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Remifentanil is not metabolised by plasmacholinesterase, therefore, interactions with drugs metabolised by this enzyme are not anticipated.
As with other opioids remifentanil, whether given by manually controlled infusion or TCI, decreases the amounts or doses of inhalational and IV anaesthetics, and benzodiazepines required for anaesthesia (see Dosage & Administration). If doses of concomitantly administered CNS depressant drugs are not reduced patients may experience an increased incidence of adverse effects associated with these agents.
Information of drug interactions with other opioids in relation to anaesthesia is very limited. The cardiovascular effects of remifentanil (hypotension and bradycardia), may exacerbate in patients receiving concomitant cardiac depressant drugs, such as beta-blockers and calcium channel blocking agents (see Precautions and Adverse Reactions).
