ALTIREM IV should not be administered:
- if you are hypersensitive (allergic) to remifentanil or any of the other ingredients of this medicine (listed in section 6) or medicines in the same class (opioids)
- if you are hypersensitive (allergic) to any other pain-relieving medicines which are similar to fentanyl; and which are related to the class of medicines known as opioids, or to any of the ingredients of ALTIREM IV (see section 6) Opioids are used to treat acute pain. Symptoms of an allergic reaction may be mild or severe. They usually include some or all of the following: Wheezing, swelling of the lips/mouth, difficulty in breathing, hay fever, lump rash (“hives”) or fainting
- as injection into the spinal canal
- together with nitrous oxide and oxygen alone at altitudes above sea level
- without artificial ventilation
- if you are pregnant or breastfeeding your baby.
Warnings and precautions
Tell your doctor or healthcare professional before being given ALTIREM IV if:
- you are allergic (hypersensitive) to any other opioid medicines, such as morphine or codeine
- you are taking sedative medicines such as benzodiazepines, commonly used to treat anxiety, panic disorders, insomnia, epilepsy and alcohol dependence (see Other medicines and ALTIREM IV)
- suffer from serotonin syndrome if your doctor recognizes that you may develop serotonin syndrome (a potentially life-threatening syndrome), the doctor will decide if the administration of ALTIREM IV has to be stopped. Signs of serotonin syndrome include high body temperature, high blood pressure, fast heartbeat, excess sweating, shivering, widening of your pupils, increased reflexes, muscle twitching, tremor, muscle rigidity, lack of coordination, gut-related cramps, feeling sick or coma
- you are undergoing surgery, your doctor will administer an alternative pain or sleeping medicine to manage any pain.
Take special care with ALTIREM IV and tell your doctor if:
- you have a personal or family history of substance abuse or mental health disorders (there is an increased risk of addiction)
- you are over 65 years of age, as you may experience the effects of ALTIREM IV for a longer time period
- you are dehydrated, have lost a lot of blood or have been feeling weak or unwell as you are more likely to experience effects on your heart (low blood pressure or a slower than normal heart rate)
- you have liver problems as ALTIREM IV may affect your ability to breathe
- you are overweight as your doctor might reduce the dosage of ALTIREM IV
- you have a neuromuscular disorder that causes weakness in the muscles your body uses for movement as you may experience more pronounced muscle tension, or stiffness that may affect your breathing
- you have a severe condition that affects parts of your body or even your whole body such as poorly controlled diabetes, poorly controlled high blood pressure, lung disorders, heart problems
- you have a severe condition that is life-threatening such as poorly controlled disorders or at end stage, heart conditions or kidney failure.
You should not make any legal decisions or sign any contracts for 24 hours after receiving ALTIREM IV, as this medicine may interfere with your daily activities.
If you are unsure if any of the above apply to you, talk to your doctor, pharmacist or nurse before you are given ALTIREM IV.
Children
ALTIREM IV should not be given to infants under 1 year of age as it is unlikely to be safe and there is limited information on the use of ALTIREM IV in this age group.
Other medicines and ALTIREM IV
Always tell your healthcare provider if you are taking any other medicine. (This includes complementary or traditional medicines.) Tell your doctor if you are taking any of the following medicines:
- sedatives or medicines called benzodiazepines (used to treat anxiety, panic attacks, insomnia, seizures and alcohol dependence) as these medicines increase the risk of drowsiness, difficulties in breathing (respiratory depression), coma and may be life-threatening. Because of this, concomitant use should only be considered when other treatment options are not possible. However, if your doctor does prescribe ALTIREM IV together with sedative medicines the dose and duration of concomitant treatment should be limited by your doctor
- medicines for your heart or blood pressure, such as beta blockers (these include atenolol, metoprolol, carvedilol, propranolol and bisoprolol) or calcium channel blockers (these include amlodipine, diltiazem and nifedipine) as you may experience effects on your heart (low blood pressure or a slower than normal heart rate)
ALTIREM IV with alcohol
You should avoid alcohol for up to 24 hours after being given ALTIREM IV as you may experience increased side effects (sleepiness, difficulty breathing, coma and slow brain function).
Pregnancy, breastfeeding and fertility
If you are pregnant or breastfeeding your baby, think you may be pregnant or are planning to have a baby, please consult your doctor, pharmacist or other healthcare provider for advice before being given ALTIREM IV. You should not be administered ALTIREM IV if you are pregnant or breastfeeding (see What you need to know before you are given ALTIREM IV).
Driving and using machines
ALTIREM IV has major influence on the ability to drive and use machines. If you are only staying in hospital for the day, your doctor will tell you how long to wait before leaving the hospital or driving a car. It can be dangerous to drive too soon after having an operation. ALTIREM IV can affect your ability to drive as it may make you sleepy or dizzy. Do not drive after taking ALTIREM IV until you know how it affects you. It is not always possible to predict to what extent ALTIREM IV may interfere with the daily activities of a patient. Patients should ensure that they do not engage in the above activities until they are aware of the measure to which ALTIREM IV affects them.
