MDose · Veterinary drug reference
TIER2 TOPIC: SHORT-ACTING OPIOID INFUSIONS (ALFENTANIL / REMIFENTANIL / SUFENTANIL)
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Recorded excerpts for one species. Each dose remains a separate source entry; no regimen is selected.
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Pending clinical review (PROPOSED)Rule-based (RULE_BASED)— applies to the facts and dose entries in this species selection; individual source records retain their own status.
Indications2
Intraoperative analgesia CRIs (anesthesia-sparing, rapid titration); alfentanil/sufentanil premed-induction adjuncts; sufentanil epidural; emergency acute pain (sufentanil)
DogCatExtra-label (EXTRA_LABEL)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Intraoperative analgesia CRIs (anesthesia-sparing, rapid titration); alfentanil/sufentanil premed-induction adjuncts; sufentanil epidural; emergency acute pain (sufentanil) — Extra-label (human drugs; C-II)
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Intraoperative analgesia CRIs (anesthesia-sparing, rapid titration); alfentanil/sufentanil premed-induction adjuncts; sufentanil epidural; emergency acute pain (sufentanil) — Extra-label (human drugs; C-II)
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens0
No dose regimens recorded for this species selection.
Adverse effects4
Dysphoria on wake-up — Transition-to-oral era issue
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Respiratory depression/apnea (induction doses) — Expected — ventilation ready
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Bradycardia, hypotension — Infusion-titration effects
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Chest-wall rigidity (high-dose alfentanil-class) — Anesthesia-team event
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Monitoring1
Ventilation/capnography + pulse ox (mandatory), HR/BP, infusion-rate double-checks, awake-transition analgesia plan (remifentanil wears off INSTANTLY — start oral/transdermal before stopping)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Precautions4
Obese patients: dose on LEAN body weight (Plumb note); MAOI co-use cautions; anesthetist-administered only
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Remifentanil's esterase clearance = the operating-room favorite: minute-by-minute titration with zero accumulation — but analgesia vanishes the second the pump stops; bridging analgesia must precede discontinuation.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
µg/kg/MIN vs µg/kg/HOUR unit confusion is a named, recurring medication error in this class (Plumb flags it explicitly for remifentanil) — the pharmacy double-check point.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Sufentanil epidural (0.7–1 µg/kg) = the neuroaxial niche of the trio.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Interactions3
Propofol/inhalants — Deliberate dose-sparing MAC reduction
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Naloxone — Reversal
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Benzodiazepines — Induction combos
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics4
Potency ladder — Fentanyl ≈ 100× morphine; sufentanil ~5–10× fentanyl; alfentanil ~¼ fentanyl but faster onset; remifentanil ≈ fentanyl potency
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Remifentanil — Nonspecific esterases → ultra-short context-insensitive t½ — the only one not accumulating with prolonged infusion; renal/hepatic failure irrelevant
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Alfentanil/sufentanil — Hepatic redistribution/clearance — accumulate with long infusions
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
All — Respiratory depression, bradycardia, rigidity (high-dose, esp. alfentanil-class), sphincter-of-Oddi pressure
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
Anesthetic/perioperative context.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 50–51 (alfentanil), p. 1041–1042 (remifentanil), p. 1085–1086 (sufentanil) — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Sources: Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.
Owner information handout
Plain-language medication information to review with the owner. Open the handout to print it or download a PDF.