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| Trade names | Dsuvia, Sufenta, Zalviso, others |
| Other names | R30730 |
| AHFS/Drugs.com | Monograph |
| License data | |
| Routes of administration | Intravenous therapy (IV),intramuscular injection (IM),subcutaneous injection (SQ),epidural,intrathecal,sublingual |
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| Pharmacokinetic data | |
| Bioavailability | Sublingual: 53% IV/IM/SC: 100% |
| Eliminationhalf-life | 162 minutes |
| Duration of action | 30 to 60 min[5] |
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| ECHA InfoCard | 100.168.858 |
| Chemical and physical data | |
| Formula | C22H30N2O2S |
| Molar mass | 386.55 g·mol−1 |
| 3D model (JSmol) | |
| Melting point | 97 °C (207 °F) |
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Sufentanil, sold under the brand namesSufenta among others, is asyntheticopioidanalgesic drug approximately 5 to 10 times aspotent as itsparent drug,fentanyl, and 500 to 1,000 times as potent asmorphine. Structurally, sufentanil differs from fentanyl through the addition of a methoxymethyl group on the piperidine ring (which increases potency but is believed to reduce duration of action[6]), and the replacement of thephenyl ring bythiophene. Sufentanil first was synthesized atJanssen Pharmaceutica in 1974.[7]
Sufentanil offers properties of sedation and can be used as analgesic component ofanesthetic regimen during an operation.[8]
Because of its extremely high potency, it is often used in surgery and post-operative pain management for patients that are heavily opioid dependent/opioid tolerant because of long term opiate use for chronic pain or illicit opiate use. It is also used in surgery and post-operative pain control in people that are taking high dosebuprenorphine for chronic pain because it has the potency and binding affinity strong enough to displace buprenorphine from the opioid receptors in the central nervous system and provide analgesia.[9]
In 2018, theFood and Drug Administration (FDA) approved Dsuvia, a sublingual tablet form of the drug, that was developed in a collaboration between AcelRx Pharmaceuticals and theUnited States Department of Defense for use in battlefield settings where intravenous (IV) treatments may not be readily available.[10] The decision to approve this new potent synthetic opioid came under criticism from politicians and from the chair of the FDA advisory committee, who fear that the tablets will be easily diverted to the illegal drug market.[11] Dsuvia has since been withdrawn from the market due to "unresolvable manufacturing constraints."[12]
Because sufentanil is very potent, practitioners must be prepared to reverse the effects of the drug should the patient exhibit symptoms of overdose such asrespiratory depression orrespiratory arrest. As for all other opioid-based medications,naloxone (trade name Narcan) is the definitive antidote for overdose. Depending on the amount administered, it can reverse the respiratory depression and, if enough is administered, completely reverse the effects of sufentanil.[2]
Sufentanil is marketed under various brand names including Dsuvia,[13] Dzuveo, Sufenta, and Sufentil.
In cats sufentanil's half-life is longer than that of fentanyl andalfentanil. In dogs sufentanil produces a better anaesthetic recovery with similar analgesic and respiratory depression than fentanyl. One report suggest that for post-operative painbupivacaine and sufentanil provides greater analgesia than fentanyl and bupivacaine in dogs. There is little information on sufentanil's use in large animals. Due to the greater risk of cardiovascular and respiratory depression sufentanil is rarely used in practice.[14]
