The total dose of all opioid agonists administered should be considered by the practitioner before ordering opioid analgesics during recovery from anesthesia.Certain forms of conduction anesthesia, such as spinal anesthesia and some epidural anesthetics, can alter respiration by blocking intercostal nerves Patients with significant chronic obstructive pulmonary disease or cor pulmonale, and those with a substantially decreased respiratory reserve, hypoxia, hypercapnia, or pre-existing respiratory depression are at increased risk of decreased respiratory drive including apnea, even at recommended dosages of Sufentanil Citrate Injection. Rare reports of bradycardia associated with the concomitant use of succinylcholine and sufentanil have been reported.When benzodiazepines or other CNS depressants are used with Sufentanil Citrate Injection, pulmonary arterial pressure may be decreased. Kava Kava: May enhance the adverse/toxic effect of CNS Depressants.Lacosamide: Bradycardia-Causing Agents may enhance the AV-blocking effect of Lacosamide. Je dostupný v 2ml a 10ml ampulkách v baleních 5 x 2 ml, 5 x 10 ml, 10 x 10 ml, 20 x 10 ml SUFENTANIL TORREX 50 mikrogramů/ml. In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in sufentanil plasma concentration.

Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects.Physical dependence results in withdrawal symptoms after abrupt discontinuation or a significant dosage reduction of a drug. Management: Avoid coadministration of siponimod with drugs that may cause bradycardia.Sodium Oxybate: May enhance the CNS depressant effect of CNS Depressants. Physical dependence may not occur to a clinically significant degree until after several days to weeks of continued opioid usage.Acute overdose with Sufentanil Citrate Injection can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, and, in some cases, pulmonary edema, bradycardia, hypotension, partial or complete airway obstruction, atypical snoring, and death.

Tofacitinib: May enhance the bradycardic effect of Bradycardia-Causing Agents.Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem. These mechanisms increase pain threshold, alter pain perception, inhibit ascending pain pathways; short-acting opioid; dose-related inhibition of catecholamine release (up to 30 mcg/kg) controls sympathetic response to surgical stress.Primarily hepatic and small intestine via demethylation and dealkylation Urine (2% excreted as unchanged drug; 80% metabolites) within 24 hoursAnalgesia: IV: 1 to 3 minutes; Epidural: 10 minutes; Sublingual tablets: ~30 minutes (Fisher 2018)IV: Context-sensitive half-time and recovery varies depending on dose, duration of administration, concomitant anesthesia, and other clinical factors (Miller 2015).Epidural: 10 to 15 mcg with bupivacaine 0.125%: 1.7 hours.IV: Neonates: 7.2 ± 2.7 hours; Infants and Children (2 to 8 years): 97 ± 42 minutes; Adolescents 10 to 15 years: 76 ± 33 minutes; Adults: 164 minutesNeonates: 79%; Adults: 91% to 93%; primarily to alpha 1-acid glycoproteinLimitations of use: Reserve for use in patients for whom alternative treatment options (eg, nonopioid analgesics, opioid combination products) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.

If combined, limit the dosages and duration of each drug.Conivaptan: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).CYP3A4 Inducers (Strong): May decrease the serum concentration of SUFentanil.CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4 Substrates (High risk with Inhibitors).CYP3A4 Inhibitors (Strong): May increase the serum concentration of SUFentanil. Flunitrazepam: CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs.Magnesium Sulfate: May enhance the CNS depressant effect of CNS Depressants.Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine.

Lisuride Maleate: May enhance the CNS depressant effect of CNS Depressants.Lofexidine: May enhance the CNS depressant effect of CNS Depressants. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion.Opioid Agonists: CNS Depressants may enhance the CNS depressant effect of Opioid Agonists.

This could result in serotonin syndrome. Onset was rapid (within 10 minutes). The hemodynamic effects and degree of skeletal muscle relaxation required should be considered in the selection of a neuromuscular blocking agent. PHENobarbital may decrease the serum concentration of SUFentanil. Management: If a strong CYP3A4 inhibitor is initiated in a patient on sufentanil, consider a sufentanil dose reduction and monitor for increased sufentanil effects and toxicities (eg, respiratory depression).Desmopressin: Opioid Agonists may enhance the adverse/toxic effect of Desmopressin. When combined use is needed, consider minimizing doses of one or more drugs. Use non-CNS depressant alternatives when available.Fosaprepitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).Fosnetupitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).Gastrointestinal Agents (Prokinetic): Opioid Agonists may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). May also be administered as a continuous infusion.Oral: Sublingual tablet: Administer by a health care provider in a certified medically supervised health care setting only. Onset, duration, and severity depend on the drug used, duration of use, maternal dose, and rate of drug elimination by the newborn.

Select one or more newsletters to continue. Monitor for symptoms of hypotension following initiation or dose titration. Close monitoring for CNS depressant effects is necessary.Levodopa-Containing Products: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Containing Products. ]Distributed by Hospira, Inc., Lake Forest, IL 60045 USADistributed by Hospira, Inc., Lake Forest, IL 60045 USADistributed by Hospira, Inc., Lake Forest, IL 60045 USAProtect from light. Specifically, the risk for constipation and urinary retention may be increased with this combination.Aprepitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors).Azelastine (Nasal): CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal). The respiratory depression involves both a reduction in the responsiveness of the brain stem respiratory centers to increases in carbon dioxide tension and to electrical stimulation.Sufentanil causes miosis, even in total darkness. Management: Avoid use of sufentanil and primidone when possible.