Details of the Drug

General Information of Drug (ID: DMZTXCH)

Drug Name
Remifentanil
Synonyms
Remifentanyl; Ultiva; GI 87084B; GI 87084X; GI87084B; Remifentanil (INN); Remifentanil [INN:BAN]; Ultiva (TN); Methyl 1-(3-methoxy-3-oxopropyl)-4-(N-propanoylanilino)piperidine-4-carboxylate; 1-Piperidinepropanoic acid, 4-(methoxy-carbonyl)-4-((1-oxopropyl)phenylamino)-, methyl ester; 3-(4-methoxycarbonyl-4-((1-oxopropyl)phenylamino)-1-piperidine)propanoic acid methyl ester; 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester
Indication
Disease Entry ICD 11 Status REF
Anaesthesia 9A78.6 Approved [1]
Therapeutic Class
Hypnotics and Sedatives
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 0 Molecular Weight (mw) 376.4
Logarithm of the Partition Coefficient (xlogp) 1.9
Rotatable Bond Count (rotbonds) 9
Hydrogen Bond Donor Count (hbonddonor) 0
Hydrogen Bond Acceptor Count (hbondacc) 6
ADMET Property
BDDCS Class
Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [2]
Clearance
The drug present in the plasma can be removed from the body at the rate of 37 mL/min/kg [3]
Elimination
0.1% of drug is excreted from urine in the unchanged form [2]
Half-life
The concentration or amount of drug in body reduced by one-half in 1 - 20 minutes [3]
Metabolism
The drug is metabolized via the nonspecific blood and tissue esterases []
Unbound Fraction
The unbound fraction of drug in plasma is 0.3% [3]
Vd
The volume of distribution (Vd) of drug is 0.35 L/kg []
Chemical Identifiers
Formula
C20H28N2O5
IUPAC Name
methyl 1-(3-methoxy-3-oxopropyl)-4-(N-propanoylanilino)piperidine-4-carboxylate
Canonical SMILES
CCC(=O)N(C1=CC=CC=C1)C2(CCN(CC2)CCC(=O)OC)C(=O)OC
InChI
InChI=1S/C20H28N2O5/c1-4-17(23)22(16-8-6-5-7-9-16)20(19(25)27-3)11-14-21(15-12-20)13-10-18(24)26-2/h5-9H,4,10-15H2,1-3H3
InChIKey
ZTVQQQVZCWLTDF-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
60815
ChEBI ID
CHEBI:8802
CAS Number
132875-61-7
DrugBank ID
DB00899
TTD ID
D0T5OX
VARIDT ID
DR00457
Combinatorial Drugs (CBD) Click to Jump to the Detailed CBD Information of This Drug

