Alfentanil is a short-acting opioid analgesic related to fentanyl. It binds with stereospecific receptors within the CNS, thereby altering pain perception, increasing pain threshold, and inhibiting ascending pain pathways.

Alfentanil is an adjunct in the maintenance of general anesthesia. It is also used to induce spontaneous respiration and assisted ventilation, induction of anesthesia and analgesia in patients with spontaneous respiration.

Do not give Alfentanil in the following:

  • Obstructive airway disease
  • Respiratory depression
  • Supervision in labour or before clamping of cord during caesarean section
  • Simultaneous use during or within 14 days of MAOI therapy

Alfentanil may give rise to the following:

  • Hypotension
  • Bradycardia
  • Drug dependency
  • Exaggerated elevation of intracranial pressure
  • Skeletal muscle rigidity
  • Fatigue
  • Agitation
  • Euphoric mood
  • Disorientation
  • Movement disorder
  • Dizziness
  • Sedation
  • Dyskinesia
  • Headache
  • Somnolence
  • Unresponsive to stimuli
  • Loss of consciousness
  • Convulsion
  • Myoclonus
  • Apnoea
  • Tachycardia
  • Arrhythmia
  • Decreased heart rate
  • Cardiac arrest
  • Hypertension
  • Nausea
  • Vomiting
  • Hiccups
  • Laryngospasm
  • Cough
  • Hypercapnia
  • Visual disturbance
  • Miosis
  • Dermatitis
  • Hyperhidrosis
  • Erythema
  • Rash
  • Chills
  • Injection site pain
  • Pyrexia
  • Respiratory depression


Take extra precautions in the following diseases:

  • Hypovolemia
  • Cardiovascular disease
  • Bradyarrhythmias
  • History of drug abuse or acute alcoholism
  • Head injury
  • Intracranial lesions
  • Increased intracranial pressure
  • Pulmonary disease
  • Decreased respiratory reserve
  • Compromised respiration
  • COPD or other obstructive pulmonary disease
  • Kyphoscoliosis or other skeletal disorder
  • Compromised intracerebral compliance
  • Hypothyroidism
  • Renal and hepatic impairment
  • Weak and elderly patients, children
  • Pregnancy and lactation


Alfentanil may interact with the following medications:

  • CYP3A4 isoenzyme inhibitors (e.g. ketoconazole, itraconazole, fluconazole, voriconazole, ritonavir, erythromycin, diltiazem, cimetidine)
  • Barbiturates
  • Benzodiazepines
  • Neuroleptics
  • Halogenic gases
  • Non-selective CNS depressants (e.g. alcohol)
  • Propofol
  • Drugs that depress the heart or increase vagal tone (e.g. β-blockers, anaesth agents)
  • Non-vagolytic muscle relaxants
  • MAOIs

Alfentanil overdose may give rise to the following symptoms:

  • Bradycardia
  • Hypoventilation/apnoea
  • Muscle rigidity
  • Hypovolaemia
  • Respiratory depression

Seek medical help immediately.

Available Brands:

  • Alfenta
  • Rapifen

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