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Identification
NameAlfentanil
Accession NumberDB00802  (APRD00726)
TypeSmall Molecule
GroupsApproved, Illicit
DescriptionA short-acting opioid anesthetic and analgesic derivative of fentanyl. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients. [PubChem]
Structure
Thumb
Synonyms
Alfentanilum
Alfentanyl
N-(1-(2-(4-Ethyl-5-oxo-2-tetrazolin-1-yl)ethyl)-4-(methoxymethyl)-4-piperidyl)propionanilide
External Identifiers Not Available
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Alfenta Inj 500mcg/mlSolution500 mcgIntravenousJanssen Inc1988-12-312008-09-05Canada
AlfentanilInjection500 ug/mLIntravenousAkorn, Inc.2013-07-19Not applicableUs
Alfentanil HydrochlorideInjection500 ug/mLIntravenousAkorn, Inc.2010-02-01Not applicableUs
Alfentanil Injection USPSolution500 mcgIntravenousSandoz Canada Incorporated2004-11-01Not applicableCanada
Approved Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Alfentanil HydrochlorideInjection, solution500 ug/mLIntravenousHospira, Inc.1999-10-28Not applicableUs
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
RapifenJanssen
Brand mixturesNot Available
Salts
Name/CASStructureProperties
Alfentanil hydrochloride
ThumbNot applicableDBSALT001202
Categories
UNII1N74HM2BS7
CAS number71195-58-9
WeightAverage: 416.5172
Monoisotopic: 416.25358892
Chemical FormulaC21H32N6O3
InChI KeyIDBPHNDTYPBSNI-UHFFFAOYSA-N
InChI
InChI=1S/C21H32N6O3/c1-4-19(28)27(18-9-7-6-8-10-18)21(17-30-3)11-13-24(14-12-21)15-16-26-20(29)25(5-2)22-23-26/h6-10H,4-5,11-17H2,1-3H3
IUPAC Name
N-{1-[2-(4-ethyl-5-oxo-4,5-dihydro-1H-1,2,3,4-tetrazol-1-yl)ethyl]-4-(methoxymethyl)piperidin-4-yl}-N-phenylpropanamide
SMILES
CCN1N=NN(CCN2CCC(COC)(CC2)N(C(=O)CC)C2=CC=CC=C2)C1=O
Pharmacology
IndicationFor the management of postoperative pain and the maintenance of general anesthesia.
Structured Indications Not Available
PharmacodynamicsAlfentanil is a synthetic opioid analgesic. Alfentanil interacts predominately with the opioid mu-receptor. These mu-binding sites are discretely distributed in the human brain, spinal cord, and other tissues. In clinical settings, alfentanil exerts its principal pharmacologic effects on the central nervous system. Its primary actions of therapeutic value are analgesia and sedation. Alfentanil may increase the patient's tolerance for pain and decrease the perception of suffering, although the presence of the pain itself may still be recognized. In addition to analgesia, alterations in mood, euphoria and dysphoria, and drowsiness commonly occur. Alfentanil depresses the respiratory centers, depresses the cough reflex, and constricts the pupils.
Mechanism of actionOpiate receptors are coupled with G-protein receptors and function as both positive and negative regulators of synaptic transmission via G-proteins that activate effector proteins. Binding of the opiate stimulates the exchange of GTP for GDP on the G-protein complex. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine and noradrenaline is inhibited. Opioids also inhibit the release of vasopressin, somatostatin, insulin and glucagon. Alfentanil's analgesic activity is, most likely, due to its conversion to morphine. Opioids close N-type voltage-operated calcium channels (OP2-receptor agonist) and open calcium-dependent inwardly rectifying potassium channels (OP3 and OP1 receptor agonist). This results in hyperpolarization and reduced neuronal excitability.
TargetKindPharmacological actionActionsOrganismUniProt ID
Mu-type opioid receptorProteinyes
agonist
HumanP35372 details
Related Articles
AbsorptionFor intravenous injection or infusion only.
Volume of distribution
  • 0.4 to 1 L/kg
Protein binding92%
Metabolism

The liver is the major site of biotransformation.

SubstrateEnzymesProduct
Alfentanil
AMXDetails
Alfentanil
noralfentanilDetails
Route of eliminationOnly 1.0% of the dose is excreted as unchanged drug; urinary excretion is the major route of elimination of metabolites.
Half life90-111 minutes
Clearance
  • 5 mL/kg/min
ToxicitySymptoms of overexposure include characteristic rigidity of the skeletal muscles, cardiac and respiratory depression, and narrowing of the pupils.
Affected organisms
  • Humans and other mammals
Pathways
PathwayCategorySMPDB ID
Alfentanil Action PathwayDrug actionSMP00413
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
Interactions
Drug Interactions
DrugInteractionDrug group
1,1,1,2 TetrafluoroethaneThe risk or severity of adverse effects can be increased when Alfentanil is combined with 1,1,1,2 Tetrafluoroethane.Investigational
2,5-Dimethoxy-4-ethylamphetamine2,5-Dimethoxy-4-ethylamphetamine may increase the analgesic activities of Alfentanil.Experimental, Illicit
3,4-Methylenedioxyamphetamine3,4-Methylenedioxyamphetamine may increase the analgesic activities of Alfentanil.Experimental, Illicit
3,4-Methylenedioxymethamphetamine3,4-Methylenedioxymethamphetamine may increase the analgesic activities of Alfentanil.Experimental, Illicit
4-Bromo-2,5-dimethoxyamphetamine4-Bromo-2,5-dimethoxyamphetamine may increase the analgesic activities of Alfentanil.Experimental, Illicit
7-NitroindazoleThe risk or severity of adverse effects can be increased when Alfentanil is combined with 7-Nitroindazole.Experimental
7,8-DICHLORO-1,2,3,4-TETRAHYDROISOQUINOLINEAlfentanil may increase the serotonergic activities of 7,8-DICHLORO-1,2,3,4-TETRAHYDROISOQUINOLINE.Experimental
AcebutololThe serum concentration of Acebutolol can be increased when it is combined with Alfentanil.Approved
AcepromazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Acepromazine.Approved, Vet Approved
AceprometazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Aceprometazine.Approved
AcetaminophenThe serum concentration of Acetaminophen can be increased when it is combined with Alfentanil.Approved
AcetazolamideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Acetazolamide.Approved, Vet Approved
Acetylsalicylic acidThe serum concentration of Acetylsalicylic acid can be increased when it is combined with Alfentanil.Approved, Vet Approved
AclidiniumThe risk or severity of adverse effects can be increased when Aclidinium is combined with Alfentanil.Approved
adipiplonThe risk or severity of adverse effects can be increased when Alfentanil is combined with adipiplon.Investigational
AfatinibThe serum concentration of Afatinib can be increased when it is combined with Alfentanil.Approved
AgomelatineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Agomelatine.Approved, Investigational
AldosteroneThe serum concentration of Aldosterone can be increased when it is combined with Alfentanil.Experimental
AlfaxaloneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Alfaxalone.Vet Approved
AlimemazineAlimemazine may increase the hypotensive activities of Alfentanil.Approved, Vet Approved
AlitretinoinThe serum concentration of Alitretinoin can be increased when it is combined with Alfentanil.Approved, Investigational
AlphacetylmethadolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Alphacetylmethadol.Experimental, Illicit
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Alfentanil.Approved, Illicit, Investigational
AlprenololAlfentanil may increase the bradycardic activities of Alprenolol.Approved, Withdrawn
AlvimopanThe risk or severity of adverse effects can be increased when Alfentanil is combined with Alvimopan.Approved
AmbrisentanThe serum concentration of Ambrisentan can be increased when it is combined with Alfentanil.Approved, Investigational
AmilorideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Amiloride.Approved
AmiodaroneThe metabolism of Alfentanil can be decreased when combined with Amiodarone.Approved, Investigational
AmisulprideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Amisulpride.Approved, Investigational
AmitriptylineThe serum concentration of Amitriptyline can be increased when it is combined with Alfentanil.Approved
Ammonium chlorideAmmonium chloride may increase the excretion rate of Alfentanil which could result in a lower serum level and potentially a reduction in efficacy.Approved, Vet Approved
AmobarbitalThe risk or severity of adverse effects can be increased when Alfentanil is combined with Amobarbital.Approved, Illicit
AmoxapineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Amoxapine.Approved
AmperozideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Amperozide.Experimental
AmphetamineAmphetamine may increase the analgesic activities of Alfentanil.Approved, Illicit
Anisotropine MethylbromideThe risk or severity of adverse effects can be increased when Anisotropine Methylbromide is combined with Alfentanil.Approved
Aop200704Alfentanil may increase the bradycardic activities of Aop200704.Investigational
ApixabanThe serum concentration of Apixaban can be increased when it is combined with Alfentanil.Approved
AprepitantThe serum concentration of Alfentanil can be increased when it is combined with Aprepitant.Approved, Investigational
AripiprazoleThe risk or severity of adverse effects can be increased when Alfentanil is combined with Aripiprazole.Approved, Investigational
ArotinololAlfentanil may increase the bradycardic activities of Arotinolol.Approved
Arsenic trioxideThe serum concentration of Arsenic trioxide can be increased when it is combined with Alfentanil.Approved, Investigational
ArticaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Articaine.Approved
AsenapineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Asenapine.Approved
AtazanavirThe metabolism of Alfentanil can be decreased when combined with Atazanavir.Approved, Investigational
AtenololThe serum concentration of Atenolol can be increased when it is combined with Alfentanil.Approved
AtomoxetineThe metabolism of Alfentanil can be decreased when combined with Atomoxetine.Approved
Atracurium besylateThe risk or severity of adverse effects can be increased when Atracurium besylate is combined with Alfentanil.Approved
AtropineThe risk or severity of adverse effects can be increased when Atropine is combined with Alfentanil.Approved, Vet Approved
AxitinibThe serum concentration of Axitinib can be increased when it is combined with Alfentanil.Approved, Investigational
AzaperoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Azaperone.Vet Approved
AzelastineAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Azelastine.Approved
AzelastineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Azelastine.Approved
AzosemideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Azosemide.Investigational
BaclofenThe risk or severity of adverse effects can be increased when Alfentanil is combined with Baclofen.Approved
BarbitalThe risk or severity of adverse effects can be increased when Alfentanil is combined with Barbital.Illicit
BefunololAlfentanil may increase the bradycardic activities of Befunolol.Experimental
BenactyzineThe risk or severity of adverse effects can be increased when Benactyzine is combined with Alfentanil.Withdrawn
BendroflumethiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Bendroflumethiazide.Approved
BenmoxinAlfentanil may increase the serotonergic activities of Benmoxin.Withdrawn
BenperidolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Benperidol.Investigational
BenzatropineThe risk or severity of adverse effects can be increased when Benzatropine is combined with Alfentanil.Approved
BenzocaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Benzocaine.Approved
BenzphetamineBenzphetamine may increase the analgesic activities of Alfentanil.Approved, Illicit
Benzyl alcoholThe risk or severity of adverse effects can be increased when Alfentanil is combined with Benzyl alcohol.Approved
BetamethasoneThe serum concentration of Betamethasone can be increased when it is combined with Alfentanil.Approved, Vet Approved
BetaxololAlfentanil may increase the bradycardic activities of Betaxolol.Approved
BevantololAlfentanil may increase the bradycardic activities of Bevantolol.Approved
BexaroteneThe serum concentration of Alfentanil can be decreased when it is combined with Bexarotene.Approved, Investigational
BiperidenThe risk or severity of adverse effects can be increased when Biperiden is combined with Alfentanil.Approved
BisoprololAlfentanil may increase the bradycardic activities of Bisoprolol.Approved
BL-1020BL-1020 may increase the hypotensive activities of Alfentanil.Investigational
BoceprevirThe metabolism of Alfentanil can be decreased when combined with Boceprevir.Approved
BopindololAlfentanil may increase the bradycardic activities of Bopindolol.Approved
BortezomibThe metabolism of Alfentanil can be decreased when combined with Bortezomib.Approved, Investigational
BosentanThe serum concentration of Alfentanil can be decreased when it is combined with Bosentan.Approved, Investigational
BosutinibThe serum concentration of Bosutinib can be increased when it is combined with Alfentanil.Approved
Brentuximab vedotinThe serum concentration of Brentuximab vedotin can be increased when it is combined with Alfentanil.Approved
BrexpiprazoleThe risk or severity of adverse effects can be increased when Alfentanil is combined with Brexpiprazole.Approved
BrimonidineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Brimonidine.Approved
BrimonidineBrimonidine may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved
BromazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Bromazepam.Approved, Illicit
BromocriptineThe serum concentration of Bromocriptine can be increased when it is combined with Alfentanil.Approved, Investigational
BrompheniramineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Brompheniramine.Approved
BrotizolamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Brotizolam.Approved, Withdrawn
BucindololAlfentanil may increase the bradycardic activities of Bucindolol.Investigational
BufuralolAlfentanil may increase the bradycardic activities of Bufuralol.Experimental, Investigational
BumetanideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Bumetanide.Approved
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Alfentanil.Approved, Investigational
BupranololAlfentanil may increase the bradycardic activities of Bupranolol.Approved
BuprenorphineAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.Approved, Illicit, Investigational, Vet Approved
BuspironeThe risk or severity of adverse effects can be increased when Buspirone is combined with Alfentanil.Approved, Investigational
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Alfentanil.Approved, Illicit
ButacaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Butacaine.Vet Approved
ButalbitalThe risk or severity of adverse effects can be increased when Alfentanil is combined with Butalbital.Approved, Illicit
ButambenThe risk or severity of adverse effects can be increased when Alfentanil is combined with Butamben.Approved
ButethalThe risk or severity of adverse effects can be increased when Alfentanil is combined with Butethal.Approved, Illicit
ButorphanolButorphanol may decrease the analgesic activities of Alfentanil.Approved, Illicit, Vet Approved
CabazitaxelThe serum concentration of Cabazitaxel can be increased when it is combined with Alfentanil.Approved
CaffeineThe serum concentration of Caffeine can be increased when it is combined with Alfentanil.Approved
CamptothecinThe serum concentration of Camptothecin can be increased when it is combined with Alfentanil.Experimental
CanagliflozinThe serum concentration of Canagliflozin can be increased when it is combined with Alfentanil.Approved
Canrenoic acidThe risk or severity of adverse effects can be increased when Alfentanil is combined with Canrenoic acid.Approved, Withdrawn
CanrenoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Canrenone.Investigational
CarbamazepineThe metabolism of Alfentanil can be increased when combined with Carbamazepine.Approved, Investigational
CarbinoxamineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Carbinoxamine.Approved
CarbomycinThe serum concentration of Alfentanil can be increased when it is combined with Carbomycin.Vet Approved
CarfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Carfentanil.Illicit, Vet Approved
CarfilzomibThe serum concentration of Carfilzomib can be increased when it is combined with Alfentanil.Approved
CarisoprodolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Carisoprodol.Approved
CaroxazoneAlfentanil may increase the serotonergic activities of Caroxazone.Withdrawn
CarteololAlfentanil may increase the bradycardic activities of Carteolol.Approved
CarvedilolAlfentanil may increase the bradycardic activities of Carvedilol.Approved, Investigational
CeliprololAlfentanil may increase the bradycardic activities of Celiprolol.Approved, Investigational
CeritinibThe serum concentration of Alfentanil can be increased when it is combined with Ceritinib.Approved
CerivastatinThe serum concentration of Cerivastatin can be increased when it is combined with Alfentanil.Withdrawn
CetirizineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Cetirizine.Approved
Chloral hydrateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chloral hydrate.Approved, Illicit, Vet Approved
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Alfentanil.Approved, Illicit
ChlormezanoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chlormezanone.Approved, Withdrawn
ChloroprocaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chloroprocaine.Approved
ChlorothiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chlorothiazide.Approved, Vet Approved
ChlorphenamineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chlorphenamine.Approved
ChlorphenoxamineThe risk or severity of adverse effects can be increased when Chlorphenoxamine is combined with Alfentanil.Withdrawn
ChlorphentermineChlorphentermine may increase the analgesic activities of Alfentanil.Illicit, Withdrawn
ChlorpromazineThe serum concentration of Chlorpromazine can be increased when it is combined with Alfentanil.Approved, Vet Approved
ChlorprothixeneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chlorprothixene.Approved, Withdrawn
ChlorthalidoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chlorthalidone.Approved
ChlorzoxazoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Chlorzoxazone.Approved
CicletanineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Cicletanine.Investigational
CimetidineThe serum concentration of Alfentanil can be increased when it is combined with Cimetidine.Approved
CinchocaineThe risk or severity of adverse effects can be increased when Cinchocaine is combined with Alfentanil.Approved, Vet Approved
CiprofloxacinThe serum concentration of Ciprofloxacin can be increased when it is combined with Alfentanil.Approved, Investigational
CisplatinThe serum concentration of Cisplatin can be increased when it is combined with Alfentanil.Approved
CitalopramThe serum concentration of Citalopram can be increased when it is combined with Alfentanil.Approved
ClarithromycinThe serum concentration of Alfentanil can be increased when it is combined with Clarithromycin.Approved
ClemastineThe metabolism of Alfentanil can be decreased when combined with Clemastine.Approved
ClidiniumThe risk or severity of adverse effects can be increased when Alfentanil is combined with Clidinium.Approved
ClobazamThe serum concentration of Clobazam can be increased when it is combined with Alfentanil.Approved, Illicit
clomethiazoleThe risk or severity of adverse effects can be increased when Alfentanil is combined with clomethiazole.Investigational
ClomifeneThe serum concentration of Clomifene can be increased when it is combined with Alfentanil.Approved, Investigational
ClomipramineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Clomipramine.Approved, Vet Approved
ClonazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Clonazepam.Approved, Illicit
ClonidineThe serum concentration of Clonidine can be increased when it is combined with Alfentanil.Approved
ClopidogrelThe serum concentration of Clopidogrel can be increased when it is combined with Alfentanil.Approved, Nutraceutical
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Alfentanil.Approved, Illicit
ClotrimazoleThe metabolism of Alfentanil can be decreased when combined with Clotrimazole.Approved, Vet Approved
ClozapineThe serum concentration of Clozapine can be increased when it is combined with Alfentanil.Approved
CobicistatThe metabolism of Alfentanil can be decreased when combined with Cobicistat.Approved
CobimetinibThe serum concentration of Cobimetinib can be increased when it is combined with Alfentanil.Approved
CocaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Cocaine.Approved, Illicit
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Alfentanil.Approved, Illicit
ColchicineThe serum concentration of Colchicine can be increased when it is combined with Alfentanil.Approved
ConivaptanThe serum concentration of Alfentanil can be increased when it is combined with Conivaptan.Approved, Investigational
Conjugated Equine EstrogensThe serum concentration of Conjugated Equine Estrogens can be increased when it is combined with Alfentanil.Approved
CrizotinibThe serum concentration of Alfentanil can be increased when it is combined with Crizotinib.Approved
CyclizineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Cyclizine.Approved
CyclobenzaprineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Cyclobenzaprine.Approved
CyclopentolateThe risk or severity of adverse effects can be increased when Cyclopentolate is combined with Alfentanil.Approved
CyclosporineThe metabolism of Alfentanil can be decreased when combined with Cyclosporine.Approved, Investigational, Vet Approved
CyclothiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Cyclothiazide.Approved
CyproheptadineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Cyproheptadine.Approved
Dabigatran etexilateThe serum concentration of the active metabolites of Dabigatran etexilate can be increased when Dabigatran etexilate is used in combination with Alfentanil.Approved
DabrafenibThe serum concentration of Alfentanil can be decreased when it is combined with Dabrafenib.Approved
DactinomycinThe serum concentration of Dactinomycin can be increased when it is combined with Alfentanil.Approved
DantroleneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dantrolene.Approved
DapagliflozinThe serum concentration of Dapagliflozin can be increased when it is combined with Alfentanil.Approved
DapiprazoleThe risk or severity of adverse effects can be increased when Dapiprazole is combined with Alfentanil.Approved
DapoxetineAlfentanil may increase the serotonergic activities of Dapoxetine.Investigational
