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.
Available strengths
- inj 0.05 mg/mL
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.
Cost
Sufentanil (SUFENTA)
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 0.05 mg/mL | inj | per unit | not offered |
NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Sufentanil is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.
⚠ BOXED WARNINGS
- Addiction, abuse and misuse
- Life-threatening respiratory depression
- Risk from concomitant use with benzodiazepines
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityRespiratory depression and chest-wall rigidity