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Ultiva – Remifentanil (Intravenous Route)


Description and Brand Names of Ultiva – Remifentanil (Intravenous Route)

US Brand Name

  1. Ultiva


Remifentanil is used to relieve pain during and after surgery or other medical procedures. It is also used with other medicines (e.g., isoflurane, propofol, midazolam, thiopental, Diprivan®) just before or during an operation to help the anesthetic work better.

Remifentanil belongs to the group of medicines known as narcotic analgesics (pain medicines). It works by acting on the central nervous system (CNS) or brain to relieve pain.

Remifentanil is to be administered only by or under the immediate supervision of your doctor.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

  • Powder for Solution

Before Using Ultiva – Remifentanil (Intravenous Route)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of remifentanil in children when given with an anesthetic before or during an operation. However, safety and efficacy have not been established in children for the relief of pain after surgery.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of remifentanil in the elderly. However, elderly patients are more sensitive to the effects of remifentanil, which may require an adjustment in the dose for patients receiving remifentanil.



There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adinazolam
  • Alfentanil
  • Alprazolam
  • Anileridine
  • Bromazepam
  • Brotizolam
  • Butalbital
  • Carbinoxamine
  • Carisoprodol
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorzoxazone
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Codeine
  • Dantrolene
  • Diazepam
  • Estazolam
  • Ethchlorvynol
  • Fentanyl
  • Flunitrazepam
  • Flurazepam
  • Fospropofol
  • Halazepam
  • Hydrocodone
  • Hydromorphone
  • Ketazolam
  • Levorphanol
  • Lorazepam
  • Lormetazepam
  • Meclizine
  • Medazepam
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Metaxalone
  • Methocarbamol
  • Methohexital
  • Midazolam
  • Morphine
  • Morphine Sulfate Liposome
  • Nitrazepam
  • Nordazepam
  • Opium
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Prazepam
  • Propoxyphene
  • Quazepam
  • Remifentanil
  • Sodium Oxybate
  • Sufentanil
  • Tapentadol
  • Temazepam
  • Thiopental
  • Triazolam

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Perampanel

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bradycardia (slow heartbeat) or
  • Breathing or lung problems (e.g., apnea, respiratory depression) or
  • Heart rhythm problems or
  • Hypotension (low blood pressure) – Use with caution. May make these conditions worse.
  • Fentanyl allergy (e.g., Actiq®, Duragesic®, Sublimaze®), history of – Should not be used in patients with this condition.

Proper Use of Ultiva – Remifentanil (Intravenous Route)

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins.


It is very important that your doctor check your progress closely while you are receiving this medicine to see if it is working properly and to allow for a change in the dose.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or other anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are receiving this medicine.

Check with your doctor right away if you have bluish lips or skin; chest pain; difficulty with breathing; a fast, pounding, or irregular heartbeat or pulse; shortness of breath; or muscle stiffness after receiving this medicine.

Dizziness, lightheadedness, or fainting may occur with this medicine, especially when you get up from a lying or sitting position suddenly. Getting up slowly may help, but if the problem continues or gets worse, check with your doctor.

This medicine may cause constipation. This is more common if you use it for a long time. Ask your doctor if you should also use a laxative to prevent and treat constipation.

Side Effects of Ultiva – Remifentanil (Intravenous Route)

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  1. Blurred vision
  2. chest pain or discomfort
  3. confusion
  4. difficult or troubled breathing
  5. dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  6. irregular, fast or slow, or shallow breathing
  7. lightheadedness, dizziness, or fainting
  8. muscle stiffness or tightness
  9. pale or blue lips, fingernails, or skin
  10. shortness of breath
  11. slow or irregular heartbeat
  12. sweating
  13. unusual tiredness or weakness

Less common

  1. Bluish lips or skin
  2. chills
  3. decrease in cardiac output
  4. fast, pounding, or irregular heartbeat or pulse
  5. feeling of warmth
  6. fever
  7. headache
  8. nausea or vomiting
  9. nervousness
  10. not breathing
  11. pain after surgery
  12. pain in the shoulders, arms, jaw, or neck
  13. pounding in the ears
  14. problems with bleeding or clotting
  15. redness of the face, neck, arms, and occasionally, upper chest
  16. shivering


  1. Abdominal or stomach pain
  2. black, tarry stools
  3. bleeding gums
  4. blood in the urine or stools
  5. body aches or pain
  6. burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  7. congestion
  8. cough or hoarseness
  9. cough producing mucus
  10. coughing that sometimes produces a pink frothy sputum
  11. coughing up blood
  12. decreased frequency or amount of urine
  13. difficult, fast, or noisy breathing, sometimes with wheezing
  14. difficulty with swallowing
  15. disorientation
  16. dry mouth
  17. dryness or soreness of the throat
  18. dysphoria
  19. eye pain
  20. flushed, dry skin
  21. fruit-like breath odor
  22. general feeling of illness
  23. hiccups
  24. hives
  25. increased blood pressure
  26. increased hunger
  27. increased menstrual flow or vaginal bleeding
  28. increased sweating
  29. increased thirst
  30. increased urination
  31. itching
  32. loss of appetite
  33. lower back or side pain
  34. muscle cramps or pain
  35. nervousness
  36. noisy breathing
  37. nosebleeds
  38. numbness or tingling in the hands, feet, or lips
  39. painful or difficult urination
  40. pale skin
  41. paralysis
  42. pinpoint red spots on the skin
  43. prolonged bleeding from cuts
  44. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  45. rapid heartbeat
  46. red or black, tarry stools
  47. red or dark brown urine
  48. runny nose
  49. seizures
  50. shakiness in the legs, arms, hands, or feet
  51. skin rash
  52. small clicking, bubbling, or rattling sounds in the lungs when listening with a stethoscope
  53. stuffy nose
  54. swelling in the legs and ankles
  55. swelling of the face, fingers, or lower legs
  56. tender, swollen glands in the neck
  57. tightness in the chest
  58. troubled breathing with exertion
  59. unexplained weight loss
  60. unusual bleeding or bruising
  61. voice changes
  62. vomiting
  63. weakness and heaviness of the legs
  64. weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  1. Anxiety
  2. blurred or loss of vision
  3. difficulty having a bowel movement (stool)
  4. disturbed color perception
  5. double vision
  6. halos around lights
  7. hyperventilation
  8. night blindness
  9. overbright appearance of lights
  10. pain at the injection site
  11. restlessness
  12. trouble with sleeping
  13. tunnel vision


  1. Burning while urinating
  2. heartburn
  3. hives or welts
  4. loss of bladder control
  5. loss of memory
  6. nightmares
  7. problems with memory
  8. seeing, hearing, or feeling things that are not there
  9. severe constipation
  10. severe vomiting
  11. trouble with urinating
  12. uncontrolled eye movements

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.