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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Remifentanil - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Remifentanil">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2023/12/15">
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<meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK501253/">
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<meta name="citation_keywords" content="REMIFENTANIL">
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<meta name="citation_keywords" content="Remifentanyl">
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<meta name="citation_keywords" content="Remifentanil [INN:BAN]">
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<meta name="citation_keywords" content="UNII-P10582JYYK">
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<meta name="citation_keywords" content="P10582JYYK">
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<meta name="citation_keywords" content="DEA No. 9739">
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<meta name="citation_keywords" content="GI 87084X">
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<meta name="citation_keywords" content="HSDB 8377">
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<meta name="citation_keywords" content="4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester">
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<meta name="citation_keywords" content="1-Piperidinepropanoic acid, 4-(methoxy-carbonyl)-4-((1-oxopropyl)phenylamino)-, methyl ester">
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<meta name="citation_keywords" content="4-(methoxycarbonyl)-4-((1-oxopropyl)phenylamino)-1-piperidinepropanoic acid methyl ester">
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<meta name="DC.Title" content="Remifentanil">
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<meta name="DC.Date" content="2023/12/15">
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<meta name="description" content="Because the half-life of remifentanil is extremely short, it is unlikely to cause any adverse effects in the breastfed newborn if it is given to the mother for labor analgesia or a surgical procedure. Maternal use of opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. If remifentanil is required by the mother of a newborn, it is not a reason to discontinue breastfeeding; however, once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of remifentanil to a few days with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Because no information is available on the use of remifentanil during breastfeeding, an alternate drug may be preferred if the mother requires prolonged administration of remifentanil during the early postpartum period.">
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<meta name="og:description" content="Because the half-life of remifentanil is extremely short, it is unlikely to cause any adverse effects in the breastfed newborn if it is given to the mother for labor analgesia or a surgical procedure. Maternal use of opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. If remifentanil is required by the mother of a newborn, it is not a reason to discontinue breastfeeding; however, once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of remifentanil to a few days with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Because no information is available on the use of remifentanil during breastfeeding, an alternate drug may be preferred if the mother requires prolonged administration of remifentanil during the early postpartum period.">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501253_"><span class="title" itemprop="name">Remifentanil</span></h1><p class="fm-aai"><a href="#_NBK501253_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 2 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 132875-61-7</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/135049469" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135049469" alt="image 135049469 in the ncbi pubchem database" /></a><div id="LM385.Drug_Levels_and_Effects"><h2 id="_LM385_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM385.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Because the half-life of remifentanil is extremely short, it is unlikely to cause any adverse effects in the breastfed newborn if it is given to the mother for labor analgesia or a surgical procedure. Maternal use of opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. If remifentanil is required by the mother of a newborn, it is not a reason to discontinue breastfeeding; however, once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of remifentanil to a few days with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Because no information is available on the use of remifentanil during breastfeeding, an alternate drug may be preferred if the mother requires prolonged administration of remifentanil during the early postpartum period.</p></div><div id="LM385.Drug_Levels"><h3>Drug Levels</h3><p>Remifentanil is administered intravenously and has a half-life of about 3 minutes in adults. Its oral bioavailability is unknown.</p><p><i>Maternal Levels.</i> Relevant published information was not found as of the revision date.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM385.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Four mothers who were breastfeeding their infants received remifentanil as part of their general anesthesia for surgical procedures. All patients also received intravenous propofol and rocuronium, and inhaled xenon as part of the anesthesia. They were given doses of remifentanil that targeted a serum concentration of 4.5 mcg/L during the procedure and reduced to achieve a target concentration of 1.5 mcg/L at the end of anesthesia. Individual infants were first breastfed as follows: 1.5 hours, 2.8 hours, 4.6 hours, and 5 hours after extubation. No signs of sedation were observed in any of the infants.[1]</p></div><div id="LM385.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Narcotics can increase serum prolactin.[2,3] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed.</p><p>A double-blind, randomized study compared patient-controlled intravenous (IV) analgesia with remifentanil (n = 43) to a continuous meperidine infusion (n = 45) for labor analgesia. Patients receiving remifentanil used an average total dosage of 1035 mcg/kg and those receiving meperidine received an average total dosage of 150 mg/kg. Breastfeeding difficulties were experienced in 6.3% of the infants of mothers who received remifentanil and 12.8% of infants whose mothers received meperidine; however, this difference was not statistically significant.[4]</p></div><div id="LM385.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p><a href="/books/n/lactmed/LM330/?report=reader">Acetaminophen</a>, <a href="/books/n/lactmed/LM339/?report=reader">Butorphanol</a>, <a href="/books/n/lactmed/LM356/?report=reader">Fentanyl</a>, <a href="/books/n/lactmed/LM360/?report=reader">Hydromorphone</a>, <a href="/books/n/lactmed/LM142/?report=reader">Ibuprofen</a>, <a href="/books/n/lactmed/LM370/?report=reader">Morphine</a></p></div><div id="LM385.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM385.REF.1">Stuttmann
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R, Schafer
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C, Hilbert
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P, et al.
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The breast feeding mother and xenon anaesthesia: Four case reports. Breast feeding and xenon anaesthesia.
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BMC Anesthesiol
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2010;10:1.
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[<a href="/pmc/articles/PMC2837001/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2837001</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20167123" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20167123</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM385.REF.2">Tolis
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G, Dent
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R, Guyda
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H. Opiates, prolactin, and the dopamine receptor.
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J Clin Endocrinol Metab
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1978;47:200-3.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/263291" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 263291</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM385.REF.3">Frecska
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E, Perenyi
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A, Arato
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M. Blunted prolactin response to fentanyl in depression. Normalizing effect of partial sleep deprivation.
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Psychiatry Res
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2003;118:155-64.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/12798980" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12798980</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM385.REF.4">Evron
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S, Glezerman
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M, Sadan
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O, et al.
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Remifentanil: a novel systemic analgesic for labor pain.
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Anesth Analg
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2005;100:233-8.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/15616083" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15616083</span></a>]</div></dd></dl></dl></div></div><div id="LM385.Substance_Identification"><h2 id="_LM385_Substance_Identification_">Substance Identification</h2><div id="LM385.Substance_Name"><h3>Substance Name</h3><p>Remifentanil</p></div><div id="LM385.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>132875-61-7</p></div><div id="LM385.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Analgesics, Opioid</p><p>Narcotics</p><p>Anesthetics, Intravenous</p><p>Opiates</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501253_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">December 15, 2023</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Remifentanil. [Updated 2023 Dec 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/remdesevir/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/remimazolam/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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