Details
| Stereochemistry | ACHIRAL |
| Molecular Formula | C21H32N6O3.ClH |
| Molecular Weight | 452.978 |
| Optical Activity | NONE |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
Cl.CCN1N=NN(CCN2CCC(COC)(CC2)N(C(=O)CC)C3=CC=CC=C3)C1=O
InChI
InChIKey=AQORHZJDCHLLJN-UHFFFAOYSA-N
InChI=1S/C21H32N6O3.ClH/c1-4-19(28)27(18-9-7-6-8-10-18)21(17-30-3)11-13-24(14-12-21)15-16-26-20(29)25(5-2)22-23-26;/h6-10H,4-5,11-17H2,1-3H3;1H
| Molecular Formula | ClH |
| Molecular Weight | 36.461 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
| Molecular Formula | C21H32N6O3 |
| Molecular Weight | 416.5172 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
Alfentanil is an opioid analgesic with a rapid onset of action. Alfentanil interacts predominately with the opioid mu-receptor. These mu-binding sites are discretely distributed in the human brain, spinal cord, and other tissues. In clinical settings, alfentanil exerts its principal pharmacologic effects on the central nervous system. Its primary actions of therapeutic value are analgesia and sedation. Alfentanil may increase the patient's tolerance for pain and decrease the perception of suffering, although the presence of the pain itself may still be recognized. In addition to analgesia, alterations in mood, euphoria and dysphoria, and drowsiness commonly occur. Alfentanil depresses the respiratory centers, depresses the cough reflex, and constricts the pupils. Alfentanil, marketed under the trade name Alfenta, Rapifen in Australia is indicated for the management of postoperative pain and the maintenance of general anesthesia.
CNS Activity
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | ALFENTA Approved UseAlfentanil HCl injection is indicated: as an analgesic adjunct given in incremental doses in the maintenance of anesthesia with barbiturate/nitrous oxide/oxygen. as an analgesic administered by continuous infusion with nitrous oxide/oxygen in the maintenance of general anesthesia. as a primary anesthetic agent for the induction of anesthesia in patients undergoing general surgery in which endotracheal intubation and mechanical ventilation are required. as the analgesic component for monitored anesthesia care (MAC). Launch Date1986 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
20.1 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/7598917 |
0.54 mg single, nasal dose: 0.54 mg route of administration: Nasal experiment type: SINGLE co-administered: |
ALFENTANIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
1985.7 ng × min/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/7598917 |
0.54 mg single, intravenous dose: 0.54 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
ALFENTANIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
1241.2 ng × min/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/7598917 |
0.54 mg single, nasal dose: 0.54 mg route of administration: Nasal experiment type: SINGLE co-administered: |
ALFENTANIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
60.1 min EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/7598917 |
0.54 mg single, intravenous dose: 0.54 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
ALFENTANIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
59.4 min EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/7598917 |
0.54 mg single, nasal dose: 0.54 mg route of administration: Nasal experiment type: SINGLE co-administered: |
ALFENTANIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
8% |
ALFENTANIL plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://pubmed.ncbi.nlm.nih.gov/15557344/ Page: 1.0 |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/15557344/ Page: 8.0 |
yes | |||
| yes | likely (co-administration study) Comment: Concomitant use of Alfentanil HCl Injection with a CYP3A4 inhibitor, such as macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), and protease inhibitors (e.g., ritonavir), may increase plasma concentrations of Alfentanil HCl Injection; discontinuation of a CYP3A4 inducer, such as rifampin, carbamazepine, and phenytoin, in Alfentanil HCl Injection-treated patients may increase alfentanil plasma concentrations and prolong opioid adverse reactions Page: 1.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Effects of adding alfentanil or atracurium to lidocaine solution for intravenous regional anaesthesia. | 2002-07 |
