1 What is Ultiva?

Brand: Ultiva

Generic: Remifentanil

Ultiva is a prescription-only pain medicine of narcotic analgesic class.

Using this medicine together with other medicines, such as isoflurane, propofol, midazolam, thiopental just before or during an operation helps smooth anesthesia throughout the operation.

It is injected only by a doctor or a health professional in the presence of a doctor. It is available as a powder for solution.

2 What to Know Before Using

Before using Ultiva, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will provide you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: Safety and efficacy of remifentanil in children have not been well documented. Consult your child’s doctor before using.

Geriatric: It may be used in elderly after adjusting the doses.

Pregnancy: It falls under pregnancy category C for all trimester meaning that despite potential risks, it may be used in pregnancy after assessing risks and benefits of the use.

Breastfeeding: It may be used in a nursing mother after assessing risks and benefits of the use.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions.

The following medicine is not generally recommended to be used with remifentanil. Inform your doctor if you are using Naltrexone.

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

  • Alfentanil
  • Alprazolam
  • Anileridine
  • Baclofen
  • Buprenorphine
  • Butalbital
  • Carbinoxamine
  • Carisoprodol
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorzoxazone
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Codeine
  • Dantrolene
  • Diazepam
  • Donepezil
  • Estazolam
  • Ethchlorvynol
  • Fentanyl
  • Flibanserin
  • Fospropofol
  • Hydrocodone
  • Hydromorphone
  • Ketazolam
  • Levorphanol
  • Meclizine
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Metaxalone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Morphine
  • Opium
  • Orphenadrine
  • Oxycodone
  • Oxymorphone
  • Propoxyphene
  • Quazepam
  • Remifentanil
  • Sodium Oxybate
  • Sufentanil
  • Suvorexant
  • Tapentadol
  • Tizanidine

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe.

Inform your doctor if you have any of the following conditions:

  • Bradycardia (slow heartbeat)
  • Breathing disorders such as apnea or respiratory depression
  • Abnormal heart rhythms
  • Hypotension (low blood pressure): Use cautiously.
  • History of allergy to fentanyl: Do not use remifentanil.

3 Proper Usage

Proper usage of Ultiva requires strict adherence to your doctor’s orders. This medicine is injected into your vein by a nurse in a hospital.

4 Precautions to Take

Before using Ultiva, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment. Remember:

Avoid taking this medicine with alcohol or other CNS depressants such as allergy or cold medicines, sleeping pills, narcotic pain killers, medicine for seizures, muscle relaxants, or other anesthetics. If you need to, consult your doctor.

Consult your doctor immediately if you notice bluish discoloration of your lips or skin, chest discomfort, breathing problems, rapid heartbeat or pulse, or stiff muscles after getting remifentanil.

You may feel dizzy when standing suddenly from a lying or sitting position. Therefore, take care not to faint. If you have constipation while taking remifentanil, you may take a laxative after consulting your doctor.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Ultiva.

Consult your doctor immediately if you experience any of the following side effects:

More common:

  • Blurry vision
  • Pain in chest
  • Confusion
  • Breathing problems such as sudden change in rate of respiration
  • Feeling dizzy when changing position
  • Dizziness
  • Stiff muscles
  • Bluish lips, fingernails, or skin
  • Abnormal heart rhythm
  • Sweating
  • Excessive tiredness

Less common:

  • Bluish lips or skin
  • Fever or chills
  • The decrease in cardiac output
  • Rapid throbbing heartbeat or pulse
  • Headache
  • Nausea or vomiting
  • Feeling nervous
  • Cessation of breathing
  • Bleeding abnormalities
  • Red face, neck, arms, and sometimes, upper chest
  • Shaking


  • Pain in stomach
  • Black, tar-like stools
  • Bleeding from gums or nose
  • Bloody urine or stools
  • Generalized body pain
  • Numbness, tingling or pin prick“ sensations
  • A cough or hoarseness
  • Coughing up blood or pink sputum
  • Decreased urinary frequency or volume
  • Wheezing
  • Disorientation
  • Dryness of mouth, skin, or throat
  • Feeling dysphoric
  • Hives
  • Increased blood pressure, hunger, menstrual discharge, sweating, thirst, or urination
  • Pain in lower back or side
  • Muscle soreness
  • Pallor
  • Paralysis
  • Red dots on the skin
  • Puffed eyelids or around the eyes, face, lips, or tongue
  • Fits
  • Swollen legs and ankles, or neck glands
  • Abnormal bleeding or bruising

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

Less common:

  • Anxiety
  • Vision problems such as blurry or double vision
  • Difficulty bowel evacuation
  • Rapid, shallow breathing
  • Pain at the injection site
  • Agitation
  • Sleep problems
  • Tunnel vision


  • Burning in the chest or while urinating
  • Hives
  • Incontinence
  • Impaired memory
  • Hallucinations
  • Severe constipation or vomiting
  • Difficult urination
  • Involuntary eye movements

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.

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