Remikaf Drug Interactions

Table 20 includes clinically significant drug interactions with REMIKAF. (See Table 20.)


Click on icon to see table/diagram/image


Drug Abuse And Dependence: Controlled Substance: REMIKAF contains remifentanil, a Schedule II controlled substance.
Abuse: REMIKAF is a Schedule II controlled drug substance that can produce drug dependence of the morphine type and has the potential for being abused.
REMIKAF contains remifentanil, a substance with a high potential for abuse similar to other opioids including fentanyl, alfentanil, sufentanil, and meperidine. REMIKAF can be abused and is subject to misuse, addiction, and criminal diversion.
Drug addiction is a cluster of behavioral, cognitive, and physiological phenomena that develop after repeated substance use and includes: a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal. Abuse and addiction are separate and distinct from physical dependence and tolerance. Health care providers should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of opioids can occur in the absence of true addiction.
REMIKAF, like other opioids, can be diverted for non-medical use into illicit channels of distribution. Careful record-keeping of prescribing information, including quantity, frequency, and renewal requests, as required by state and federal law, is strongly advised.
Risks Specific To Abuse Of REMIKAF: Abuse of REMIKAF poses a risk of overdose and death. The risk is increased with concurrent use of REMIKAF with alcohol and other central nervous system depressants.
Parenteral drug abuse is commonly associated with transmission of infectious diseases such as hepatitis and HIV.
Dependence: Both tolerance and physical dependence can develop during chronic opioid therapy. Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects.
Physical dependence results in withdrawal symptoms after abrupt discontinuation or a significant dosage reduction of a drug. Withdrawal also may be precipitated through the administration of drugs with opioid antagonist activity (e.g., naloxone, nalmefene), mixed agonist/antagonist analgesics (pentazocine, butorphanol, nalbuphine), or partial agonists (buprenorphine). Physical dependence may not occur to a clinically significant degree until after several days to weeks of continued opioid usage.