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Opioid receptor mu (MOP) TTKWM86 OPRM_HUMAN Agonist [4]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Anaesthesia
ICD Disease Classification 9A78.6
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
Opioid receptor mu (MOP) DTT OPRM1 5.94E-01 -0.02 -0.17
Molecular Expression Atlas (MEA) Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Remifentanil (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Chlormezanone DMTWUXR Major Additive CNS depression effects by the combination of Remifentanil and Chlormezanone. Anxiety disorder [6B00-6B0Z] [5]
Desipramine DMT2FDC Moderate Additive serotonergic effects by the combination of Remifentanil and Desipramine. Attention deficit hyperactivity disorder [6A05] [6]
Cariprazine DMJYDVK Major Additive CNS depression effects by the combination of Remifentanil and Cariprazine. Bipolar disorder [6A60] [5]
Levomilnacipran DMV26S8 Major Additive serotonergic effects by the combination of Remifentanil and Levomilnacipran. Chronic pain [MG30] [7]
Sertraline DM0FB1J Major Additive serotonergic effects by the combination of Remifentanil and Sertraline. Depression [6A70-6A7Z] [7]
Vilazodone DM4LECQ Major Additive serotonergic effects by the combination of Remifentanil and Vilazodone. Depression [6A70-6A7Z] [7]
Vortioxetine DM6F1PU Major Additive serotonergic effects by the combination of Remifentanil and Vortioxetine. Depression [6A70-6A7Z] [7]
Milnacipran DMBFE74 Major Additive serotonergic effects by the combination of Remifentanil and Milnacipran. Depression [6A70-6A7Z] [7]
Escitalopram DMFK9HG Major Additive serotonergic effects by the combination of Remifentanil and Escitalopram. Depression [6A70-6A7Z] [7]
Desvenlafaxine DMHD4PE Major Additive serotonergic effects by the combination of Remifentanil and Desvenlafaxine. Depression [6A70-6A7Z] [7]
OPC-34712 DMHG57U Major Additive CNS depression effects by the combination of Remifentanil and OPC-34712. Depression [6A70-6A7Z] [5]
Clomipramine DMINRKW Moderate Additive serotonergic effects by the combination of Remifentanil and Clomipramine. Depression [6A70-6A7Z] [6]
Doxepin DMPI98T Moderate Additive serotonergic effects by the combination of Remifentanil and Doxepin. Depression [6A70-6A7Z] [6]
Maprotiline DMPWB7T Moderate Additive serotonergic effects by the combination of Remifentanil and Maprotiline. Depression [6A70-6A7Z] [6]
Esketamine DMVU687 Moderate Additive CNS depression effects by the combination of Remifentanil and Esketamine. Depression [6A70-6A7Z] [8]
Mepenzolate DM8YU2F Moderate Additive antimotility effects by the combination of Remifentanil and Mepenzolate. Digestive system disease [DE2Z] [9]
Oxybutynine DMJPBAX Moderate Additive CNS depression effects by the combination of Remifentanil and Oxybutynine. Discovery agent [N.A.] [10]
Gabapentin DM6T924 Major Additive CNS depression effects by the combination of Remifentanil and Gabapentin. Epilepsy/seizure [8A61-8A6Z] [11]
Clonazepam DMTO13J Major Additive CNS depression effects by the combination of Remifentanil and Clonazepam. Epilepsy/seizure [8A61-8A6Z] [5]
Phenobarbital DMXZOCG Major Additive CNS depression effects by the combination of Remifentanil and Phenobarbital. Epilepsy/seizure [8A61-8A6Z] [5]
Dantrolene DM1D8XY Major Additive CNS depression effects by the combination of Remifentanil and Dantrolene. Fever [MG26] [5]
Solifenacin DMG592Q Moderate Additive CNS depression effects by the combination of Remifentanil and Solifenacin. Functional bladder disorder [GC50] [9]
Tolterodine DMSHPW8 Moderate Additive CNS depression effects by the combination of Remifentanil and Tolterodine. Functional bladder disorder [GC50] [9]
Belladonna DM2RBWK Moderate Additive antimotility effects by the combination of Remifentanil and Belladonna. Infectious gastroenteritis/colitis [1A40] [10]
Suvorexant DM0E6S3 Major Additive CNS depression effects by the combination of Remifentanil and Suvorexant. Insomnia [7A00-7A0Z] [5]
Amobarbital DM0GQ8N Major Additive CNS depression effects by the combination of Remifentanil and Amobarbital. Insomnia [7A00-7A0Z] [5]
Zaleplon DMGFWSM Major Additive CNS depression effects by the combination of Remifentanil and Zaleplon. Insomnia [7A00-7A0Z] [5]
Tasimelteon DMLOQ1V Major Additive CNS depression effects by the combination of Remifentanil and Tasimelteon. Insomnia [7A00-7A0Z] [5]
Paraldehyde DMOC1BX Major Additive CNS depression effects by the combination of Remifentanil and Paraldehyde. Insomnia [7A00-7A0Z] [5]
ITI-007 DMUQ1DO Major Additive CNS depression effects by the combination of Remifentanil and ITI-007. Insomnia [7A00-7A0Z] [5]
Quazepam DMY4D87 Major Additive CNS depression effects by the combination of Remifentanil and Quazepam. Insomnia [7A00-7A0Z] [5]
Estazolam DMZGXUM Major Additive CNS depression effects by the combination of Remifentanil and Estazolam. Insomnia [7A00-7A0Z] [5]
Polyethylene glycol DM4I1JP Moderate Increased risk of lowers seizure threshold by the combination of Remifentanil and Polyethylene glycol. Irritable bowel syndrome [DD91] [12]
Remimazolam DMLVSYX Major Additive CNS depression effects by the combination of Remifentanil and Remimazolam. Labour/delivery anaesthesia complication [JB0C] [5]
Allopregnanolone DMNLHAC Moderate Additive CNS depression effects by the combination of Remifentanil and Allopregnanolone. Mental/behavioural/neurodevelopmental disorder [6E20-6E8Z] [13]
Flibanserin DM70DTN Moderate Additive CNS depression effects by the combination of Remifentanil and Flibanserin. Mood disorder [6A60-6E23] [14]
Thalidomide DM70BU5 Moderate Additive CNS depression effects by the combination of Remifentanil and Thalidomide. Multiple myeloma [2A83] [15]
Prasugrel DM7MT6E Moderate Altered absorption of Remifentanil due to GI dynamics variation caused by Prasugrel. Myocardial infarction [BA41-BA43] [16]
Metoclopramide DMFA5MY Moderate Additive CNS depression effects by the combination of Remifentanil and Metoclopramide. Nausea/vomiting [MD90] [17]
Ondansetron DMOTQ1I Major Additive serotonergic effects by the combination of Remifentanil and Ondansetron. Nausea/vomiting [MD90] [18]
Bupropion DM5PCS7 Major Increased risk of lowers seizure threshold by the combination of Remifentanil and Bupropion. Nicotine use disorder [6C4A] [19]
Sibutramine DMFJTDI Major Additive serotonergic effects by the combination of Remifentanil and Sibutramine. Obesity [5B80-5B81] [20]
Lorcaserin DMG6OYJ Major Additive serotonergic effects by the combination of Remifentanil and Lorcaserin. Obesity [5B80-5B81] [21]
Dexfenfluramine DMJ7YDS Major Additive serotonergic effects by the combination of Remifentanil and Dexfenfluramine. Obesity [5B80-5B81] [7]
Apraclonidine DMO4PVE Moderate Additive CNS depression effects by the combination of Remifentanil and Apraclonidine. Optic nerve disorder [9C40] [22]
Flavoxate DMKV4NL Moderate Additive antimotility effects by the combination of Remifentanil and Flavoxate. Pain [MG30-MG3Z] [10]
Pimavanserin DMR7IVC Major Additive CNS depression effects by the combination of Remifentanil and Pimavanserin. Parkinsonism [8A00] [5]
Orphenadrine DMW542E Major Additive CNS depression effects by the combination of Remifentanil and Orphenadrine. Parkinsonism [8A00] [5]
Methylscopolamine DM5VWOB Moderate Additive CNS depression effects by the combination of Remifentanil and Methylscopolamine. Peptic ulcer [DA61] [10]
Quetiapine DM1N62C Major Additive CNS depression effects by the combination of Remifentanil and Quetiapine. Schizophrenia [6A20] [23]
Mesoridazine DM2ZGAN Major Additive CNS depression effects by the combination of Remifentanil and Mesoridazine. Schizophrenia [6A20] [23]
Aripiprazole DM3NUMH Major Additive CNS depression effects by the combination of Remifentanil and Aripiprazole. Schizophrenia [6A20] [5]
Iloperidone DM6AUFY Major Additive CNS depression effects by the combination of Remifentanil and Iloperidone. Schizophrenia [6A20] [5]
Paliperidone DM7NPJS Major Additive CNS depression effects by the combination of Remifentanil and Paliperidone. Schizophrenia [6A20] [5]
Molindone DMAH70G Major Additive CNS depression effects by the combination of Remifentanil and Molindone. Schizophrenia [6A20] [5]
Thiothixene DMDINC4 Major Additive CNS depression effects by the combination of Remifentanil and Thiothixene. Schizophrenia [6A20] [23]
Asenapine DMSQZE2 Major Additive CNS depression effects by the combination of Remifentanil and Asenapine. Schizophrenia [6A20] [5]
Pimozide DMW83TP Major Additive CNS depression effects by the combination of Remifentanil and Pimozide. Schizophrenia [6A20] [5]
Brilinta DMBR01X Moderate Altered absorption of Remifentanil due to GI dynamics variation caused by Brilinta. Thrombosis [DB61-GB90] [16]
⏷ Show the Full List of 59 DDI Information of This Drug

