Products
Alfentanil is commercially available as a solution for injection (Rapifen). It has been approved in many countries since 1983.
Structure and properties
Alfentanil (C21H32N6O3, Mr = 416.5 g/mol) is a 4-anilidopiperidine and a tetrazole derivative. It is present in the drug as alfentanil hydrochloride, a white powder that is readily soluble in water. The active ingredient is structurally related to fentanyl.
Effects
Alfentanil (ATC N01AH02) has analgesic, depressant, and anesthetic properties. The effects are due to binding to opioid receptors. Compared with fentanyl, the onset of action is rapid and lasts for a shorter time.
Indications
As an analgesic for anesthesia.
Dosage
According to the SmPC. The drug is administered intravenously.
Abuse
Alfentanil can be abused as a euphoric intoxicant. Therefore, its sale is strictly regulated and the drug is subject to narcotics legislation.
Contraindications
- Hypersensitivity
- Obstructive respiratory diseases
- Respiratory depression without ventilation
Full precautions can be found in the drug label.
Interactions
Alfentanil is metabolized by CYP3A4 and corresponding interactions have been described. Other drug-drug interactions are possible with central depressant drugs, alcohol, MAO inhibitors, and propofol.
Adverse effects
The most common possible adverse effects include nausea and vomiting. Other common adverse effects include:
- Apnea
- Euphoria
- Low blood pressure, drop in blood pressure, high blood pressure, slow or fast heartbeat.
- Motor disturbances, dizziness, dullness, movement disorders.
- Fatigue, chills, pain at the injection site.
- Muscle stiffness
- Visual disturbances: Blurred vision, double vision
In case of overdose, there is a risk of respiratory depression. This should be treated with oxygen and an opioid antagonist such as naloxone.