DarifenacinThe risk or severity of adverse effects can be increased when Darifenacin is combined with Alfentanil.Approved, Investigational
DarunavirThe metabolism of Alfentanil can be decreased when combined with Darunavir.Approved
DasabuvirThe serum concentration of Alfentanil can be increased when it is combined with Dasabuvir.Approved
DasatinibThe serum concentration of Alfentanil can be increased when it is combined with Dasatinib.Approved, Investigational
DaunorubicinThe serum concentration of Daunorubicin can be increased when it is combined with Alfentanil.Approved
DebrisoquinThe serum concentration of Debrisoquin can be increased when it is combined with Alfentanil.Approved
DeferasiroxThe serum concentration of Alfentanil can be decreased when it is combined with Deferasirox.Approved, Investigational
DelavirdineThe metabolism of Alfentanil can be decreased when combined with Delavirdine.Approved
deramciclaneThe risk or severity of adverse effects can be increased when Alfentanil is combined with deramciclane.Investigational
DesfluraneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Desflurane.Approved
DesipramineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Desipramine.Approved
DesloratadineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Desloratadine.Approved, Investigational
DesmopressinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Desmopressin.Approved
DesvenlafaxineAlfentanil may increase the serotonergic activities of Desvenlafaxine.Approved
DetomidineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Detomidine.Vet Approved
DexamethasoneThe serum concentration of Alfentanil can be decreased when it is combined with Dexamethasone.Approved, Investigational, Vet Approved
DexbrompheniramineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dexbrompheniramine.Approved
DexetimideThe risk or severity of adverse effects can be increased when Dexetimide is combined with Alfentanil.Withdrawn
DexmedetomidineThe risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Alfentanil.Approved, Vet Approved
DextroamphetamineDextroamphetamine may increase the analgesic activities of Alfentanil.Approved, Illicit
DextromoramideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dextromoramide.Experimental, Illicit
DextropropoxypheneThe risk or severity of adverse effects can be increased when Dextropropoxyphene is combined with Alfentanil.Approved, Illicit, Withdrawn
DezocineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dezocine.Approved
DiazepamDiazepam may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved, Illicit, Vet Approved
DicyclomineThe risk or severity of adverse effects can be increased when Dicyclomine is combined with Alfentanil.Approved
DiethylpropionDiethylpropion may increase the analgesic activities of Alfentanil.Approved, Illicit
DiethylstilbestrolThe serum concentration of Diethylstilbestrol can be increased when it is combined with Alfentanil.Approved
DifenoxinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Difenoxin.Approved, Illicit
DigitoxinThe serum concentration of Digitoxin can be increased when it is combined with Alfentanil.Approved
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Alfentanil.Approved
DihydrocodeineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dihydrocodeine.Approved, Illicit
DihydroergotamineThe metabolism of Alfentanil can be decreased when combined with Dihydroergotamine.Approved
DihydroetorphineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dihydroetorphine.Experimental, Illicit
DihydromorphineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dihydromorphine.Experimental, Illicit
DihydrotestosteroneThe serum concentration of Dihydrotestosterone can be increased when it is combined with Alfentanil.Illicit
DiltiazemThe serum concentration of Alfentanil can be increased when it is combined with Diltiazem.Approved
DimenhydrinateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Dimenhydrinate.Approved
DiphenhydramineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Diphenhydramine.Approved
DiphenoxylateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Diphenoxylate.Approved, Illicit
DipyridamoleThe serum concentration of Dipyridamole can be increased when it is combined with Alfentanil.Approved
DocetaxelThe serum concentration of Docetaxel can be increased when it is combined with Alfentanil.Approved, Investigational
DomperidoneThe serum concentration of Domperidone can be increased when it is combined with Alfentanil.Approved, Investigational, Vet Approved
DoramectinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Doramectin.Vet Approved
DoxepinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Doxepin.Approved
DoxorubicinThe serum concentration of Doxorubicin can be increased when it is combined with Alfentanil.Approved, Investigational
DoxycyclineThe metabolism of Alfentanil can be decreased when combined with Doxycycline.Approved, Investigational, Vet Approved
DoxylamineDoxylamine may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved, Vet Approved
DPDPEThe risk or severity of adverse effects can be increased when Alfentanil is combined with DPDPE.Investigational
DronabinolDronabinol may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved, Illicit
DronedaroneThe metabolism of Alfentanil can be decreased when combined with Dronedarone.Approved
DroperidolDroperidol may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved, Vet Approved
DrospirenoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Drospirenone.Approved
DrotebanolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Drotebanol.Experimental, Illicit
DuloxetineAlfentanil may increase the serotonergic activities of Duloxetine.Approved
DyclonineThe risk or severity of adverse effects can be increased when Dyclonine is combined with Alfentanil.Approved
EcgonineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ecgonine.Experimental, Illicit
ECGONINE METHYL ESTERThe risk or severity of adverse effects can be increased when Alfentanil is combined with ECGONINE METHYL ESTER.Experimental
EcopipamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ecopipam.Investigational
EdoxabanThe serum concentration of Edoxaban can be increased when it is combined with Alfentanil.Approved
EfavirenzThe serum concentration of Alfentanil can be decreased when it is combined with Efavirenz.Approved, Investigational
EfonidipineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Efonidipine.Approved
EletriptanThe serum concentration of Eletriptan can be increased when it is combined with Alfentanil.Approved, Investigational
EluxadolineAlfentanil may increase the constipating activities of Eluxadoline.Approved
EnfluraneThe risk or severity of adverse effects can be increased when Enflurane is combined with Alfentanil.Approved, Vet Approved
EntacaponeThe risk or severity of adverse effects can be increased when Alfentanil is combined with Entacapone.Approved, Investigational
EnzalutamideThe serum concentration of Alfentanil can be decreased when it is combined with Enzalutamide.Approved
EpinastineThe serum concentration of Epinastine can be increased when it is combined with Alfentanil.Approved, Investigational
EplerenoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Eplerenone.Approved
ErlotinibThe serum concentration of Erlotinib can be increased when it is combined with Alfentanil.Approved, Investigational
ErythromycinThe serum concentration of Alfentanil can be increased when it is combined with Erythromycin.Approved, Vet Approved
EscitalopramAlfentanil may increase the serotonergic activities of Escitalopram.Approved, Investigational
Eslicarbazepine acetateThe serum concentration of Alfentanil can be decreased when it is combined with Eslicarbazepine acetate.Approved
EsmololAlfentanil may increase the bradycardic activities of Esmolol.Approved
EstazolamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Estazolam.Approved, Illicit
EstradiolThe serum concentration of Estradiol can be increased when it is combined with Alfentanil.Approved, Investigational, Vet Approved
EstriolThe serum concentration of Estriol can be increased when it is combined with Alfentanil.Approved, Vet Approved
EstroneThe serum concentration of Estrone can be increased when it is combined with Alfentanil.Approved
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Alfentanil.Approved
Etacrynic acidThe risk or severity of adverse effects can be increased when Alfentanil is combined with Etacrynic acid.Approved
EthanolAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Ethanol.Approved
EthchlorvynolThe risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Alfentanil.Approved, Illicit, Withdrawn
Ethinyl EstradiolThe serum concentration of Ethinyl Estradiol can be increased when it is combined with Alfentanil.Approved
EthopropazineThe risk or severity of adverse effects can be increased when Ethopropazine is combined with Alfentanil.Approved
EthosuximideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ethosuximide.Approved
EthotoinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ethotoin.Approved
EthoxzolamideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ethoxzolamide.Withdrawn
Ethyl carbamateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ethyl carbamate.Withdrawn
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ethyl loflazepate.Approved, Illicit
EthylmorphineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ethylmorphine.Approved, Illicit
EtidocaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Etidocaine.Approved
EtifoxineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Etifoxine.Withdrawn
EtizolamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Etizolam.Approved
EtomidateThe risk or severity of adverse effects can be increased when Etomidate is combined with Alfentanil.Approved
EtoperidoneAlfentanil may increase the serotonergic activities of Etoperidone.Approved
EtoposideThe serum concentration of Etoposide can be increased when it is combined with Alfentanil.Approved
EtorphineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Etorphine.Illicit, Vet Approved
EtravirineThe serum concentration of Alfentanil can be decreased when it is combined with Etravirine.Approved
EverolimusThe serum concentration of Everolimus can be increased when it is combined with Alfentanil.Approved
EzetimibeThe serum concentration of Ezetimibe can be increased when it is combined with Alfentanil.Approved
EzogabineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ezogabine.Approved
FelbamateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Felbamate.Approved
FencamfamineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Fencamfamine.Approved, Illicit, Withdrawn
FentanylThe risk or severity of adverse effects can be increased when Alfentanil is combined with Fentanyl.Approved, Illicit, Investigational, Vet Approved
FesoterodineThe serum concentration of Fesoterodine can be increased when it is combined with Alfentanil.Approved
FexofenadineThe serum concentration of Fexofenadine can be increased when it is combined with Alfentanil.Approved
FidaxomicinThe serum concentration of Fidaxomicin can be increased when it is combined with Alfentanil.Approved
FlibanserinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Flibanserin.Approved
