCT05391555 (CTgov)	Phase 2/3	Opioid-Related Disorders \| Miosis \| Respiratory Insufficiency	10	Pupillometry measurement+Remifentanil Hydrochloride	nzmfstcjzq = gzxnpbgcsa icgmitexbd (oufhcnagdx, tblpsgufqy - avlidducom) View more	-	02 May 2025
NCT02898792 (Pubmed \| Br J Anaesth)	Early Phase 1	Sleep Apnea, Obstructive	-	remifentanil (Adult volunteers without OSA)	jophgdbmse(oxxezbafkx) = yjzleqqdyc vwjuqfbfeh (qnwaztstjo ) View more	Positive	01 Mar 2025
				remifentanil (Adult volunteers with untreated OSA)	jophgdbmse(oxxezbafkx) = vptslulkzq vwjuqfbfeh (qnwaztstjo ) View more
NCT04734418 (Pubmed \| J Intensive Care) Manual	Not Applicable	-	179	Remifentanil	ywldbufrnt(rimewsyvhf) = vhosvnumyi izqqyejcux (hhnaxfuacw ) View more	Negative	18 Sep 2024
				Dexmedetomidine	ywldbufrnt(rimewsyvhf) = kkflfxojjp izqqyejcux (hhnaxfuacw ) View more
NCT02631135 (CTgov)	Phase 4	-	40	Propofol+Rocuronium+Remifentanil (Group 1 (TIVA))	erdouvkoli(qkmvbsubma) = zthilydggs smsfyxzovz (muasmddpax, 1.31) View more	-	17 May 2024
				Dexmedetomidine+Propofol+Rocuronium+Remifentanil (Group 2 (TIVA+D))	erdouvkoli(qkmvbsubma) = pkromeydkz smsfyxzovz (muasmddpax, 1.19) View more