|
| Mu-receptor agonism with alfentanil increases striatal dopamine D2 receptor binding in man. | 2002-07 |
|
| A new highly reliable instrument for the assessment of pre- and postoperative gynecological pain. | 2002-07 |
|
| Improved long-lasting postoperative analgesia, recovery function and patient satisfaction after inguinal hernia repair with inguinal field block compared with general anesthesia. | 2002-07 |
|
| Psychomotor performance after short-term anaesthesia. | 2002-06 |
|
| Postoperative nausea and vomiting after total intravenous anesthesia with propofol and remifentanil or alfentanil: how important is the opioid? | 2002-06 |
|
| Effects of low-dose alfentanil administration on central respiratory drive and respiratory pattern in spontaneously breathing ASA 1 patients. | 2002-06 |
|
| Respiratory response to skin incision during anaesthesia with infusions of propofol and alfentanil. | 2002-05 |
|
| Comparison of hemodynamics, recovery profile, and early postoperative pain control and costs of remifentanil versus alfentanil-based total intravenous anesthesia (TIVA). | 2002-05 |
|
| Co-administration of alfentanil-propofol improves laryngeal mask airway insertion compared to fentanyl-propofol. | 2002-05 |
|
| Mild core hypothermia and anesthetic requirement for loss of responsiveness during propofol anesthesia for craniotomy. | 2002-05 |
|
| Target-controlled versus manually-controlled infusion of propofol for direct laryngoscopy and bronchoscopy. | 2002-05 |
|
| Relative reinforcing effects of three opioids with different durations of action. | 2002-05 |
|
| Effect of sevoflurane/nitrous oxide versus propofol anaesthesia on somatosensory evoked potential monitoring of the spinal cord during surgery to correct scoliosis. | 2002-04 |
|
| Interaction of morphine, fentanyl, sufentanil, alfentanil, and loperamide with the efflux drug transporter P-glycoprotein. | 2002-04 |
|
| Alfentanil and sufentanil in fast-track anesthesia for coronary artery bypass graft surgery. | 2002-04 |
|
| A new paradigm for the closed-loop intraoperative administration of analgesics in humans. | 2002-04 |
|
| Analgesia for shock wave lithotripsy. | 2002-04 |
|
| Effects of remifentanil and alfentanil on the cardiovascular responses to induction of anaesthesia and tracheal intubation in the elderly. | 2002-03 |
|
| Total intravenous anesthesia for intraoperative monitoring of the motor pathways: an integral view combining clinical and experimental data. | 2002-03 |
|
| Implicit memory for words played during isoflurane- or propofol-based anesthesia: the lexical decision task. | 2002-03 |
|
| Prolonged neuromuscular block after rocuronium in postpartum patients. | 2002-03 |
|
| Comparison of effects of remifentanil, alfentanil and fentanyl on cardiovascular responses to tracheal intubation in morbidly obese patients. | 2002-02 |
|
| Bispectral index variations during tracheal suction in mechanically ventilated critically ill patients: effect of an alfentanil bolus. | 2002-02 |
|
| Alfentanil-induced epileptiform activity. | 2002-02 |
|
| [Sedation analgesia in interventional radiology]. | 2002-02 |
|
| Comparison of rocuronium and suxamethonium for rapid tracheal intubation in children. | 2002-02 |
|
| General anesthesia versus monitored anesthesia care with remifentanil for assisted reproductive technologies: effect on pregnancy rate. | 2002-02 |
|
| Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. | 2002-02 |
|
| Pain model and fuzzy logic patient-controlled analgesia in shock-wave lithotripsy. | 2002-01 |
|
| Concurrent ketamine and alfentanil administration: pharmacokinetic considerations. | 2002-01 |
|
| Effects of propofol and nitrous oxide on middle cerebral artery flow velocity and cerebral autoregulation. | 2002-01 |
|
| Concentration-effect relationships for intravenous alfentanil and ketamine infusions in human volunteers: effects on acute thresholds and capsaicin-evoked hyperpathia. | 2002-01 |
|
| Bispectral Index (BIS) may not predict awareness reaction to intubation in surgical patients. | 2002-01 |