FluconazoleThe serum concentration of Alfentanil can be increased when it is combined with Fluconazole.Approved
FludiazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Fludiazepam.Approved, Illicit
FlunarizineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Flunarizine.Approved
FlunitrazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Flunitrazepam.Approved, Illicit
FluoxetineAlfentanil may increase the serotonergic activities of Fluoxetine.Approved, Vet Approved
FlupentixolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Flupentixol.Approved, Withdrawn
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Alfentanil.Approved
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Alfentanil.Approved, Illicit
FluspirileneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Fluspirilene.Approved
Fluticasone furoateThe serum concentration of Fluticasone furoate can be increased when it is combined with Alfentanil.Approved
Fluticasone PropionateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Fluticasone Propionate.Approved
FluvoxamineThe metabolism of Alfentanil can be decreased when combined with Fluvoxamine.Approved, Investigational
FosamprenavirThe metabolism of Alfentanil can be decreased when combined with Fosamprenavir.Approved
FosaprepitantThe serum concentration of Alfentanil can be increased when it is combined with Fosaprepitant.Approved
FosphenytoinThe metabolism of Alfentanil can be increased when combined with Fosphenytoin.Approved
FospropofolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Fospropofol.Approved, Illicit
FurazolidoneAlfentanil may increase the serotonergic activities of Furazolidone.Approved, Vet Approved
FurosemideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Furosemide.Approved, Vet Approved
Fusidic AcidThe serum concentration of Alfentanil can be increased when it is combined with Fusidic Acid.Approved
GabapentinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Gabapentin.Approved, Investigational
gabapentin enacarbilThe risk or severity of adverse effects can be increased when Alfentanil is combined with gabapentin enacarbil.Approved
Gallamine TriethiodideThe risk or severity of adverse effects can be increased when Gallamine Triethiodide is combined with Alfentanil.Approved
Gamma Hydroxybutyric AcidThe risk or severity of adverse effects can be increased when Alfentanil is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
GefitinibThe serum concentration of Gefitinib can be increased when it is combined with Alfentanil.Approved, Investigational
GemcitabineThe serum concentration of Gemcitabine can be increased when it is combined with Alfentanil.Approved
GepironeThe risk or severity of adverse effects can be increased when Alfentanil is combined with Gepirone.Investigational
GlutethimideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Glutethimide.Approved, Illicit
GlycopyrroniumThe risk or severity of adverse effects can be increased when Glycopyrronium is combined with Alfentanil.Approved, Investigational, Vet Approved
GrazoprevirThe serum concentration of Grazoprevir can be increased when it is combined with Alfentanil.Approved
GrepafloxacinThe serum concentration of Grepafloxacin can be increased when it is combined with Alfentanil.Withdrawn
GuanfacineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Guanfacine.Approved, Investigational
HalazepamThe risk or severity of adverse effects can be increased when Halazepam is combined with Alfentanil.Approved, Illicit, Withdrawn
HaloperidolThe serum concentration of Haloperidol can be increased when it is combined with Alfentanil.Approved
HalothaneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Halothane.Approved, Vet Approved
HeroinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Heroin.Approved, Illicit
HexamethoniumThe risk or severity of adverse effects can be increased when Hexamethonium is combined with Alfentanil.Experimental
HexobarbitalThe risk or severity of adverse effects can be increased when Alfentanil is combined with Hexobarbital.Approved
HomatropineThe risk or severity of adverse effects can be increased when Homatropine is combined with Alfentanil.Approved
HydracarbazineAlfentanil may increase the serotonergic activities of Hydracarbazine.Approved
HydrochlorothiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Hydrochlorothiazide.Approved, Vet Approved
HydrocodoneAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.Approved, Illicit
HydrocortisoneThe serum concentration of Hydrocortisone can be increased when it is combined with Alfentanil.Approved, Vet Approved
HydroflumethiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Hydroflumethiazide.Approved
HydromorphoneThe risk or severity of adverse effects can be increased when Hydromorphone is combined with Alfentanil.Approved, Illicit
Hydroxyamphetamine hydrobromideHydroxyamphetamine hydrobromide may increase the analgesic activities of Alfentanil.Approved
HydroxyzineHydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved
HyoscyamineThe risk or severity of adverse effects can be increased when Hyoscyamine is combined with Alfentanil.Approved
IbuprofenThe serum concentration of Ibuprofen can be increased when it is combined with Alfentanil.Approved
IdelalisibThe serum concentration of Alfentanil can be increased when it is combined with Idelalisib.Approved
IloperidoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Iloperidone.Approved
ImatinibThe metabolism of Alfentanil can be decreased when combined with Imatinib.Approved
ImipramineThe serum concentration of Imipramine can be increased when it is combined with Alfentanil.Approved
IndacaterolThe serum concentration of Indacaterol can be increased when it is combined with Alfentanil.Approved
IndalpineAlfentanil may increase the serotonergic activities of Indalpine.Investigational, Withdrawn
IndapamideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Indapamide.Approved
IndenololAlfentanil may increase the bradycardic activities of Indenolol.Withdrawn
IndinavirThe metabolism of Alfentanil can be decreased when combined with Indinavir.Approved
IndomethacinThe serum concentration of Indomethacin can be increased when it is combined with Alfentanil.Approved, Investigational
Ipratropium bromideThe risk or severity of adverse effects can be increased when Ipratropium bromide is combined with Alfentanil.Approved
IproclozideAlfentanil may increase the serotonergic activities of Iproclozide.Withdrawn
IproniazidAlfentanil may increase the serotonergic activities of Iproniazid.Withdrawn
IrinotecanThe serum concentration of Irinotecan can be increased when it is combined with Alfentanil.Approved, Investigational
IsavuconazoniumThe metabolism of Alfentanil can be decreased when combined with Isavuconazonium.Approved, Investigational
IsocarboxazidAlfentanil may increase the serotonergic activities of Isocarboxazid.Approved
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Alfentanil.Approved, Vet Approved
IsosorbideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Isosorbide.Approved
IsradipineThe metabolism of Alfentanil can be decreased when combined with Isradipine.Approved
ItraconazoleThe metabolism of Alfentanil can be decreased when combined with Itraconazole.Approved, Investigational
IvacaftorThe serum concentration of Alfentanil can be increased when it is combined with Ivacaftor.Approved
IvermectinThe serum concentration of Ivermectin can be increased when it is combined with Alfentanil.Approved, Vet Approved
JosamycinThe serum concentration of Alfentanil can be increased when it is combined with Josamycin.Approved
KetamineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ketamine.Approved, Vet Approved
KetazolamThe serum concentration of Ketazolam can be increased when it is combined with Alfentanil.Approved
KetobemidoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ketobemidone.Approved
KetoconazoleThe metabolism of Alfentanil can be decreased when combined with Ketoconazole.Approved, Investigational
KitasamycinThe serum concentration of Alfentanil can be increased when it is combined with Kitasamycin.Experimental
KW-3902The risk or severity of adverse effects can be increased when Alfentanil is combined with KW-3902.Investigational
LabetalolAlfentanil may increase the bradycardic activities of Labetalol.Approved
LamivudineThe serum concentration of Lamivudine can be increased when it is combined with Alfentanil.Approved, Investigational
LamotrigineThe serum concentration of Lamotrigine can be increased when it is combined with Alfentanil.Approved, Investigational
LansoprazoleThe serum concentration of Lansoprazole can be increased when it is combined with Alfentanil.Approved, Investigational
LedipasvirThe serum concentration of Ledipasvir can be increased when it is combined with Alfentanil.Approved
LenalidomideThe serum concentration of Lenalidomide can be increased when it is combined with Alfentanil.Approved
LenvatinibThe serum concentration of Lenvatinib can be increased when it is combined with Alfentanil.Approved
LevetiracetamThe serum concentration of Levetiracetam can be increased when it is combined with Alfentanil.Approved, Investigational
LevobunololAlfentanil may increase the bradycardic activities of Levobunolol.Approved
LevobupivacaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levobupivacaine.Approved
LevocabastineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levocabastine.Approved
LevocetirizineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levocetirizine.Approved
LevodopaThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levodopa.Approved
LevofloxacinThe serum concentration of Levofloxacin can be increased when it is combined with Alfentanil.Approved, Investigational
Levomethadyl AcetateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levomethadyl Acetate.Approved
LevomilnacipranThe serum concentration of Levomilnacipran can be increased when it is combined with Alfentanil.Approved
LevorphanolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Levorphanol.Approved
LidocaineThe risk or severity of adverse effects can be increased when Lidocaine is combined with Alfentanil.Approved, Vet Approved
LinagliptinThe serum concentration of Linagliptin can be increased when it is combined with Alfentanil.Approved
LisdexamfetamineLisdexamfetamine may increase the analgesic activities of Alfentanil.Approved, Investigational
LithiumThe risk or severity of adverse effects can be increased when Alfentanil is combined with Lithium.Approved
LofentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Lofentanil.Illicit
LoperamideThe serum concentration of Loperamide can be increased when it is combined with Alfentanil.Approved
LopinavirThe metabolism of Alfentanil can be decreased when combined with Lopinavir.Approved
LoratadineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Loratadine.Approved
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Alfentanil.Approved
LosartanThe serum concentration of Losartan can be increased when it is combined with Alfentanil.Approved
LovastatinThe metabolism of Alfentanil can be decreased when combined with Lovastatin.Approved, Investigational
LoxapineThe risk or severity of adverse effects can be increased when Loxapine is combined with Alfentanil.Approved
