Chemical: Drug

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PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for remifentanil

Gene ? Variant?
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
No VIP available No Clinical Annotations available VA
rs1042713 NC_000005.10:g.148826877G=, NC_000005.10:g.148826877G>A, NC_000005.9:g.148206440G=, NC_000005.9:g.148206440G>A, NG_016421.1:g.5285A=, NG_016421.1:g.5285A>G, NM_000024.5:c.46A=, NM_000024.5:c.46A>G, NP_000015.1:p.Arg16=, NP_000015.1:p.Arg16Gly, XM_005268382.1:c.46G=, XM_005268382.1:c.46G>A, XM_005268383.1:c.46G=, XM_005268383.1:c.46G>A, XP_005268439.1:p.Gly16=, XP_005268439.1:p.Gly16Arg, XP_005268440.1:p.Gly16=, XP_005268440.1:p.Gly16Arg, rs17287432, rs17334179, rs17334242, rs17721693, rs17839749, rs17846639, rs17859732, rs3182174, rs3729940, rs52812686, rs56964295
G > A
No VIP available No Clinical Annotations available VA
rs1042714 NC_000005.10:g.148826910G=, NC_000005.10:g.148826910G>C, NC_000005.9:g.148206473G=, NC_000005.9:g.148206473G>C, NG_016421.1:g.5318C=, NG_016421.1:g.5318C>G, NM_000024.5:c.79C=, NM_000024.5:c.79C>G, NP_000015.1:p.Gln27=, NP_000015.1:p.Gln27Glu, XM_005268382.1:c.79G=, XM_005268382.1:c.79G>C, XM_005268383.1:c.79G=, XM_005268383.1:c.79G>C, XP_005268439.1:p.Glu27=, XP_005268439.1:p.Glu27Gln, XP_005268440.1:p.Glu27=, XP_005268440.1:p.Glu27Gln, rs17287411, rs17287474, rs17334200, rs17640526, rs17845338, rs17858183, rs17859733, rs3182175, rs3729941, rs52793394, rs60374884
G > C
G > T
No VIP available CA VA
C > A
No VIP available No Clinical Annotations available VA
G > C
No VIP available No Clinical Annotations available VA
rs1800888 NC_000005.10:g.148827322C>T, NC_000005.9:g.148206885C>T, NG_016421.1:g.5730C>T, NM_000024.5:c.491C>T, NP_000015.1:p.Thr164Ile, XM_005268382.1:c.491C>T, XM_005268383.1:c.491C>T, XP_005268439.1:p.Thr164Ile, XP_005268440.1:p.Thr164Ile, rs17334207, rs17707796, rs3729606
C > T
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147


Generic Names
  • Remifentanyl
Trade Names
  • Ultiva
Brand Mixture Names

PharmGKB Accession Id





Remifentanil (marketed by Abbott as Ultiva) is a potent ultra short-acting synthetic opioid analgesic drug. It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic. Remifentanil is a specific mu-type-opioid receptor agonist. Hence, it causes a reduction in sympathetic nervous system tone, respiratory depression and analgesia.

Source: Drug Bank


For use during the induction and maintenance of general anesthesia.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Remifentanil is a micro-opioid agonist with rapid onset and peak effect, and short duration of action. The micro-opioid activity of remifentanil is antagonized by opioid antagonists such as naloxone.

Source: Drug Bank


Remifentanil is an opioid agonist with rapid onset and peak effect and ultra-short duration of action. The opioid activity of remifentanil is antagonized by opioid antagonists such as naloxone. The analgesic effects of remifentanil are rapid in onset and offset. Its effects and side effects are dose dependent and similar to other opioids. Remifentanil in humans has a rapid blood-brain equilibration half-time of 1 +/- 1 minutes (mean +/- SD) and a rapid onset of action.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity


By hydrolysis of the propanoic acid-methyl ester linkage by nonspecific blood and tissue esterases.

Source: Drug Bank

Protein Binding

70% (bound to plasma proteins)

Source: Drug Bank


1-20 minutes

Source: Drug Bank


* 40 mL/min/kg [young, healthy adults]

Source: Drug Bank

Route of Elimination

Remifentanil is an esterase-metabolized opioid. The carboxylic acid metabolite is essentially inactive (1/4600 as potent as remifentanil in dogs) and is excreted by the kidneys with an elimination half-life of approximately 90 minutes.

Source: Drug Bank

Volume of Distribution

* 350 mL/kg * 452 ± 144 mL/kg [neonates] * 223 ± 30.6 mL/kg [adolescents]

Source: Drug Bank

Chemical Properties

Chemical Formula


Source: Drug Bank

Isomeric SMILES


Source: OpenEye

Canonical SMILES


Source: Drug Bank

Average Molecular Weight


Source: Drug Bank

Monoisotopic Molecular Weight


Source: Drug Bank



Source: Drug Bank

InChI String


Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available

Drug Targets

Gene Description
OPRD1 (source: Drug Bank )
OPRK1 (source: Drug Bank )
OPRM1 (source: Drug Bank )

Drug Interactions

Interaction Description
tranylcypromine - remifentanil Possible increased risk of serotonin syndrome. (source: Drug Bank )
triprolidine - remifentanil The CNS depressants, Triprolidine and Remifentanil, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank )
triprolidine - remifentanil The CNS depressants, Triprolidine and Remifentanil, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank )

Curated Information ?

No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to remifentanil: 2

No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
The Gly16 Allele of the Gly16Arg Single-Nucleotide Polymorphism in the beta₂-Adrenergic Receptor Gene Augments Perioperative Use of Vasopressors: A Retrospective Cohort Study. Anesthesia and analgesia. 2016. Nielsen Morten, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Reversal of opioid-induced bladder dysfunction by intravenous naloxone and methylnaltrexone. Clinical pharmacology and therapeutics. 2007. Rosow C E, et al. PubMed


Web Resource:
National Drug Code Directory:
KEGG Compound:
PubChem Compound:
PubChem Substance:
Drugs Product Database (DPD):
Therapeutic Targets Database:
FDA Drug Label at DailyMed:

Clinical Trials

These are trials that mention remifentanil and are related to either pharmacogenetics or pharmacogenomics.

No trials loaded.

NURSA Datasets

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No NURSA datasets available.

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Sources for PharmGKB drug information: DrugBank, PubChem.