Remifentanil

Summary

Remifentanil (CHEMBL1005) is an approved small-molecule μ-opioid receptor agonist (ATC N01AH06); indicated across 18 conditions including neoplasm and stroke disorder.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: N01AH06
• Indications: 18 conditions
• Clinical trials: 404
• Chemistry: 376.4 Da · C20H28N2O5

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL1005
Name	Remifentanil
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	60815
ChEBI	CHEBI:8802
ATC	N01AH06
Molecular formula	C20H28N2O5
Molecular weight	376.4
InChIKey	ZTVQQQVZCWLTDF-UHFFFAOYSA-N

SMILES: CCC(=O)N(C1=CC=CC=C1)C2(CCN(CC2)CCC(=O)OC)C(=O)OC

IUPAC name: methyl 1-(3-methoxy-3-oxopropyl)-4-(N-propanoylanilino)piperidine-4-carboxylate

ChEBI definition: A piperidinecarboxylate ester that is methyl piperidine-4-carboxylate in which the hydrogen attached to the nitrogen is substituted by a 3-methoxy-3-oxopropyl group and the hydrogen at position 4 is substituted the nitrogen of N-propanoylaniline.

Pharmacological roles (ChEBI): μ-opioid receptor agonist, opioid analgesic, intravenous anaesthetic, sedative.

Also known as: GI 87084X, IDS-NR-005, Ramifentanyl, Remifentanil, Remifentanilo, Remifentanyl, Ultiva-, remifentanil, REMIFENTANIL

Parent form; salt/anhydrous children: CHEMBL1201120

Patent coverage: 2,917 distinct patent families (10,990 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 2 (assay-derived). Sample: Voltage-dependent L-type calcium channel subunit alpha-1C, Mu-type opioid receptor.

Bioactivity

ChEMBL activities: 1 potent at pChembl ≥ 5 of 2 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
P33535	9.22	IC50	0.6	nM	CHEMBL_ACT_19128512

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

18 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
neoplasm	3	MONDO:0005070	EFO:0000616
stroke disorder	3	MONDO:0005098	EFO:0000712
heart disorder	3	MONDO:0005267	EFO:0003777
opiate dependence	3	MONDO:0005530	EFO:0005611
malignant ear neoplasm	3	MONDO:0003277	MONDO:0021233
toxic shock syndrome	3	MONDO:0001881	EFO:0006834
breast disorder	3	MONDO:0002657	EFO:0009483
morbid obesity	2	MONDO:0005139	EFO:0001074
brain neoplasm	2	MONDO:0021211	EFO:0003833
respiratory failure	2	MONDO:0021113	EFO:0009842
obstructive sleep apnea syndrome	1	MONDO:0007147	EFO:0003918
sleep apnea syndrome	0	MONDO:0005296	EFO:0003877

6 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 404.