Lu AA21004The risk or severity of adverse effects can be increased when Alfentanil is combined with Lu AA21004.Investigational
LuliconazoleThe serum concentration of Alfentanil can be increased when it is combined with Luliconazole.Approved
LumacaftorThe metabolism of Alfentanil can be increased when combined with Lumacaftor.Approved
LurasidoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Lurasidone.Approved
Magnesium SulfateMagnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved, Vet Approved
MannitolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Mannitol.Approved, Investigational
MaprotilineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Maprotiline.Approved
MebanazineAlfentanil may increase the serotonergic activities of Mebanazine.Withdrawn
MecamylamineThe risk or severity of adverse effects can be increased when Mecamylamine is combined with Alfentanil.Approved
MeclizineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Meclizine.Approved
MedetomidineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Medetomidine.Vet Approved
MelatoninThe risk or severity of adverse effects can be increased when Alfentanil is combined with Melatonin.Approved, Nutraceutical, Vet Approved
MelperoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Melperone.Approved
MephedroneMephedrone may increase the analgesic activities of Alfentanil.Investigational
MephentermineMephentermine may increase the analgesic activities of Alfentanil.Approved
MepivacaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Mepivacaine.Approved, Vet Approved
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Alfentanil.Approved, Illicit
MersalylThe risk or severity of adverse effects can be increased when Alfentanil is combined with Mersalyl.Approved
MesoridazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Mesoridazine.Approved
MetaxaloneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Metaxalone.Approved
MethadoneThe risk or severity of adverse effects can be increased when Methadone is combined with Alfentanil.Approved
Methadyl AcetateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methadyl Acetate.Approved, Illicit
MethamphetamineMethamphetamine may increase the analgesic activities of Alfentanil.Approved, Illicit
MethanthelineThe risk or severity of adverse effects can be increased when Methantheline is combined with Alfentanil.Approved
MethapyrileneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methapyrilene.Withdrawn
MethaqualoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methaqualone.Illicit, Withdrawn
MethazolamideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methazolamide.Approved
MethocarbamolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methocarbamol.Approved, Vet Approved
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Alfentanil.Approved
MethotrexateThe serum concentration of Methotrexate can be increased when it is combined with Alfentanil.Approved
MethotrimeprazineAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.Approved
MethoxyfluraneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methoxyflurane.Approved, Vet Approved
MethsuximideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methsuximide.Approved
MethyclothiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methyclothiazide.Approved
Methylene blueAlfentanil may increase the serotonergic activities of Methylene blue.Investigational
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Alfentanil is combined with Methylphenobarbital.Approved
MethylprednisoloneThe serum concentration of Methylprednisolone can be increased when it is combined with Alfentanil.Approved, Vet Approved
MetipranololAlfentanil may increase the bradycardic activities of Metipranolol.Approved
MetixeneThe risk or severity of adverse effects can be increased when Metixene is combined with Alfentanil.Approved
MetolazoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Metolazone.Approved
MetoprololThe serum concentration of Metoprolol can be increased when it is combined with Alfentanil.Approved, Investigational
MetyrosineAlfentanil may increase the sedative activities of Metyrosine.Approved
MidazolamThe serum concentration of Midazolam can be increased when it is combined with Alfentanil.Approved, Illicit
MifepristoneThe serum concentration of Alfentanil can be increased when it is combined with Mifepristone.Approved, Investigational
MilnacipranAlfentanil may increase the serotonergic activities of Milnacipran.Approved
MinaprineAlfentanil may increase the serotonergic activities of Minaprine.Approved
MinocyclineMinocycline may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved, Investigational
MirabegronThe serum concentration of Mirabegron can be increased when it is combined with Alfentanil.Approved
MirtazapineAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.Approved
MitotaneThe serum concentration of Alfentanil can be decreased when it is combined with Mitotane.Approved
MitoxantroneThe serum concentration of Mitoxantrone can be increased when it is combined with Alfentanil.Approved, Investigational
MMDAMMDA may increase the analgesic activities of Alfentanil.Experimental, Illicit
MoclobemideAlfentanil may increase the serotonergic activities of Moclobemide.Approved
ModafinilThe serum concentration of Alfentanil can be decreased when it is combined with Modafinil.Approved, Investigational
MolindoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Molindone.Approved
MoricizineMoricizine may increase the hypotensive activities of Alfentanil.Approved, Withdrawn
MorphineThe serum concentration of Morphine can be increased when it is combined with Alfentanil.Approved, Investigational
Mycophenolate mofetilThe serum concentration of Mycophenolate mofetil can be increased when it is combined with Alfentanil.Approved, Investigational
N-butylscopolammonium bromideThe risk or severity of adverse effects can be increased when N-butylscopolammonium bromide is combined with Alfentanil.Vet Approved
NabiloneNabilone may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved, Investigational
NadololThe serum concentration of Nadolol can be increased when it is combined with Alfentanil.Approved
NafcillinThe serum concentration of Alfentanil can be decreased when it is combined with Nafcillin.Approved
NalbuphineNalbuphine may decrease the analgesic activities of Alfentanil.Approved
NaloxegolThe serum concentration of Naloxegol can be increased when it is combined with Alfentanil.Approved
NaloxoneThe serum concentration of Naloxone can be increased when it is combined with Alfentanil.Approved, Vet Approved
NaltrexoneThe therapeutic efficacy of Alfentanil can be decreased when used in combination with Naltrexone.Approved, Investigational, Vet Approved
NefazodoneThe metabolism of Alfentanil can be decreased when combined with Nefazodone.Approved, Withdrawn
NelfinavirThe metabolism of Alfentanil can be decreased when combined with Nelfinavir.Approved
NetupitantThe serum concentration of Alfentanil can be increased when it is combined with Netupitant.Approved
NevirapineThe metabolism of Alfentanil can be increased when combined with Nevirapine.Approved
NialamideAlfentanil may increase the serotonergic activities of Nialamide.Withdrawn
NicardipineThe serum concentration of Nicardipine can be increased when it is combined with Alfentanil.Approved
NifedipineThe serum concentration of Nifedipine can be increased when it is combined with Alfentanil.Approved
NilotinibThe metabolism of Alfentanil can be decreased when combined with Nilotinib.Approved, Investigational
NintedanibThe serum concentration of Nintedanib can be increased when it is combined with Alfentanil.Approved
NitrazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Nitrazepam.Approved
Nitrous oxideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Nitrous oxide.Approved, Vet Approved
NizatidineThe serum concentration of Nizatidine can be increased when it is combined with Alfentanil.Approved
NormethadoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Normethadone.Approved, Illicit
NortriptylineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Nortriptyline.Approved
NVA237The risk or severity of adverse effects can be increased when NVA237 is combined with Alfentanil.Investigational
OctamoxinAlfentanil may increase the serotonergic activities of Octamoxin.Withdrawn
OlanzapineThe serum concentration of Olanzapine can be increased when it is combined with Alfentanil.Approved, Investigational
OlaparibThe metabolism of Alfentanil can be decreased when combined with Olaparib.Approved
OleandomycinThe serum concentration of Alfentanil can be increased when it is combined with Oleandomycin.Vet Approved
OlopatadineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Olopatadine.Approved
OmbitasvirThe serum concentration of Alfentanil can be increased when it is combined with Ombitasvir.Approved
OndansetronThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ondansetron.Approved
OpiumThe risk or severity of adverse effects can be increased when Alfentanil is combined with Opium.Approved, Illicit
OrphenadrineAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.Approved
OsanetantThe risk or severity of adverse effects can be increased when Alfentanil is combined with Osanetant.Investigational
OsimertinibThe serum concentration of Alfentanil can be increased when it is combined with Osimertinib.Approved
OxazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Oxazepam.Approved
OxetacaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Oxetacaine.Investigational
OxprenololThe risk or severity of adverse effects can be increased when Alfentanil is combined with Oxprenolol.Approved
OxybuprocaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Oxybuprocaine.Approved
OxybutyninThe risk or severity of adverse effects can be increased when Oxybutynin is combined with Alfentanil.Approved, Investigational
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Alfentanil.Approved, Illicit, Investigational
OxymorphoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Oxymorphone.Approved, Investigational, Vet Approved
OxyphenoniumThe risk or severity of adverse effects can be increased when Oxyphenonium is combined with Alfentanil.Approved
PaclitaxelThe serum concentration of Paclitaxel can be increased when it is combined with Alfentanil.Approved, Vet Approved
PalbociclibThe serum concentration of Alfentanil can be increased when it is combined with Palbociclib.Approved
PaliperidoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Paliperidone.Approved
PancuroniumThe risk or severity of adverse effects can be increased when Pancuronium is combined with Alfentanil.Approved
PanobinostatThe serum concentration of Panobinostat can be increased when it is combined with Alfentanil.Approved, Investigational
ParaldehydeAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.Approved
PargylineAlfentanil may increase the serotonergic activities of Pargyline.Approved
ParitaprevirThe serum concentration of Alfentanil can be increased when it is combined with Paritaprevir.Approved
ParoxetineAlfentanil may increase the serotonergic activities of Paroxetine.Approved, Investigational
PazopanibThe serum concentration of Pazopanib can be increased when it is combined with Alfentanil.Approved
