When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to remifentanil or to similar medicines, such as fentanyl, Actiq®, Sublimaze®, or Duragesic®.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine. You will receive this medicine in a hospital or surgery center.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have lung disease, heart rhythm problems (slow heartbeat), or low blood pressure.
• Tell your doctor right away if you have bluish lips or skin; chest pain; difficulty with breathing; a fast, pounding, or irregular heartbeat or pulse; shortness of breath; or muscle stiffness after receiving this medicine.
• Dizziness, lightheadedness, or fainting may occur with this medicine, especially when you get up from a lying or sitting position suddenly. Getting up slowly may help. If this continues or gets worse, check with your doctor.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blue lips, fingernails, or skin.
• Fast, slow, or uneven heartbeat or pulse.
• Lightheadedness or fainting.
• Muscle stiffness in your neck, chest, hands, or legs.
• Problems with your vision.
• Trouble breathing or chest tightness.

If you notice these less serious side effects, talk with your doctor:

• Agitation or dizziness.
• Fever or headache.
• Mild skin rash or itching.
• Nausea or vomiting.
• Pain, itching, burning, swelling, or lump under your skin where the needle is placed.
• Shivering.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088