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Predictable control of depth and duration of analgesia

  • Rapid onset in 1 to 2 minutes1
  • Rapid response to dose adjustment1
  • Rapid recovery from ULTIVA effects in 5 to 10 minutes1
  • No accumulation regardless of infusion duration1

ULTIVA produces adverse events that are characteristic of μ-opioids, such as respiratory depression, apnea, tachycardia, bradycardia, hypotension, hypertension, and skeletal muscle (including chest wall) rigidity.

Predictable control for specific procedures

  • Craniotomies1-4
  • Spinal fusion1,5-8
  • Cardiac surgery1,9-12
  • Carotid artery surgery1,13,14
  • Functional endoscopic sinus surgery15,16
  • Gastric bypass surgery17-21


  1. ULTIVA [package insert]. Rockford, IL: Mylan Institutional LLC; 2011.
  2. Guy J, Hindman BJ, Baker KZ, et al. Comparison of remifentanil and fentanyl in patients undergoing craniotomy for supratentorial space-occupying lesions. Anesthesiology. 1997;86(3):514-524.
  3. Gesztesi Z, Mootz BL, White PF. The use of a remifentanil infusion for hemodynamic control during intracranial surgery. Anesth Analg. 1999;89(5):1282-1287.
  4. Bilotta F, Caramia R, Paoloni FP, et al. Early postoperative cognitive recovery after remifentanil-propofol or sufentanil-propofol anaesthesia for supratentorial craniotomy: a randomized trial. Eur J Anaesthesiol. 2007;24(2):122-127.
  5. Imani F, Jafarian A, Hassani V, Khan ZH. Propofol-alfentanil vs propofol-remifentanil for posterior spinal fusion including wake-up test. Br J Anaesth. 2006;96(5):583-586.
  6. Kimball-Jones PL, Schell RM, Shook JP. The use of remifentanil infusion to allow intraoperative awakening for intentional fracturing of the anterior cervical spine. Anesth Analg. 1999;89(4):1059-1061.
  7. Samra SK, Dy EA, Welch KB, Lovely LK, Graziano GP. Remifentanil- and fentanyl-based anesthesia for intraoperative monitoring of somatosensory evoked potentials. Anesth Analg. 2001;92(6):1510-1515.
  8. Grottke O, Dietrich PJ, Wiegels S, Wappler F. Intraoperative wake-up test and postoperative emergence in patients undergoing spinal surgery: a comparison of intravenous and inhaled anesthetic techniques using short-acting anesthetics. Anesth Analg. 2004;99(5):1521-1527.
  9. Lison S, Schill M, Conzen P. Fast-track cardiac anesthesia: efficacy and safety of remifentanil versus sufentanil. J Cardiothorac Vasc Anesth. 2007;21(1):35-40.
  10. Knapik M, Knapik P, Nadziakiewicz P, et al. Comparison of remifentanil or fentanyl administration during isoflurane anesthesia for coronary artery bypass surgery. Med Sci Monit. 2006;12(8):P133-P138.
  11. Bonfreschi V, Giuliani E, Malagnino FC, et al. Analgesia during abdominal aortic aneurysm endovascular repair: remifentanil vs fentanyl-midazolam––a randomized controlled trial. Eur J Anaesthesiol. 2009;26(9):782-787.
  12. Howie MB, Cheng D, Newman MF, et al. A randomized double-blinded multicenter comparison of remifentanil versus fentanyl when combined with isoflurane/propofol for early extubation in coronary artery bypass graft surgery. Anesth Analg. 2001;92(5):1084-1093.
  13. Wilhelm W, Schlaich N, Harrer J, et al. Recovery and neurological examination after remifentanil-desflurane or fentanyl-desflurane anaesthesia for carotid artery surgery. Br J Anaesth. 2001;86(1):44-49.
  14. Gerhardt MA, Grichnik KP. Early extubation and neurologic examination following combined carotid endarterectomy and coronary artery bypass grafting using remifentanil. J Clin Anesth. 1998;10(3):249-252.
  15. Eberhart LH, Folz BJ, Wulf H, Geldner G. Intravenous anesthesia provides optimal surgical conditions during microscopic and endoscopic sinus surgery. Laryngoscope. 2003;113(8):1369-1373.
  16. Wormald PJ, van Renen G, Perks J, Jones JA, Langton-Hewer CD. The effect of the total intravenous anesthesia compared with inhalational anesthesia on the surgical field during endoscopic sinus surgery. Am J Rhinol. 2005;19(5):514-520.
  17. Egan TD, Huizinga B, Gupta SK, et al. Remifentanil pharmacokinetics in obese versus lean patients. Anesthesiology. 1998;89(3):562-573.
  18. De Baerdemaeker LEC, Jacobs S, Pattyn P, Mortier EP, Struys MMRF. Influence of intraoperative opioid on postoperative pain and pulmonary function after laparoscopic gastric banding: remifentanil TCI vs sufentanil TCI in morbid obesity. Br J Anaesth. 2007;99(3):404-411.
  19. Bidgoli J, Delesalle S, De Hert SG, Reiles E, Van der Linden PJ. A randomised trial comparing sufentanil versus remifentanil for laparoscopic gastroplasty in the morbidly obese patient. Eur J Anaesthesiol. 2011;28(2):120-124.
  20. Gaszynski TM, Strzelczyk JM, Gaszynski WP. Post-anesthesia recovery after infusion of propofol with remifentanil or alfentanil or fentanyl in morbidly obese patients. Obes Surg. 2004;14(4):498-503; discussion 504.
  21. Twersky RS, Jamerson B, Warner DS, Fleisher LA, Hogue S. Hemodynamics and emergence profile of remifentanil versus fentanyl prospectively compared in a large population of surgical patients. J Clin Anesth. 2001;13(6):407-416.

The study by Lison and colleagues (reference 9) was supported by a grant from GlaxoSmithKline.

The study by Twersky and colleagues (reference 21) was sponsored by GlaxoWellcome Inc.