PegvisomantThe therapeutic efficacy of Pegvisomant can be decreased when used in combination with Alfentanil.Approved
PenbutololAlfentanil may increase the bradycardic activities of Penbutolol.Approved, Investigational
PentazocinePentazocine may decrease the analgesic activities of Alfentanil.Approved, Vet Approved
PentobarbitalThe metabolism of Alfentanil can be increased when combined with Pentobarbital.Approved, Vet Approved
PentoliniumThe risk or severity of adverse effects can be increased when Pentolinium is combined with Alfentanil.Approved
PerampanelPerampanel may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved
PerazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Perazine.Investigational
PerospironeThe risk or severity of adverse effects can be increased when Alfentanil is combined with Perospirone.Approved
PerphenazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Perphenazine.Approved
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Alfentanil.Approved
PhenelzineAlfentanil may increase the serotonergic activities of Phenelzine.Approved
PheniprazineAlfentanil may increase the serotonergic activities of Pheniprazine.Withdrawn
PhenobarbitalThe metabolism of Alfentanil can be increased when combined with Phenobarbital.Approved
PhenoxyethanolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Phenoxyethanol.Approved
PhenoxypropazineAlfentanil may increase the serotonergic activities of Phenoxypropazine.Withdrawn
PhenterminePhentermine may increase the analgesic activities of Alfentanil.Approved, Illicit
PhenytoinThe metabolism of Alfentanil can be increased when combined with Phenytoin.Approved, Vet Approved
PimozideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Pimozide.Approved
PindololAlfentanil may increase the bradycardic activities of Pindolol.Approved
PipamperoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Pipamperone.Approved
PipecuroniumThe risk or severity of adverse effects can be increased when Pipecuronium is combined with Alfentanil.Approved
PipotiazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Pipotiazine.Approved
PirenzepineThe risk or severity of adverse effects can be increased when Pirenzepine is combined with Alfentanil.Approved
PiretanideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Piretanide.Experimental
PiritramideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Piritramide.Investigational
PirlindoleAlfentanil may increase the serotonergic activities of Pirlindole.Approved
PitavastatinThe serum concentration of Pitavastatin can be increased when it is combined with Alfentanil.Approved
PivhydrazineAlfentanil may increase the serotonergic activities of Pivhydrazine.Withdrawn
PizotifenThe risk or severity of adverse effects can be increased when Alfentanil is combined with Pizotifen.Approved
PolythiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Polythiazide.Approved
PomalidomideThe serum concentration of Pomalidomide can be increased when it is combined with Alfentanil.Approved
PonatinibThe serum concentration of Ponatinib can be increased when it is combined with Alfentanil.Approved
PosaconazoleThe metabolism of Alfentanil can be decreased when combined with Posaconazole.Approved, Investigational, Vet Approved
PotassiumThe risk or severity of adverse effects can be increased when Alfentanil is combined with Potassium.Approved
Potassium CitrateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Potassium Citrate.Approved, Vet Approved
PractololAlfentanil may increase the bradycardic activities of Practolol.Approved
PramipexoleAlfentanil may increase the sedative activities of Pramipexole.Approved, Investigational
PramocaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Pramocaine.Approved
PravastatinThe serum concentration of Pravastatin can be increased when it is combined with Alfentanil.Approved
PrazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Prazepam.Approved, Illicit
PrazosinThe serum concentration of Prazosin can be increased when it is combined with Alfentanil.Approved
PrednisoloneThe serum concentration of Prednisolone can be increased when it is combined with Alfentanil.Approved, Vet Approved
PrednisoneThe serum concentration of Prednisone can be increased when it is combined with Alfentanil.Approved, Vet Approved
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Alfentanil.Approved, Illicit, Investigational
PregnanoloneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Pregnanolone.Investigational
PrilocaineThe risk or severity of adverse effects can be increased when Prilocaine is combined with Alfentanil.Approved
PrimidoneThe metabolism of Alfentanil can be increased when combined with Primidone.Approved, Vet Approved
ProcaineThe risk or severity of adverse effects can be increased when Procaine is combined with Alfentanil.Approved, Investigational, Vet Approved
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Alfentanil.Approved, Vet Approved
ProcyclidineThe risk or severity of adverse effects can be increased when Procyclidine is combined with Alfentanil.Approved
ProgesteroneThe serum concentration of Progesterone can be increased when it is combined with Alfentanil.Approved, Vet Approved
PromazineThe risk or severity of adverse effects can be increased when Promazine is combined with Alfentanil.Approved, Vet Approved
PromethazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Promethazine.Approved
PropanthelineThe risk or severity of adverse effects can be increased when Propantheline is combined with Alfentanil.Approved
ProparacaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Proparacaine.Approved, Vet Approved
PropiopromazinePropiopromazine may increase the hypotensive activities of Alfentanil.Vet Approved
PropiverineThe risk or severity of adverse effects can be increased when Propiverine is combined with Alfentanil.Investigational
PropofolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Propofol.Approved, Investigational, Vet Approved
PropoxycaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Propoxycaine.Approved
PropranololThe serum concentration of Propranolol can be increased when it is combined with Alfentanil.Approved, Investigational
ProtriptylineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Protriptyline.Approved
PrucaloprideThe serum concentration of Prucalopride can be increased when it is combined with Alfentanil.Approved
PSD502The risk or severity of adverse effects can be increased when Alfentanil is combined with PSD502.Investigational
PseudoephedrinePseudoephedrine may increase the analgesic activities of Alfentanil.Approved
QuazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Quazepam.Approved, Illicit
QuetiapineThe serum concentration of Quetiapine can be increased when it is combined with Alfentanil.Approved
QuinethazoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Quinethazone.Approved
QuinidineThe serum concentration of Quinidine can be increased when it is combined with Alfentanil.Approved
QuinineThe serum concentration of Quinine can be increased when it is combined with Alfentanil.Approved
RacloprideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Raclopride.Investigational
RamelteonThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ramelteon.Approved, Investigational
RamosetronAlfentanil may increase the constipating activities of Ramosetron.Approved
RanitidineThe serum concentration of Ranitidine can be increased when it is combined with Alfentanil.Approved
RanolazineThe serum concentration of Ranolazine can be increased when it is combined with Alfentanil.Approved, Investigational
RasagilineAlfentanil may increase the serotonergic activities of Rasagiline.Approved
RemifentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Remifentanil.Approved
RemoxiprideThe risk or severity of adverse effects can be increased when Remoxipride is combined with Alfentanil.Approved, Withdrawn
ReserpineThe serum concentration of Reserpine can be increased when it is combined with Alfentanil.Approved
RifabutinThe serum concentration of Alfentanil can be decreased when it is combined with Rifabutin.Approved
RifampicinThe serum concentration of Alfentanil can be decreased when it is combined with Rifampicin.Approved
RifapentineThe serum concentration of Alfentanil can be decreased when it is combined with Rifapentine.Approved
RifaximinThe serum concentration of Rifaximin can be increased when it is combined with Alfentanil.Approved, Investigational
RisperidoneThe serum concentration of Risperidone can be increased when it is combined with Alfentanil.Approved, Investigational
RitanserinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ritanserin.Investigational
RitobegronRitobegron may increase the analgesic activities of Alfentanil.Investigational
RitonavirThe serum concentration of Alfentanil can be increased when it is combined with Ritonavir.Approved, Investigational
RivaroxabanThe serum concentration of Rivaroxaban can be increased when it is combined with Alfentanil.Approved
RolofyllineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Rolofylline.Investigational
RomidepsinThe serum concentration of Romidepsin can be increased when it is combined with Alfentanil.Approved, Investigational
RomifidineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Romifidine.Vet Approved
RopiniroleAlfentanil may increase the sedative activities of Ropinirole.Approved, Investigational
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Alfentanil.Approved
RotigotineAlfentanil may increase the sedative activities of Rotigotine.Approved
RufinamideThe risk or severity of adverse effects can be increased when Rufinamide is combined with Alfentanil.Approved
S-EthylisothioureaThe risk or severity of adverse effects can be increased when Alfentanil is combined with S-Ethylisothiourea.Experimental
SafrazineAlfentanil may increase the serotonergic activities of Safrazine.Withdrawn
Sage 547The risk or severity of adverse effects can be increased when Alfentanil is combined with Sage 547.Investigational
Salicylic acidThe serum concentration of Salicylic acid can be increased when it is combined with Alfentanil.Approved, Vet Approved
SaquinavirThe metabolism of Alfentanil can be decreased when combined with Saquinavir.Approved, Investigational
ScopolamineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Scopolamine.Approved
Scopolamine butylbromideThe risk or severity of adverse effects can be increased when Scopolamine butylbromide is combined with Alfentanil.Approved
SecobarbitalThe risk or severity of adverse effects can be increased when Secobarbital is combined with Alfentanil.Approved, Vet Approved
SelegilineAlfentanil may increase the serotonergic activities of Selegiline.Approved, Investigational, Vet Approved
SelexipagThe serum concentration of Selexipag can be increased when it is combined with Alfentanil.Approved
SertindoleThe risk or severity of adverse effects can be increased when Alfentanil is combined with Sertindole.Approved, Withdrawn
SertralineAlfentanil may increase the serotonergic activities of Sertraline.Approved
SevofluraneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Sevoflurane.Approved, Vet Approved
SildenafilThe metabolism of Alfentanil can be decreased when combined with Sildenafil.Approved, Investigational
SilodosinThe serum concentration of Silodosin can be increased when it is combined with Alfentanil.Approved