References

1 URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7292).
2 BDDCS applied to over 900 drugs
3 Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
4 The pro-nociceptive effects of remifentanil or surgical injury in mice are associated with a decrease in delta-opioid receptor mRNA levels: Prevent... Pain. 2009 Jan;141(1-2):88-96.
5 US Food and Drug Administration "FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines requires its strongest warning.".
6 Vizcaychipi MP, Walker S, Palazzo M "Serotonin syndrome triggered by tramadol." Br J Anaesth 99 (2007): 919. [PMID: 18006535]
7 Achamallah NS "Visual hallucinations after combining fluoxetine and dextromethorphan ." Am J Psychiatry 149 (1992): 1406. [PMID: 1530079]
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10 Product Information. Apadaz (acetaminophen-benzhydrocodone). KemPharm, Inc, Coralville, IA.
11 Eckhardt K, Ammon S, Hofmann U, Riebe A, Gugeler N, Mikus G "Gabapentin enhances the analgesic effect of morphine in healthy volunteers." Anesth Analg 91 (2000): 185-91. [PMID: 10866910]
12 Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates). Braintree Laboratories, Braintree, MA.
13 Product Information. Zulresso (brexanolone). Sage Therapeutics, Inc., Cambridge, MA.
14 Product Information. Addyi (flibanserin). Sprout Pharmaceuticals, Raleigh, NC.
15 Product Information. Thalomid (thalidomide). Celgene Corporation, Warren, NJ.
16 Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
17 Product Information. Reglan (metoclopramide). Wyeth-Ayerst Laboratories, Philadelphia, PA.
18 Canadian Pharmacists Association.
19 Product Information. Wellbutrin XL (buPROPion). GlaxoSmithKline, Philadelphia, PA.
20 Chan BSH, Graudins A, Whyte IM, Dawson AH, Braitberg G, Duggin GG "Serotonin syndrome resulting from drug interactions." Med J Aust 169 (1998): 523-5. [PMID: 9861909]
21 Product Information. Belviq (lorcaserin). Eisai Inc, Teaneck, NJ.
22 Product Information. Alphagan (brimonidine ophthalmic). Allergan Inc, Irvine, CA.
23 Product Information. Clozaril (clozapine). Novartis Pharmaceuticals, East Hanover, NJ.