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

Globally, we are approaching 1 million surgical procedures each day. Tracheal intubation is the mainstay of securing the patient's airway and breathing during general anaesthesia. Approximately 100.000 tracheal intubations are performed annually in Denmark. Airway management remains the primary reason for anaesthesia-related morbidity and mortality. It has been traditionally accepted that best tracheal intubation conditions are obtained by paralysing the patient's muscles, including vocal cords, using a neuromuscular blocking agent (NMBA) such as rocuronium. However, using NBMA may increase the risk of pulmonary complications, intra-operative awareness, in which the patient is paralysed but awake during surgery, anaphylaxis, and re-intubation. In addition, there is a risk of residual neuromuscular blockade postoperatively. In the US, prolonged ventilation and unplanned intubation are the top two most costly perioperative complications. An alternative to NMBA is a large dose of opioids to depress laryngeal reflexes during intubation. The most commonly used non-NMBA modality includes bolus administration of remifentanil. However, remifentanil may cause bradycardia and hypotension. Even short periods of hypotension have been shown to increase the risk of myocardial injury and other serious adverse events such as renal failure, delirium, and even mortality.
Evidence also indicates that intubation conditions using only opioids to facilitate intubation, including remifentanil, are inferior to NMBA. However, these trials are underpowered to assess effects on patient-important outcomes and are mostly at high risk of bias. A recent trial has suggested that remifentanil intubation conditions may not be very different. Almost all existing research comparing NMBA to opioids has focused on intubation conditions for direct laryngoscopy using a conventional Macintosh laryngoscopy blade. In recent years, the implementation and availability of the video laryngoscope have grown exponentially and become universal. The video laryngoscope has vastly improved the ease of tracheal intubation, and the number of failed intubations has decreased by two-thirds in Denmark, where a rapid implementation of the video laryngoscope took place. However, limited evidence exists on whether NMBA improves intubation conditions compared to remifentanil when performing video laryngoscope-assisted tracheal intubation.

Start Date01 Jun 2025

Sponsor / Collaborator-

CTRI/2025/04/084898

/ Not yet recruitingNot Applicable

Comparison of Effects of Remifentanil and Fentanyl on Hemodynamic Response to Endotracheal Intubation in Patients undergoing Elective Surgeries under General Anesthesia A Prospective Randomised Control Double Blinded Study. - NIL

Start Date01 May 2025

Sponsor / Collaborator-

ChiCTR2500098772

/ SuspendedPhase 4IIT

Comparison of efficacy and safety of Afentanil, oxelidine fumarate, Sufentanil combined with etomidate and propofol in painless gastroscopy

Start Date15 Apr 2025

Sponsor / Collaborator-

100 Clinical Results associated with Remifentanil Hydrochloride

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100 Translational Medicine associated with Remifentanil Hydrochloride

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100 Patents (Medical) associated with Remifentanil Hydrochloride

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9,476

Literatures (Medical) associated with Remifentanil Hydrochloride

01 Aug 2025·JOURNAL OF CRITICAL CARE

Analgosedation practice during noninvasive respiratory supports: Results from an Italian survey

Article

Author: Spinazzola, G ; Ball, L ; Giarratano, A ; Grieco, D L ; Ferrone, G ; Cammarota, G ; Cortegiani, A ; Misseri, G ; Maggiore, S M ; Patroniti, N ; Cabrini, L ; Antonelli, M ; Spadaro, S ; Gregoretti, C ; Cinnella, G ; Grasso, S ; Conti, G

PURPOSE:

There are currently no established guidelines pertaining the application of analgosedation strategies for patients undergoing Noninvasive Respiratory Supports (NRSs) for acute respiratory failure treatment. The Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) conducted a nation-wide survey to describe the current clinical practice in the management of analgosedation during NRSs.

METHODS:

This is a nationwide online survey, involving Italian anesthesiologist-intensivists, developed by experts affiliated with SIAARTI. Invitations to participate were distributed via emails and social networks. Data were collected over a period of three months (March 16 to May 10, 2024).