SiltuximabThe serum concentration of Alfentanil can be decreased when it is combined with Siltuximab.Approved
SimeprevirThe serum concentration of Alfentanil can be increased when it is combined with Simeprevir.Approved
SitagliptinThe serum concentration of Sitagliptin can be increased when it is combined with Alfentanil.Approved, Investigational
Sodium oxybateSodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved
SofosbuvirThe serum concentration of Sofosbuvir can be increased when it is combined with Alfentanil.Approved
SolifenacinThe risk or severity of adverse effects can be increased when Solifenacin is combined with Alfentanil.Approved
SolithromycinThe serum concentration of Alfentanil can be increased when it is combined with Solithromycin.Investigational
SorafenibThe serum concentration of Sorafenib can be increased when it is combined with Alfentanil.Approved, Investigational
SotalolAlfentanil may increase the bradycardic activities of Sotalol.Approved
SparfloxacinThe serum concentration of Sparfloxacin can be increased when it is combined with Alfentanil.Approved
SphingosineThe serum concentration of Sphingosine can be increased when it is combined with Alfentanil.Experimental
SpironolactoneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Spironolactone.Approved
St. John's WortThe serum concentration of Alfentanil can be decreased when it is combined with St. John's Wort.Nutraceutical
StiripentolThe serum concentration of Alfentanil can be increased when it is combined with Stiripentol.Approved
SuccinylcholineSuccinylcholine may increase the bradycardic activities of Alfentanil.Approved
SufentanilThe risk or severity of adverse effects can be increased when Sufentanil is combined with Alfentanil.Approved, Investigational
SulfisoxazoleThe metabolism of Alfentanil can be decreased when combined with Sulfisoxazole.Approved, Vet Approved
SulpirideThe risk or severity of adverse effects can be increased when Sulpiride is combined with Alfentanil.Approved
SuvorexantAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.Approved
TacrolimusThe serum concentration of Tacrolimus can be increased when it is combined with Alfentanil.Approved, Investigational
TamoxifenThe serum concentration of Tamoxifen can be increased when it is combined with Alfentanil.Approved
TandospironeThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tandospirone.Investigational
TapentadolTapentadol may increase the central nervous system depressant (CNS depressant) activities of Alfentanil.Approved
TasimelteonThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tasimelteon.Approved
Taurocholic AcidThe serum concentration of Taurocholic Acid can be increased when it is combined with Alfentanil.Experimental
Technetium Tc-99m sestamibiThe serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Alfentanil.Approved
TelaprevirThe metabolism of Alfentanil can be decreased when combined with Telaprevir.Approved
TelithromycinThe serum concentration of Alfentanil can be increased when it is combined with Telithromycin.Approved
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Alfentanil.Approved
TemsirolimusThe serum concentration of Temsirolimus can be increased when it is combined with Alfentanil.Approved
TetrabenazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tetrabenazine.Approved
TetracaineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tetracaine.Approved, Vet Approved
TetrodotoxinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tetrodotoxin.Investigational
ThalidomideAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.Approved, Investigational, Withdrawn
TheobromineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Theobromine.Approved
ThiamylalThe risk or severity of adverse effects can be increased when Alfentanil is combined with Thiamylal.Approved, Vet Approved
ThiethylperazineThiethylperazine may increase the hypotensive activities of Alfentanil.Withdrawn
ThiopentalThe risk or severity of adverse effects can be increased when Thiopental is combined with Alfentanil.Approved, Vet Approved
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Alfentanil.Approved
ThiothixeneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Thiothixene.Approved
TiagabineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tiagabine.Approved
TiaprideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tiapride.Investigational
TicagrelorThe serum concentration of Ticagrelor can be increased when it is combined with Alfentanil.Approved
TiclopidineThe metabolism of Alfentanil can be decreased when combined with Ticlopidine.Approved
TicrynafenThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ticrynafen.Withdrawn
TiletamineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tiletamine.Vet Approved
TimololThe serum concentration of Timolol can be increased when it is combined with Alfentanil.Approved
TiotropiumThe risk or severity of adverse effects can be increased when Tiotropium is combined with Alfentanil.Approved
TizanidineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tizanidine.Approved
TocilizumabThe serum concentration of Alfentanil can be decreased when it is combined with Tocilizumab.Approved
TolcaponeThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tolcapone.Approved, Withdrawn
ToloxatoneAlfentanil may increase the serotonergic activities of Toloxatone.Approved
TolterodineThe risk or severity of adverse effects can be increased when Tolterodine is combined with Alfentanil.Approved, Investigational
TolvaptanThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tolvaptan.Approved
TopiramateThe risk or severity of adverse effects can be increased when Alfentanil is combined with Topiramate.Approved
TopotecanThe serum concentration of Topotecan can be increased when it is combined with Alfentanil.Approved, Investigational
TorasemideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Torasemide.Approved
ToremifeneThe serum concentration of Toremifene can be increased when it is combined with Alfentanil.Approved, Investigational
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Alfentanil.Approved, Investigational
Trans-2-PhenylcyclopropylamineAlfentanil may increase the serotonergic activities of Trans-2-Phenylcyclopropylamine.Experimental
TranylcypromineAlfentanil may increase the serotonergic activities of Tranylcypromine.Approved
Trastuzumab emtansineThe serum concentration of Trastuzumab emtansine can be increased when it is combined with Alfentanil.Approved
TrazodoneThe risk or severity of adverse effects can be increased when Trazodone is combined with Alfentanil.Approved, Investigational
TriamtereneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Triamterene.Approved
TriazolamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Triazolam.Approved
TrichlormethiazideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Trichlormethiazide.Approved, Vet Approved
TrifluoperazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Trifluoperazine.Approved
TriflupromazineThe risk or severity of adverse effects can be increased when Triflupromazine is combined with Alfentanil.Approved, Vet Approved
TrihexyphenidylThe risk or severity of adverse effects can be increased when Trihexyphenidyl is combined with Alfentanil.Approved
TrimethaphanThe risk or severity of adverse effects can be increased when Trimethaphan is combined with Alfentanil.Approved
TrimipramineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Trimipramine.Approved
TriprolidineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Triprolidine.Approved
TroleandomycinThe serum concentration of Alfentanil can be increased when it is combined with Troleandomycin.Approved
TropicamideThe risk or severity of adverse effects can be increased when Tropicamide is combined with Alfentanil.Approved
TrospiumThe risk or severity of adverse effects can be increased when Trospium is combined with Alfentanil.Approved
TubocurarineThe risk or severity of adverse effects can be increased when Tubocurarine is combined with Alfentanil.Approved
TylosinThe serum concentration of Alfentanil can be increased when it is combined with Tylosin.Vet Approved
Uc1010The risk or severity of adverse effects can be increased when Alfentanil is combined with Uc1010.Investigational
UlaritideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ularitide.Investigational
UlipristalThe serum concentration of Ulipristal can be increased when it is combined with Alfentanil.Approved
UmeclidiniumThe serum concentration of Umeclidinium can be increased when it is combined with Alfentanil.Approved
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Alfentanil.Approved, Investigational
VecuroniumThe serum concentration of Vecuronium can be increased when it is combined with Alfentanil.Approved
VenetoclaxThe serum concentration of Venetoclax can be increased when it is combined with Alfentanil.Approved
VenlafaxineThe metabolism of Alfentanil can be decreased when combined with Venlafaxine.Approved
VerapamilThe metabolism of Alfentanil can be decreased when combined with Verapamil.Approved
VigabatrinThe risk or severity of adverse effects can be increased when Alfentanil is combined with Vigabatrin.Approved
VinblastineThe serum concentration of Vinblastine can be increased when it is combined with Alfentanil.Approved
VincristineThe serum concentration of Vincristine can be increased when it is combined with Alfentanil.Approved, Investigational
VismodegibThe serum concentration of Vismodegib can be increased when it is combined with Alfentanil.Approved
VoriconazoleThe metabolism of Alfentanil can be decreased when combined with Voriconazole.Approved, Investigational
VortioxetineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Vortioxetine.Approved
XylazineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Xylazine.Vet Approved
ZaleplonThe risk or severity of adverse effects can be increased when Alfentanil is combined with Zaleplon.Approved, Illicit, Investigational
ZiconotideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ziconotide.Approved
ZidovudineThe serum concentration of Zidovudine can be increased when it is combined with Alfentanil.Approved
ZimelidineAlfentanil may increase the serotonergic activities of Zimelidine.Withdrawn
ZiprasidoneThe metabolism of Alfentanil can be decreased when combined with Ziprasidone.Approved
ZolazepamThe risk or severity of adverse effects can be increased when Alfentanil is combined with Zolazepam.Vet Approved
ZolpidemAlfentanil may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.Approved
ZonisamideThe risk or severity of adverse effects can be increased when Alfentanil is combined with Zonisamide.Approved, Investigational
ZopicloneThe risk or severity of adverse effects can be increased when Alfentanil is combined with Zopiclone.Approved
ZotepineThe risk or severity of adverse effects can be increased when Alfentanil is combined with Zotepine.Approved
ZuclopenthixolThe risk or severity of adverse effects can be increased when Alfentanil is combined with Zuclopenthixol.Approved, Investigational
Food InteractionsNot Available
References
Synthesis Reference

Jacob Mathew, J. Killgore, “New methods for the synthesis of alfentanil, sufentanil, and remifentanil.” U.S. Patent US20060149071, issued July 06, 2006.

