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Alfentanil Intravenous and DexPak

Determining the interaction of Alfentanil Intravenous and DexPak and the possibility of their joint administration.

Check result:

Alfentanil Intravenous <> DexPak

Relevance: 18.07.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Dexamethasone may reduce the blood levels and effects of alfentanil. If you are currently being treated or have recently been treated with dexamethasone, you may require a higher dosage to achieve adequate response to alfentanil. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of alfentanil, which appears to be extensively metabolized by the isoenzyme. Clinical data are limited, however. In nine healthy male volunteers, intravenous administration of a single 20 mcg/kg dose of alfentanil with the potent CYP450 3A4 inducer rifampin increased alfentanil clearance by nearly 3-fold and decreased elimination half-life by 40% compared to controls. Another study also reported substantially increased clearance rates of alfentanil in seven patients receiving long-term therapy with inducer drugs compared to six patients not receiving those drugs (mean clearance 6.94 mL/min/kg vs. 3.47 mL/min/kg; half-life 50.6 hrs vs. 90.7 hrs).

MANAGEMENT: Patients who are currently receiving or have recently received drugs that induce CYP450 3A4 should be monitored for potentially decreased response to alfentanil, and the dosage adjusted as necessary.

References

Kharasch ED, Russell M, Mautz D, Thummel KE, Kunze KL, Bowdle A, Cox K "The role of cytochrome P450 3A4 in alfentanil clearance. Implications for interindividual variability in disposition and perioperative drug interactions." Anesthesiology 87 (1997): 36-50
Koehntop DE, Noormohamed SE, Fletcher CV "Effects of long-term drugs on alfentanil clearance in patients undergoing renal transplantation." Pharmacotherapy 14 (1994): 592-9
Labroo RB, Thummel KE, Kunze KL, Podoll T, Trager WF, Kharasch ED "Catalytic role of cytochrome P4503A4 in multiple pathways of alfentanil metabolism." Drug Metab Dispos 23 (1995): 490-6
Kharasch ED, Thummel KE "Human alfentanil metabolism by cytochrome P450 3A3/4. An explanation for the interindividual variability in alfentanil clearance?" Anesth Analg 76 (1993): 1033-9

Alfentanil Intravenous

Generic Name: alfentanil

Brand name:

Synonyms: Alfentanil (Intravenous)

What is Alfentanil Intravenous?

DexPak

Generic Name: dexamethasone

Brand name: Baycadron, Dexamethasone Intensol, DexPak 10 Day Taperpak, DexPak 13 DayTaperpak, DexPak 6 DayTaperpak, De-Sone LA, Dexacen-4, Dexasone, Dexasone LA, Solurex, Solurex LA, Decadron, DexPak, TaperDex, Zema-Pak, ZoDex, Zonacort

Synonyms: DexPak 10 Day Taperpak, DexPak 10 Day TaperPak

What is DexPak?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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