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Ultiva should not be mixed with propofol in the same infusion bag prior to administration.
Administration of Ultiva into the same intravenous line with blood/serum/plasma is not recommended as nonspecific esterase in blood products may lead to the hydrolysis of remifentanil to its inactive metabolite. Ultiva should not be mixed with other therapeutic agents prior to administration.
Special precautions for disposal and other handling: Ultiva should be prepared for intravenous use by adding, as appropriate 1, 2 or 5ml of diluent to give a reconstituted solution with a concentration of 1 mg/ml remifentanil. The reconstituted solution is clear, colourless, and practically free from particulate material. After reconstitution, Ultiva should not be administered without further dilution to concentration of 20 to 250 μg/mL (50 μg/mL is recommended dilution for adults and 20-25 μg/mL for paediatric patients aged 1 year and over) with one of the following IV fluids listed as follows.
The dilution is dependent upon the technical capability of the infusion device and the anticipated requirements of the patient.
Sterilised Water for Injections, 5% Dextrose Injection, 5% Dextrose and 0.9% Sodium Chloride Injection, 0.9% Sodium Chloride Injection, 0.45% Sodium Chloride Injection.
Ultiva has been shown to be compatible with the following intravenous fluids when administered into running IV catheter of: Lactated Ringer's injection, Lactated Ringer's and 5% Dextrose Injection.
Ultiva has been shown to be compatible with propofol when administered into running IV catheter.
Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
The following tables give guidelines for infusion rates of Ultiva: See Tables 8, 9, 10, 11 and 12.
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