Sufentanil
SUFENTA
What it isHighly potent mu agonist; anesthesia and neuraxial analgesia.
Why this oneIts potency and lipid solubility suit epidural and intrathecal use in tiny doses.
What limits itRespiratory depression, delayed after neuraxial use. Chest wall rigidity; Schedule II.
FDA-approved for
- anesthesia (1984)
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Addiction, abuse, and misuse; life-threatening respiratory depression; risks from concomitant benzodiazepine/other CNS depressant use; neonatal opioid withdrawal syndrome with prolonged use in pregnancy.
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Analgesia / anesthesia adjunct (IV) | Adults | 1-2 mcg/kg IV | individualized | |
| Labor and delivery (epidural) | Adults | 10-15 mcg with 10 mL bupivacaine 0.125% ± epinephrine |
Renal Undefined
Hepatic Undefined
Instructions
- Administer only by persons trained in IV/epidural anesthetics and management of respiratory effects of potent opioids.
- Ensure opioid reversal agent (naloxone/nalmefene), resuscitation/intubation equipment, and oxygen are readily available.
- Use a tuberculin syringe for accurate small-volume dosing.
Cautions
- Life-threatening respiratory depression (chronic pulmonary disease; elderly/cachectic/debilitated)
- Skeletal muscle rigidity and movement
- Severe cardiovascular depression
- Opioid-induced hyperalgesia and allodynia
- MAOIs due to risk of serotonin syndrome
- Increased ICP / head injury / brain tumors
Adverse reactions
- Apnea
- Rigidity
- Bradycardia
- Pruritus
- Respiratory depression
- Hypotension
Pregnancy Insufficient data; prolonged use may cause neonatal opioid withdrawal syndrome; not recommended during/immediately before labor.
Lactation Monitor infant for excess sedation and respiratory depression; withdrawal can occur if breastfeeding/opioid stopped.
⚠ BOXED WARNINGS
- Addiction, abuse and misuse
- Life-threatening respiratory depression
- Risk from concomitant use with benzodiazepines
Classes and tags
Clinical profile
Mechanism of action: Sufentanil ballicule