Phase distribution

Phase	Trials
Not specified	190
PHASE4	154
PHASE3	22
PHASE2	17
PHASE1/PHASE2	7
EARLY_PHASE1	7
PHASE1	6
PHASE2/PHASE3	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT06444997	PHASE4	NOT_YET_RECRUITING	Efficacy and Safety of Oxycodone Hydrochloride for Long-term Analgesia in ICU Patients
NCT06454292	PHASE4	NOT_YET_RECRUITING	Efficacy and Safety Studies of Oliceridine Fumarate
NCT06564857	PHASE4	RECRUITING	Remifentanil Versus Rocuronium for Optimizing Video Laryngoscopy-assisted Tracheal Intubation
NCT06958393	PHASE4	NOT_YET_RECRUITING	Effect of Opioid-free Anaesthesia on Postoperative Delirium in Elderly Patients Undergoing Gastrointestinal Surgery
NCT07556172	PHASE4	ACTIVE_NOT_RECRUITING	Clinical Study of Esketamine in Patients With Sepsis Undergoing Invasive Mechanical Ventilation
NCT00158873	PHASE4	COMPLETED	Pharmaco-Economic Study Of Ultiva In Intensive Care Unit(ICU)Subjects
NCT00202722	PHASE4	COMPLETED	Remifentanil as Intravenous Patient-controlled Analgesia (IVPCA) During Labour
NCT00244517	PHASE4	TERMINATED	DIAFAX I+II-Effects of Inhalative Anesthetics on Left Ventricular Diastolic Function
NCT00326859	PHASE4	TERMINATED	Comparison of Monitored Anesthesia Care Using Remifentanil or Fentanyl for Major Dressing Changes in Burns
NCT00335972	PHASE4	TERMINATED	The Effects of Dexmedetomidine and Remifentanil on Carotid Patients
NCT00349245	PHASE4	COMPLETED	Dexmedetomidine vs. Remifentanil for Sedation During AFI
NCT00391105	PHASE4	COMPLETED	Remifentanil Versus Morphine for Sedation of Premature Neonates With Respiratory Distress Syndrome
NCT00421720	PHASE4	TERMINATED	A Study Comparing Two Analgesia/Sedation Regimens, Remifentanil/Propofol Versus Sufentanil/Propofol In Mechanically Ventilated Intensive Care Patients Requiring Analgesia And Sedation.
NCT00534586	PHASE4	COMPLETED	Anesthetics and Auditory, Visceral, and Heat Evoked Potentials
NCT00567957	PHASE4	UNKNOWN	Remifentanil for General Anesthesia in Preeclamptics
NCT00611195	PHASE4	COMPLETED	Remifentanil and Laryngeal Reflex Responses in Pediatric Patients With URI
NCT00627081	PHASE4	COMPLETED	Effect of Thoracic Epidural Analgesia on Intravenous Closed-Loop Anesthesia
NCT00665119	PHASE4	COMPLETED	Effects of Remifentanil on Respiratory Function in Mechanically Ventilated Patients
NCT00667043	PHASE4	COMPLETED	Remifentanil and Propofol Versus Fentanyl and Midazolam for Sedation During Therapeutic Hypothermia. A Randomised, Controlled Trial
NCT00681174	PHASE4	TERMINATED	Controlled-Release Oxycodone For Postoperative Analgesia After Video-Assisted Thoracic Surgery
NCT00706277	PHASE4	COMPLETED	Effect of Total Intravenous Anesthesia and Balanced Anesthesia on Postoperative Lung Function
NCT00710086	PHASE4	COMPLETED	Intravenous Remifentanil for Labor Analgesia
NCT00757198	PHASE4	COMPLETED	Requirement of Analgesics After Two Remifentanil Dosing Regimen in Cardiac Surgery.
NCT00772616	PHASE4	COMPLETED	Influence of Intraoperative Analgesia on the Postoperative Morphine Consumption
NCT00778505	PHASE4	TERMINATED	Use of Closed-loop Anesthesia in Pediatric Patients
NCT00785863	PHASE4	COMPLETED	Modulation of Remifentanil-induced Postinfusion Hyperalgesia
NCT00789386	PHASE4	UNKNOWN	The Effect of Remifentanil on Established Capsaicin-Induced Hyperalgesia in Human Volunteers
NCT00801047	PHASE4	COMPLETED	Intravenous Remifentanil Patient-controlled Analgesia (PCA) and Epidural Patient Controlled Epidural Analgesia (PCEA) for Labor Analgesia
NCT00811837	PHASE4	UNKNOWN	The Effect of Remifentanil on Established Sunburn-induced Hyperalgesia in Human Volunteers
NCT00815048	PHASE4	COMPLETED	Remifentanil and Atropine for Intubation in Neonates
NCT00886106	PHASE4	UNKNOWN	The Effect of High-dose Remifentanil on Established Capsaicin-induced Hyperalgesia in Human Volunteers
NCT01015482	PHASE4	UNKNOWN	The Effect of High-dose Remifentanil on Established Sunburn-induced Hyperalgesia in Human Volunteers (HighDose RemiSun)
NCT01025245	PHASE4	COMPLETED	Effect of Intraoperative Magnesium on Remifentanil-induced Postoperative Hyperalgesia After Thyroidectomy
NCT01052324	PHASE4	COMPLETED	The Effect Site Concentration of Remifentanil for Conscious Sedation During Awake Nasotracheal Fiberoptic Intubation
NCT01079312	PHASE4	COMPLETED	Patient-controlled Sedation With Propofol and Remifentanyl for Endoscopic Retrograde Cholangiopancreatography (ERCP)
NCT01103193	PHASE4	TERMINATED	Nitrous Oxide - Sevoflurane-Remifentanil Interaction
NCT01139671	PHASE4	COMPLETED	Comparison of Sufentanil and Remifentanil Infusion During General Anaesthesia for Removal of Wisdom Teeth in Ambulatory Surgery
NCT01152515	PHASE4	COMPLETED	A Low Dose Remifentanil Infusion During Tracheal Extubation in Surgical Intensive Care Unit Patients
NCT01191645	PHASE4	COMPLETED	Opioid Effects on Swallowing and Esophageal Sphincter Pressure
NCT01229527	PHASE4	COMPLETED	Comparison Between Two Different Dosages of Remifentanil During Colonoscopy

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

PharmGKB dosing guidelines (1) — CPIC / DPWG genotype-guided dosing for this drug (drug × pharmacogene):

Guideline	Source	Gene(s)	Dosing	Recommendation
Annotation of CPIC Guideline for alfentanil, buprenorphine, codeine, f	CPIC	COMT;OPRM1

PharmGKB also curates 7 clinical and 32 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).