Sufentanil

Mechanism of action

• Opioid analgesic (strong)
• Analgesic properties are based mostly on its selective agonism to the μ-opioid receptor (MOR) which is crucial for transmission of information about pain throughout the central nervous system. These receptors are located mostly in brainstem and thalamus.
• It is five to ten times more potent than fentanyl and is the most potent opioid in clinical practice, posing a high risk of apnea with bolus administration.

Indications and dose

Pharmacokinetics

Onset of action: 2–3 minutes

Duration of action: Dependant on the dose; 30–60 minutes 

Half-life of elimination: 2-3 hours

Metabolism: Hepatic, small intestine

Elimination: Kidneys (75 %), liver

Directions for administration

Dosage should be individualized.

Administer by slow intravenous injection or infusion.

Medicinal forms

Solution for Injection/Infusion 

• 5 μg/ml, 1 vial = 2 ml (10 μg), 5 ml (25 μg), 10 ml (50 μg)
• 50 μg/ml, 1 vial = 1 ml (50 μg)

Sublingual tablets – 15 μg, 30 μg

Side-effects

Respiratory Depression

Muscle rigidity

CNS depression

Cardiovascular depression

Serotonin syndrome

Nausea, vomiting

Seizures

Reversal

Rapid reversal may be achieved with Naloxone.

See more about it in Naloxone list.

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References

1. Sufentanil: Uses, Interactions, Mechanism of Action | DrugBank Online
2. Sufentanil: Package Insert / Prescribing Information - Drugs.com
3. SUFENTA® (SUFENTANIL CITRATE INJECTION, USP) (nih.gov)
4. Sufenta (sufentanil) dosing, indications, interactions, adverse effects, and more (medscape.com)
5. Sufenta (Sufentanil Citrate Injection): Uses, Dosage, Side Effects, Interactions, Warning (rxlist.com)