RESULTS:

Two hundred and seventy-seven full responses were collected. Most respondents were attending physician (83 %), with <10 years of ICU experience (56 %) and work in ICU medical department (75 %). In terms of optimizing the NRS success, 80 % of respondents used a pharmacological strategy and 50 % of respondents did not use a non-pharmacological strategy. Dexmedetomidine was the most commonly administered drug (82 %), followed by morphine and remifentanil. Additionally, 33 % of respondents reported using a combination of dexmedetomidine and remifentanil as part of their pharmacological strategy during NRSs. Concerning the motivations for analgosedation use during NRSs, over 80 % of respondents aimed to improve patient-ventilator interaction, more than 60 % focused on reducing patient anxiety and dyspnea, 59 % sought for having a lower respiratory rate, and only 40 % prioritized pain reduction.

CONCLUSION:

Sedation is frequently used in patients with acute respiratory failure undergoing NRSs. Current analgesic practices are becoming more standardized, with analgosedation strategies increasingly tailored to individual patient characteristics.

01 Aug 2025·NEUROPHARMACOLOGY

Aged mice exhibit faster acquisition of intravenous opioid self-administration with variable effects on intake

Article

Author: Sharpe, Amanda L ; Liter, Laci R ; Donohue, Darius ; Beckstead, Michael J ; Stout, Michael B ; Vangeneugden, Patricia ; Carter, Kelsey A ; Weaver, Sofia M

Although opioid abuse is more prevalent in young individuals, the rates of opioid use, overdose, and use disorders continue to climb among the elderly. Little is known about the biology underlying abuse potential in a healthy, aged population, in part due to technical and logistical difficulties testing intravenous self-administration in aged rodents. The goal of this study was to address a critical gap in the literature regarding age-dependent effects in opioid (remifentanil and fentanyl) self-administration. Male and female C57Bl/6J and C57Bl/6NJ mice were divided into young (mean: 19 weeks) and old (mean: 101 weeks) groups and were trained to self-administer intravenous fentanyl or remifentanil in daily operant sessions. Acquisition, intake, and cue-responding after forced abstinence were measured for both drugs, and a dose-response curve and dose-escalation were conducted for remifentanil and fentanyl, respectively. Surprisingly, old mice learned to self-administer both remifentanil and fentanyl faster and more accurately than young mice. Baseline intake of remifentanil was also greater in old mice compared to the young group; however, we did not see increased intake of fentanyl with age at either dose tested. Furthermore, old mice showed greater responding for cues previously associated with remifentanil after a forced abstinence, but this result was not observed with fentanyl. This first report of opioid self-administration in greater than 20-month-old mice suggests that old mice have an increased vulnerability for opioid use compared to younger counterparts, underscoring the importance of future work to uncover the biological mechanisms that are responsible.

01 Jun 2025·Intensive and Critical Care Nursing

The comparison of pupillometry to standard clinical practice for pain and preemptive analgesia before endotracheal suctioning: A randomized controlled trial

Article

Author: Perez-Francisco, Ines ; Vallejo-De-la-Cueva, Ana ; López-de-Audícana-Jimenez-de-Aberasturi, Yolanda ; Bermudez-Ampudia, Cristina ; Parraza-Diez, Naiara ; Bengoetxea-Ibarrondo, Miren Begoña

BACKGROUND:

Pain during endotracheal aspiration (ETA) is frequent in critically ill patients. Managing pre-emptive analgesia before procedures remains a crucial aspect of care. We compared pupillometry to standard clinical practice for assessing preemptive-analgesia administration and pain before ETA according to Behavioural Pain Scale (BPS), the Behavioural Pain Indicator Scale (ESCID), and the Pupillary Dilation Reflex (PDR).

TRIAL DESIGN:

A multicentre parallel-group, controlled trial with balanced (1:1) randomization.

METHODS:

Sedated, mechanically ventilated patients aged ≥ 18 with baseline BPS = 3, ESCID = 1, and RASS scores between -1 and -4 were included.

