Alfentanil Hcl Injection

See full labeling. Should be administered only by trained persons in IV anesthetics and management of respiratory effects in an adequate facility. Have an opioid antagonist, resuscitative and intubation equipment, and oxygen readily available. Individualize. Choose appropriate neuromuscular blocking agent for patient’s condition. Administer induction doses slowly over 3mins. Spontaneously breathing/assisted ventilation: Induction: 8–20mcg/kg; maintenance: 3–5mcg/kg every 5–20mins or 0.5–1mcg/kg/min; total dose: 8–40mcg/kg. Assisted or controlled ventilation (incremental injection): Induction: 20–50mcg/kg; maintenance: 5–15mcg/kg every 5–20mins; total dose: up to 75mcg/kg. Assisted or controlled ventilation (continuous infusion): Induction 50–75mcg/kg; maintenance: 0.5–3mcg/kg/min; total dose: based on duration of procedure. Primary anesthetic agent: Induction: 130–245mcg/kg; maintenance: 0.5–1.5mcg/kg/min or general anesthetic; total dose: based on duration of procedure; utilize muscle relaxant for truncal rigidity. MAC: Induction: 3–8mcg/kg; maintenance: 3–5mcg/kg every 5–20mins or 0.25–1mcg/kg/min; total dose: 3–40mcg/kg. Guideline for continuous infusion: 0.5–3mcg/kg/min with nitrous oxide/oxygen in patients undergoing general surgery. Discontinue infusions at least 10–15mins prior to the end of surgery during general anesthesia. Infusions for MAC may continue to the end of the procedure. Elderly (>65yrs): reduce dose by up to 40%; titrate slowly. Debilitated: reduce dose. Obese patients: base dose on ideal body weight. Concomitant use or discontinuation of CYP3A4 inhibitors or inducers: monitor closely and consider dose adjustments.