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Ultiva is an opioid medication. An opioid is sometimes called a narcotic.
Ultiva is used to treat or prevent pain during and after surgery or other medical procedures.
Ultiva may also be used for purposes not listed in this medication guide.
Ultiva can slow or stop your breathing, and may be habit-forming. MISUSE OF Ultiva CAN CAUSE ADDICTION, OVERDOSE, OR DEATH.
You should not be treated with Ultiva if you are allergic to it.
Tell your doctor if you have ever had:
breathing problems, sleep apnea;
a head injury, brain tumor, or increased pressure inside your skull;
a seizure;
drug or alcohol addiction;
problems with your gallbladder or pancreas; or
if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).
Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with Ultiva and cause a serious condition called serotonin syndrome.
If you receive Ultiva while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant.
It is not known whether remifentanil passes into breast milk or if it could harm a nursing baby. Many other opioid medicines can pass into breast milk and cause drowsiness or breathing problems in a nursing baby. Tell your doctor if you are breastfeeding.
Ultiva is given as an infusion into a vein. A healthcare provider will give you this injection.
Ultiva is usually given slowly through an infusion connected to pump that will release the correct dose of the medication to provide continuous pain relief during and after your surgery.
Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving Ultiva.
Ultiva can slow or stop your breathing, and may be habit-forming. MISUSE OF Ultiva CAN CAUSE ADDICTION, OVERDOSE, OR DEATH.
You may be given other pain medications to use after your Ultiva treatment is discontinued. Keep using these medicines for as long as your doctor has prescribed.
Since Ultiva is given as needed by a healthcare professional for only a short time, you are not likely to be on a dosing schedule.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include extreme drowsiness, muscle weakness, slow heartbeats, pinpoint pupils, fainting, blue lips, cold and clammy skin, noisy breathing, very slow breathing, or coma.
Ultiva can cause side effects that may impair your thinking or reactions. You should not plan on driving or doing anything that requires you to be awake and alert right after you are treated with Ultiva. Dizziness or severe drowsiness can cause falls or other accidents.
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Like other opioid medicines, Ultiva can slow your breathing. Death may occur if breathing becomes too weak.
Your caregivers will watch for any side effects you have, such as:
noisy breathing, sighing, shallow breathing, breathing that stops during sleep;
fast or slow heart rate;
stiff muscles; or
severe weakness, feeling light-headed or fainting.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.
Common side effects may include:
slow breathing;
slow heart rate;
muscle stiffness; or
feeling light-headed.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Tell your doctor if you have used an MAO inhibitor in the past 14 days. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and tranylcypromine.
Other drugs may affect Ultiva, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
Further informationRemember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/27/2021.
Source: Drugs.com Ultiva (www.drugs.com/mtm/ultiva.html).
Note: This document contains side effect information about remifentanil. Some of the dosage forms listed on this page may not apply to the brand name Ultiva.
In SummaryCommon side effects of Ultiva include: nausea. Other side effects include: shivering and diaphoresis. See below for a comprehensive list of adverse effects.
For the ConsumerApplies to remifentanil: intravenous powder for solution, intravenous solution
Intravenous route (Powder for Solution)
Remifentanil exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk prior to prescribing remifentanil.
Along with its needed effects, remifentanil (the active ingredient contained in Ultiva) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking remifentanil:
More common
Less common
Rare
Some side effects of remifentanil may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Rare
For Healthcare Professionals
Applies to remifentanil: intravenous powder for injection, intravenous solution
GeneralThe most commonly reported adverse reactions have included respiratory depression, bradycardia, hypotension, and skeletal muscle rigidity. In pediatric patients, the most commonly reported events were nausea, vomiting, and shivering.
RespiratoryCough, dyspnea, bronchospasm, laryngospasm, rhonchi, stridor, nasal congestion, pharyngitis, pleural effusion, hiccups, pulmonary edema, rales, bronchitis, and rhinorrhea have been reported in less than 1% of patients.