CONTROL GROUP:

preemptive-analgesia was administered according to nurse criteria. In the experimental group, preemptive analgesia was administered in patients with PDR ≥ 11.5 % after a 20 mA stimulus measured using AlgiScan®. The preemptive analgesia was fentanyl one µg/kg iv bolus. We used the Chi-square statistic to compare post-intervention pain according to BPS, ESCID, and PDR pain values. A multivariate logistic regression study adjusting for sex, BIS, RASS, APACHE II, remifentanil, and preemptive analgesia was conducted.

RESULTS:

Ninety-two patients were studied, 51 in control groups and 41 in intervention groups. Pain incidence was lower in the experimental group. Significantly, 43.9 % of patients in the experimental group were prescribed preemptive analgesia before ETA compared to 19.6 % in the control group (p = 0.03). Multivariate analysis showed significant reductions in pain in the group that received preemptive-analgesia before ETA guided by pupillometry across BPS [OR = 0.34 (95 % CI: 0.12-0.99), p = 0.048], ESCID [OR = 0.29 (95 % CI: 0.09-0.88), p = 0.030] and PDR [OR = 0.27 (95 % IC: 0.08-0.86), p = 0.027] compared to standard clinical practice.

CONCLUSIONS:

Preemptive analgesia monitored with pupillometry group had a lower percentage of patients with pain than those who received analgesia based on standard clinical practice. This effect was independent of the sex, patient severity, BIS score, remifentanil use, or preemptive- analgesia.

IMPLICATIONS FOR CLINICAL PRACTICE:

The requirement for preemptive analgesia before aspiration, evaluated through routine clinical practice, was lower than detected by pupillometric monitoring of patients. The use of pupillometry to monitor preemptive analgesia reduced pain after secretion aspiration. Pupillometry would be an effective tool to individualize the need for preemptive analgesia before potentially painful interventions, applicable to all patients regardless of sex, severity, or sedation level.

17

News (Medical) associated with Remifentanil Hydrochloride

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

06 Mar 2025

·www.drugs.com

Intraoperative Remifentanil, Sufentanil Tied to Poor Postoperative Pain Experience

THURSDAY, March 6, 2025 -- For patients undergoing elective surgery , intraoperative use of remifentanil and sufentanil is independently associated with a poorer postoperative pain experience, according to a study published online Feb. 25 in Regional Anesthesia & Pain Medicine . Axel Maurice-Szamburski, M.D., Ph.D., from the University Hospital Centre Nice Pasteur Hospital in France, and colleagues conducted an exploratory secondary analysis using data from 971 adults undergoing elective surgery under general anesthesia across five hospitals to identify factors associated with poor postoperative pain experience. Patient experience measured by the Evaluation du Vécu de l'Anesthésie Generale questionnaire on postoperative day 1 was the primary end point. The researchers found that 27.9 percent of patients reported poor pain experience. Intraoperative use of remifentanil and sufentanil was identified as an independent predictor of poor pain experience in a multivariate analysis. Age, absence of premedication, and orthopedic surgery were associated with a significantly lower likelihood of poor pain experience. In contrast, predictors of poor pain experience included American Society of Anesthesiologists 3 status, postoperative anxiolytic use, amnesia, higher visual analog scale pain, and lower well-being scores on day 1. "These findings underscore the need to reassess intraoperative analgesic strategies to reduce postoperative complications and improve patient care," the authors write. "Further research is required to confirm these associations and to develop optimized perioperative pain management protocols focused on enhancing patient outcomes."