US20060149071
General ReferencesNot Available
External Links
ATC CodesN01AH02
AHFS Codes
  • 28:08.08
PDB EntriesNot Available
FDA labelNot Available
MSDSDownload (51.3 KB)
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9957
Blood Brain Barrier+0.9396
Caco-2 permeable-0.5368
P-glycoprotein substrateSubstrate0.7156
P-glycoprotein inhibitor IInhibitor0.8809
P-glycoprotein inhibitor IINon-inhibitor0.8381
Renal organic cation transporterNon-inhibitor0.7077
CYP450 2C9 substrateNon-substrate0.7897
CYP450 2D6 substrateNon-substrate0.9115
CYP450 3A4 substrateSubstrate0.7407
CYP450 1A2 substrateNon-inhibitor0.9067
CYP450 2C9 inhibitorInhibitor0.6051
CYP450 2D6 inhibitorNon-inhibitor0.9003
CYP450 2C19 inhibitorNon-inhibitor0.5591
CYP450 3A4 inhibitorInhibitor0.6691
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.6692
Ames testAMES toxic0.5858
CarcinogenicityNon-carcinogens0.7729
BiodegradationNot ready biodegradable0.9877
Rat acute toxicity2.9997 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Strong inhibitor0.6413
hERG inhibition (predictor II)Inhibitor0.5893
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
Manufacturers
  • Akorn inc
  • Hospira inc
Packagers
Dosage forms
FormRouteStrength
InjectionIntravenous500 ug/mL
Injection, solutionIntravenous500 ug/mL
SolutionIntravenous500 mcg
Prices
Unit descriptionCostUnit
Alfenta 500 mcg/ml ampul5.26USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
PatentsNot Available
Properties
StateSolid
Experimental Properties
PropertyValueSource
melting point140.8Janssens, F.; US. Patent 4,167,574; September 11, 1979; assigned to Janssen Pharmaceutica NV.
water solubility34.6 mg/LNot Available
logP2.16HANSCH,C ET AL. (1995)
Predicted Properties
PropertyValueSource
Water Solubility0.252 mg/mLALOGPS
logP2.2ALOGPS
logP2.81ChemAxon
logS-3.2ALOGPS
pKa (Strongest Basic)7.5ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count6ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area81.05 Å2ChemAxon
Rotatable Bond Count9ChemAxon
Refractivity118.59 m3·mol-1ChemAxon
Polarizability45.57 Å3ChemAxon
Number of Rings3ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, NegativeNot Available
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as anilides. These are organic heterocyclic compounds derived from oxoacids RkE(=O)l(OH)m (l not 0) by replacing an OH group by the NHPh group or derivative formed by ring substitution.
KingdomOrganic compounds
Super ClassBenzenoids
ClassBenzene and substituted derivatives
Sub ClassAnilides
Direct ParentAnilides
Alternative Parents
Substituents
  • Anilide
  • 4-aminopiperidine
  • Piperidine
  • Heteroaromatic compound
  • Tetrazole
  • Tertiary carboxylic acid amide
  • Azole
  • Tertiary aliphatic amine
  • Tertiary amine
  • Carboxamide group
  • Azacycle
  • Organoheterocyclic compound
  • Ether
  • Dialkyl ether
  • Carboxylic acid derivative
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Carbonyl group
  • Amine
  • Aromatic heteromonocyclic compound
Molecular FrameworkAromatic heteromonocyclic compounds
External Descriptors

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
agonist
General Function:
Voltage-gated calcium channel activity
Specific Function:
Receptor for endogenous opioids such as beta-endorphin and endomorphin. Receptor for natural and synthetic opioids including morphine, heroin, DAMGO, fentanyl, etorphine, buprenorphin and methadone. Agonist binding to the receptor induces coupling to an inactive GDP-bound heterotrimeric G-protein complex and subsequent exchange of GDP for GTP in the G-protein alpha subunit leading to dissociati...
Gene Name:
OPRM1
Uniprot ID:
P35372
Molecular Weight:
44778.855 Da
References
  1. Garrido M, Gubbens-Stibbe J, Tukker E, Cox E, von Frijtag J, Kunzel D, IJzerman A, Danhof M, van der Graaf PH: Pharmacokinetic-pharmacodynamic analysis of the EEG effect of alfentanil in rats following beta-funaltrexamine-induced mu-opioid receptor "knockdown" in vivo. Pharm Res. 2000 Jun;17(6):653-9. [PubMed:10955836 ]
  2. Lotsch J, Geisslinger G: Are mu-opioid receptor polymorphisms important for clinical opioid therapy? Trends Mol Med. 2005 Feb;11(2):82-9. [PubMed:15694871 ]
  3. Oertel BG, Schmidt R, Schneider A, Geisslinger G, Lotsch J: The mu-opioid receptor gene polymorphism 118A>G depletes alfentanil-induced analgesia and protects against respiratory depression in homozygous carriers. Pharmacogenet Genomics. 2006 Sep;16(9):625-36. [PubMed:16906017 ]
  4. Leung A, Wallace MS, Ridgeway B, Yaksh T: Concentration-effect relationship of intravenous alfentanil and ketamine on peripheral neurosensory thresholds, allodynia and hyperalgesia of neuropathic pain. Pain. 2001 Mar;91(1-2):177-87. [PubMed:11240090 ]
  5. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
  2. Klees TM, Sheffels P, Dale O, Kharasch ED: Metabolism of alfentanil by cytochrome p4503a (cyp3a) enzymes. Drug Metab Dispos. 2005 Mar;33(3):303-11. Epub 2004 Nov 22. [PubMed:15557344 ]
  3. Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Oxygen binding
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics.
Gene Name:
CYP3A5
Uniprot ID:
P20815
Molecular Weight:
57108.065 Da
References
  1. Kharasch ED, Walker A, Isoherranen N, Hoffer C, Sheffels P, Thummel K, Whittington D, Ensign D: Influence of CYP3A5 genotype on the pharmacokinetics and pharmacodynamics of the cytochrome P4503A probes alfentanil and midazolam. Clin Pharmacol Ther. 2007 Oct;82(4):410-26. Epub 2007 Jun 6. [PubMed:17554244 ]
  2. Klees TM, Sheffels P, Dale O, Kharasch ED: Metabolism of alfentanil by cytochrome p4503a (cyp3a) enzymes. Drug Metab Dispos. 2005 Mar;33(3):303-11. Epub 2004 Nov 22. [PubMed:15557344 ]
  3. Klees TM, Sheffels P, Thummel KE, Kharasch ED: Pharmacogenetic determinants of human liver microsomal alfentanil metabolism and the role of cytochrome P450 3A5. Anesthesiology. 2005 Mar;102(3):550-6. [PubMed:15731592 ]
  4. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
  5. Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Oxygen binding
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics.
Gene Name:
CYP3A7
Uniprot ID:
P24462
Molecular Weight:
57525.03 Da
References
  1. Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]

Carriers

Kind
Protein
Organism
Human
Pharmacological action
unknown
General Function:
Not Available
Specific Function:
Functions as transport protein in the blood stream. Binds various ligands in the interior of its beta-barrel domain. Also binds synthetic drugs and influences their distribution and availability in the body. Appears to function in modulating the activity of the immune system during the acute-phase reaction.
Gene Name:
ORM1
Uniprot ID:
P02763
Molecular Weight:
23511.38 Da
References
  1. Belpaire FM, Bogaert MG: Binding of alfentanil to human alpha 1-acid glycoprotein, albumin and serum. Int J Clin Pharmacol Ther Toxicol. 1991 Mar;29(3):96-102. [PubMed:2071261 ]
  2. Kumar K, Crankshaw DP, Morgan DJ, Beemer GH: The effect of cardiopulmonary bypass on plasma protein binding of alfentanil. Eur J Clin Pharmacol. 1988;35(1):47-52. [PubMed:3146505 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
General Function:
Toxic substance binding
Specific Function:
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloidal osmotic pressure of blood. Major zinc transporter in plasma, typically binds about 80% of all plasma zinc.
Gene Name:
ALB
Uniprot ID:
P02768
Molecular Weight:
69365.94 Da
References
  1. Belpaire FM, Bogaert MG: Binding of alfentanil to human alpha 1-acid glycoprotein, albumin and serum. Int J Clin Pharmacol Ther Toxicol. 1991 Mar;29(3):96-102. [PubMed:2071261 ]
  2. Kumar K, Crankshaw DP, Morgan DJ, Beemer GH: The effect of cardiopulmonary bypass on plasma protein binding of alfentanil. Eur J Clin Pharmacol. 1988;35(1):47-52. [PubMed:3146505 ]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
inhibitor
General Function:
Xenobiotic-transporting atpase activity
Specific Function:
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name:
ABCB1
Uniprot ID:
P08183
Molecular Weight:
141477.255 Da
References
  1. Wandel C, Kim R, Wood M, Wood A: Interaction of morphine, fentanyl, sufentanil, alfentanil, and loperamide with the efflux drug transporter P-glycoprotein. Anesthesiology. 2002 Apr;96(4):913-20. [PubMed:11964599 ]
Comments
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Drug created on June 13, 2005 07:24 / Updated on August 17, 2016 12:23