Alfentanil

Alfentanyl

Therapeutic Indications

Alfentanil is indicated for:

Analgesia, suppression of respiratory activity

Irrespective of gender only Adults (18 - 65 years old)

It is indicated for analgesia and suppression of respiratory activity in mechanically ventilated patients on intensive care and to provide analgesic cover for painful manoeuvres. It will aid compliance with mechanical ventilation, and tolerance of the endotracheal tube. Intravenous bolus doses of alfentanil (0.5 mg/ml) may be used to provide additional pain relief during brief painful procedures such as physiotherapy, endotracheal suction, etc. Despite being mechanically ventilated, patients may be awake in the presence of adequate analgesia.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Intravenous - 30 micrograms per kilogram per hour

Contraindications

Active ingredient Alfentanil is contraindicated in the following cases:

Monoamine oxidase inhibitors

No gender/age discrimination

Alfentanil is contraindicated in concurrent administration with monoamine oxidase inhibitors or within 2 weeks of their discontinuation.

Breastfeeding

No gender/age discrimination

Alfentanil may appear in breast milk. Therefore, breast-feeding or use of expressed breast milk is not recommended within 24 hours following the administration of alfentanil.

Labour

No gender/age discrimination

Alfentanil is contraindicated in labour or before clamping of the cord during Caesarian section due to the possibility of respiratory depression in the new-born infant.

Effects on ability to drive and use machines

No gender/age discrimination

No studies on the effects of alfentanil on the ability to drive and use machines have been performed.

However, where early discharge is envisaged patients should be advised not to drive or operate machinery for at least 24 hours following administration.

This medicine can impair cognitive function and can affect a patient’s ability to drive safely. This class of medicine is in the list of drugs included in regulations under 5a of the Road Traffic Act 1988. When prescribing this medicine, patients should be told:

  • The medicine is likely to affect your ability to drive.
  • Do not drive until you know how the medicine affects you.
  • It is an offence to drive while under the influence of this medicine.
  • However, you would not be committing an offence (called ‘statutory defence’) if:
    • The medicine has been prescribed to treat a medical or dental problem and
    • You have taken it according to the instructions given by the prescriber or in the information provided with the medicine and
    • It was not affecting your ability to drive safely.

Obstructive airway disease

No gender/age discrimination

Alfentanil is contraindicated in obstructive airway disease or respiratory depression if not ventilating.