Clinical Result

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

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT05391555 (CTgov)	Phase 2/3	Opioid-Related Disorders \| Miosis \| Respiratory Insufficiency	10	Pupillometry measurement+Remifentanil Hydrochloride	zzwahdncdh = etqumswmya wctpujqale (srlazotuss, zmsouxdjhx - ckhadnuxyo) View more	-	02 May 2025
NCT02898792 (Pubmed \| Br J Anaesth)	Early Phase 1	Sleep Apnea, Obstructive	-	remifentanil (Adult volunteers without OSA)	ggemlbcudy(izaxazupcc) = muxmjadtqk gqsfpgvwqp (nuxyflwdvp ) View more	Positive	01 Mar 2025
				remifentanil (Adult volunteers with untreated OSA)	ggemlbcudy(izaxazupcc) = pmjigofzsf gqsfpgvwqp (nuxyflwdvp ) View more
NCT04734418 (Pubmed \| J Intensive Care) Manual	Not Applicable	-	179	Remifentanil	fzomcxlnil(owdfnwihlj) = xnmbpsanxs lgutbukqfn (ksnuuucapg ) View more	Negative	18 Sep 2024
				Dexmedetomidine	fzomcxlnil(owdfnwihlj) = zbuthyalgk lgutbukqfn (ksnuuucapg ) View more
NCT02631135 (CTgov)	Phase 4	-	40	Propofol+Rocuronium+Remifentanil (Group 1 (TIVA))	rsrxvjyrfz(fnzvrbrrxt) = tqiyrxoydb bkkwcovfuc (fgdiagcols, 1.31) View more	-	17 May 2024
				Dexmedetomidine+Propofol+Rocuronium+Remifentanil (Group 2 (TIVA+D))	rsrxvjyrfz(fnzvrbrrxt) = xtkfdihxev bkkwcovfuc (fgdiagcols, 1.19) View more
NCT03207100 (Pubmed) Manual	Not Applicable	Cerebral Hemorrhage	338	remifentanil grdexmedetomidineil and dexmedetomidine)	btlkrxkzye(qgoxxriobk) = xkdqhgldqx dtffsnhpwr (ravtpcmnkd )	Positive	27 Mar 2024
				remifentanil (Control group (standard guideline-based management))	btlkrxkzye(qgoxxriobk) = mozodijtev dtffsnhpwr (ravtpcmnkd )
NCT03643796 (CTgov)	Phase 4	Intervertebral Disc Disease	32	Remifentanil (Remifentanil Group)	divialdshp = bgovfidfdb oobdgksmmp (xghwwodrwv, imdpnqgjzf - wwznoceqnm) View more	-	18 Sep 2023
				Dexmedetomidine+Ketamine (Ketamine and Dexmedetomidine Group)	divialdshp = vzinwxzytx oobdgksmmp (xghwwodrwv, wusezvyffc - zjataxehsb) View more
ChiCTR2100054565 (Pubmed \| BMC Anesthesiol)	Phase 4	-	-	Remifentanil	nytkaaqzfi(byfjbxsjeb) = which occurred in 3 patients lgphthpioa (bfviydaomo )	-	28 Jun 2023
NCT02989597 (MAPS, CTgov)	Phase 4	Pain, Postoperative	10	Spinal Fusion Surgery+Sufentanil+Methadone Hydrochloride+ketamine+Dexamethasone+Remifentanil (Intra-operative Methadone Hydrochloride)	glqvlghejv(nhwfqpbrwl) = rgbunwxmly fczbgzmpsw (jjexhuwdsa, jqagjvjsiq - vswfkzfexs) View more	-	25 Apr 2023
				Spinal Fusion Surgery+Sufentanil+ketamine+Dexamethasone+Remifentanil (Control)	glqvlghejv(nhwfqpbrwl) = gjrkfqwlgr fczbgzmpsw (jjexhuwdsa, fhfteicrzz - uvnlofxqgx) View more
NCT03283150 (CTgov)	Phase 4	Brain Diseases \| Sedation	20	Remifentanil (Remifentanil)	ixfapyajif(skdmmicueo) = rmvyemvduw xtepxmwmlg (jzskamhqsq, 0.37) View more	-	27 Mar 2023
				Propofol (Propofol)	gnqiqhwgth = erkluaxnny ctkuqrcimj (icsfekkcov, vvajzmeqxf - givjiedwqq) View more
NCT05217238 (Pubmed \| Pain Ther)	Not Applicable	Pain	-	Remifentanil (Group R1)	fkxjoorinn(domcpmkkad) = mhqgodajqj rbrpkwmmri (bdevdgeygy, 1.186 - 1.351)	-	08 Mar 2023
				Remifentanil (Group R2)	fkxjoorinn(domcpmkkad) = lxgwkdyogk rbrpkwmmri (bdevdgeygy, 1.065 - 1.324)