Common (1% to 10%): Respiratory depression
Uncommon (0.1% to 1%): Apnea, hypoxia
Frequency not reported: Cough, dyspnea, bronchospasm, laryngospasm, rhonchi, stridor, nasal congestion, pharyngitis, pleural effusion, hiccups, pulmonary edema, rales, bronchitis, rhinorrhea
Opioids:
Frequency not reported: Serious respiratory depression
CardiovascularCardiovascular side effects such as hypotension and bradycardia have been reported to occur most frequently during the induction and maintenance period. Bradycardia and hypotension are probably due to a centrally mediated increase in vagal nerve activity. Glycopyrrolate, atropine and/or ephedrine may be useful in treating these effects. Unlike morphine, decreases in blood pressure are not due to histamine release.
In male patients and in those patient older 65 years, the incidence of hypotension is higher. Various atrial and ventricular arrhythmias, heart block, ECG change consistent with myocardial ischemia, elevated CPK-MB level, and syncope have been reported in less than 1% of patients.
Very common (10% or more): Hypotension (up to 19%)
Common (1% to 10%): Bradycardia, atrial fibrillation, atrial flutter, myocardial ischemia, edema, flushing
Uncommon (0.1% to 1%): Decreased cardiac output
Rare (0.01% to 0.1%): Tachycardia, hypertension
Frequency not reported: Various atrial and ventricular arrhythmias, heart block, ECG change consistent with myocardial ischemia, elevated CPK-MB level, syncope, premature ventricular beats, atrioventricular block
Postmarketing reports: Asystole
GastrointestinalNausea has been reported to occur in very commonly, especially when used as a postoperative analgesic and upon discontinuation. Abdominal discomfort, xerostomia, gastro-esophageal reflux, dysphagia, diarrhea, and ileus have been reported in less than 1% of patients.
MusculoskeletalRigidity may be lessened by concomitant administration of a muscle relaxant. Muscle stiffness and musculoskeletal chest pain have been reported in less than 1% of patients.
Common (1% to 10%): Skeletal muscle rigidity
Frequency not reported: Muscle stiffness, musculoskeletal chest pain
GastrointestinalVery common (10% or more): Nausea (up to 44%), vomiting (up to 22%)
Common (1% to 10%): Constipation, heartburn
Frequency not reported: Abdominal discomfort, xerostomia, gastro-esophageal reflux, dysphagia, diarrhea, ileus
Nervous systemCommon (1% to 10%): Dizziness, headache
Frequency not reported: Serotonin syndrome, involuntary movement, prolonged emergence from anesthesia, awareness under anesthesia without pain, rapid awakening from anesthesia, tremors, paresthesia, nystagmus, twitch, seizure
Involuntary movement, prolonged emergence from anesthesia, awareness under anesthesia without pain, rapid awakening from anesthesia, tremors, paresthesia, nystagmus, twitch, and seizure have been reported in less than 1% of patients.
HypersensitivityAnaphylactic reaction was reported in less than 1% of patients.
Frequency not reported: Anaphylactic reaction
PsychiatricAnxiety, confusion, disorientation, dysphoria, nightmares, hallucinations, amnesia have been reported in less than 1% of patients.
Common (1% to 10%): Agitation
Frequency not reported: Anxiety, confusion, disorientation, dysphoria, nightmares, hallucinations, amnesia
LocalCommon (1% to 10%): Pain at IV site
Frequency not reported: Erythema, pruritus, rash
Erythema, pruritus, and rash at the infusion site was reported in less than 1% of patients.
DermatologicRash and urticaria have been reported in less than 1% of patients.
Common (1% to 10%): Pruritus, sweating
OtherCommon (1% to 10%): Shivering, fever, chills, sensation of warmth
Frequency not reported: Decreased body temperature
HematologicAnemia, lymphopenia, leukocytosis, and thrombocytopenia have been reported in less than 1% of patients.
Common (1% to 10%): Coagulation disorder
Frequency not reported: Anemia, lymphopenia, leukocytosis, thrombocytopenia
OcularCommon (1% to 10%): Visual disturbances
MetabolicFrequency not reported: Hyperglycemia, electrolyte disorders, increased CPK level
GenitourinaryUrine retention, oliguria, dysuria, and urine incontinence have been reported in less than 1% of patients.
Frequency not reported: Urine retention, oliguria, dysuria, urine incontinence
HepaticFrequency not reported: Abnormal liver function
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/27/2021.
Source: Drugs.com Ultiva (www.drugs.com/mtm/ultiva.html).
February 16, 2021
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