|
| Relaxation music decreases the dose of patient-controlled sedation during colonoscopy: a prospective randomized controlled trial. | 2002-01 |
|
| [Comparative studies of patient positioning for lumbar intervertebral disk operation]. | 2002 |
|
| A randomized study of the efficacy and recovery of remifentanil-based and alfentanil anaesthesia with desflurane or sevoflurane for gynecological surgery. | 2002 |
|
| Relative sensitivity to alfentanil and reliability of current perception threshold vs von Frey tactile stimulation and thermal sensory testing. | 2001-12 |
|
| Comparison of alfentanil and morphine in the prehospital treatment of patients with acute ischaemic-type chest pain. | 2001-12 |
|
| A pilot evaluation of alfentanil-induced miosis as a noninvasive probe for hepatic cytochrome P450 3A4 (CYP3A4) activity in humans. | 2001-12 |
|
| Esmolol promotes electroencephalographic burst suppression during propofol/alfentanil anesthesia. | 2001-12 |
|
| Comparison between dexmedetomidine and propofol for sedation in the intensive care unit: patient and clinician perceptions. | 2001-11 |
|
| Pain experience during transvaginal aspiration of immature oocytes. | 2001-11 |
|
| The effects of remifentanil on epileptiform discharges during intraoperative electrocorticography in patients undergoing epilepsy surgery. | 2001-10 |
|
| Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost. | 2001-10 |
|
| [The hereditary motor-sensory neuropathy Charcot-Marie-Tooth disease: anesthesiologic management--case report with literature review]. | 2001-10 |
|
| Clinical interpretation of pharmacokinetic and pharmacodynamic propofol-opioid interactions. | 2001 |
|
| Choice of the hypnotic and the opioid for rapid-sequence induction. | 2001 |
|
| Pharmacokinetic aspects of treating infections in the intensive care unit: focus on drug interactions. | 2001 |
|
| Response surface modeling of drug interactions on cardiorespiratory control. | 2001 |
Sample Use Guides
Spontaneously Breathing/Assisted Ventilation Induction of Analgesia: 8 to 20 mcg/kg
Maintenance of Analgesia: 3 to 5 mcg/kg q 5 to 20 min or 0.5 to 1 mcg/kg/min
Total dose: 8 to 40 mcg/kg
Assisted or Controlled Ventilation
- Assisted or Controlled Ventilation Incremental Injection
(To attenuate response to laryngoscopy and intubation) Induction of Analgesia: 20 to 50 mcg/kg
Maintenance of Analgesia: 5 to 15 mcg/kg q 5 to 20 min
Total dose: Up to 75 mcg/kg
Assisted or Controlled Ventilation
- Continuous Infusion
(To provide attenuation of response to intubation and incision) Induction of Analgesia: 50 to 75 mcg/kg
Maintenance of Analgesia: 0.5 to 3 mcg/kg/min (Average rate 1 to 1.5 mcg/kg/min) Infusion rates are variable and should be titrated to the desired clinical effect. See Infusion Dosage Guidelines Below
Total dose: Dependent on duration of procedure
Anesthetic Induction Induction of Anesthesia: 130 to 245 mcg/kg Administer slowly (over 3 minutes).
Maintenance of Anesthesia: 0.5 to 1.5 mcg/kg/min or general anesthetic.
Infusion rates are variable and should be titrated to the desired clinical effect. See Infusion Dosage Guidelines Below
Total dose: Dependent on duration of procedure
At these doses truncal rigidity should be expected and a muscle relaxant should be utilized.
Route of Administration:
Intravenous
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/17279089
Alfentanil (10 uM ) significantly increased contraction of TNF-alpha and IL-1beta treated cells via a small increase in the Ca(2+) transient and a larger increase in myofilament Ca(2+) sensitivity, effects that were not blocked by 10 uM naloxone, a broad spectrum opioid receptor antagonist.
| Substance Class |
Chemical
Created
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Edited
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| Record UNII |
333JTI7A2M
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| Record Status |
Validated (UNII)
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| Record Version |
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333JTI7A2M
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ACTIVE MOIETY |
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