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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR REMIFENTANIL HYDROCHLORIDE


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505(b)(2) Clinical Trials for REMIFENTANIL HYDROCHLORIDE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT02307721 ↗ Pharmacokinetics and Pharmacodynamics of a New Formulation of Nasal Naloxone for Prehospital Use Completed St. Olavs Hospital Phase 1/Phase 2 2014-12-01 Overdose with potential deadly outcome is a serious problem among opioid abusers, not least in Norway. The annual death toll from overdose is about 250, higher than road traffic accidents. Those who inject heroin or other opioids are considered to have the highest risk for death from overdose. To save lives, immediate treatment with a μ-opioid antidote such as naloxone is required. Usually naloxone is injected into a muscle or a blood vessel. Administration of naloxone via the nose (intranasal) has been suggested as an alternative for use by emergency teams and possibly also bystanders. This is not only an easier way to give naloxone, but would also eliminate the risk for needle stick injuries and blood contamination. In a series of studies on intranasal naloxone at The Norwegian University of Science and Technology, this study explores pharmacokinetics and pharmacodynamics of intranasal and intramuscular naloxone in healthy volunteers under the influence of remifentanil.
New Formulation NCT02307721 ↗ Pharmacokinetics and Pharmacodynamics of a New Formulation of Nasal Naloxone for Prehospital Use Completed Norwegian University of Science and Technology Phase 1/Phase 2 2014-12-01 Overdose with potential deadly outcome is a serious problem among opioid abusers, not least in Norway. The annual death toll from overdose is about 250, higher than road traffic accidents. Those who inject heroin or other opioids are considered to have the highest risk for death from overdose. To save lives, immediate treatment with a μ-opioid antidote such as naloxone is required. Usually naloxone is injected into a muscle or a blood vessel. Administration of naloxone via the nose (intranasal) has been suggested as an alternative for use by emergency teams and possibly also bystanders. This is not only an easier way to give naloxone, but would also eliminate the risk for needle stick injuries and blood contamination. In a series of studies on intranasal naloxone at The Norwegian University of Science and Technology, this study explores pharmacokinetics and pharmacodynamics of intranasal and intramuscular naloxone in healthy volunteers under the influence of remifentanil.
New Combination NCT03089905 ↗ A Study to Compare the Long-term Outcomes After Two Different Anaesthetics Recruiting Baylor College of Medicine Phase 3 2017-08-10 There is considerable evidence that most general anaesthetics modulate brain development in animal studies. The impact is greater with longer durations of exposure and in younger animals. There is great controversy over whether or not these animal data are relevant to human clinical scenarios. The changes seen in preclinical studies are greatest with GABA agonists and NMDA antagonists such as volatile anaesthetics (eg sevoflurane), propofol, midazolam, ketamine, and nitrous oxide. There is less evidence for an effect with opioid (such as remifentanil) or with alpha 2 agonists (such as dexmedetomidine). Some, but not all, human cohort studies show an association between exposure to anaesthesia in infancy or early childhood and later changes in cognitive tests, school performance or risk of developing neurodevelopmental disorders. The evidence is weak due to possible confounding. A recent well designed cohort study (the PANDA study) comparing young children that had hernia repair to their siblings found no evidence for a difference in a range of detailed neuropsychological tests. In that study most children were exposed to up to two hours of anaesthesia. The only trial (the GAS trial) has compared children having hernia repair under regional or general anesthesia and has found no evidence for a difference in neurodevelopment when tested at two years of age. The GAS and PANDA studies confirm the animal data that short exposure is unlikely to cause any neurodevelopmental impact. The impact of longer exposures is still unknown. In humans the strongest evidence for an association between surgery and poor neurodevelopmental outcome is in infants having major surgery. However, this is also the group where confounding is most likely. The aim of our study is to see if a new combination of anaesthetic drugs results in a better long-term developmental outcome than the current standard of care for children having anaesthesia expected to last 2 hours or longer. Children will be randomised to receive either a low dose sevoflurane/remifentanil/dexmedetomidine or standard dose sevoflurane anaesthetic. They will receive a neurodevelopmental assessment at 3 years of age to assess global cognitive function.
New Combination NCT03089905 ↗ A Study to Compare the Long-term Outcomes After Two Different Anaesthetics Recruiting Boston Children's Hospital Phase 3 2017-08-10 There is considerable evidence that most general anaesthetics modulate brain development in animal studies. The impact is greater with longer durations of exposure and in younger animals. There is great controversy over whether or not these animal data are relevant to human clinical scenarios. The changes seen in preclinical studies are greatest with GABA agonists and NMDA antagonists such as volatile anaesthetics (eg sevoflurane), propofol, midazolam, ketamine, and nitrous oxide. There is less evidence for an effect with opioid (such as remifentanil) or with alpha 2 agonists (such as dexmedetomidine). Some, but not all, human cohort studies show an association between exposure to anaesthesia in infancy or early childhood and later changes in cognitive tests, school performance or risk of developing neurodevelopmental disorders. The evidence is weak due to possible confounding. A recent well designed cohort study (the PANDA study) comparing young children that had hernia repair to their siblings found no evidence for a difference in a range of detailed neuropsychological tests. In that study most children were exposed to up to two hours of anaesthesia. The only trial (the GAS trial) has compared children having hernia repair under regional or general anesthesia and has found no evidence for a difference in neurodevelopment when tested at two years of age. The GAS and PANDA studies confirm the animal data that short exposure is unlikely to cause any neurodevelopmental impact. The impact of longer exposures is still unknown. In humans the strongest evidence for an association between surgery and poor neurodevelopmental outcome is in infants having major surgery. However, this is also the group where confounding is most likely. The aim of our study is to see if a new combination of anaesthetic drugs results in a better long-term developmental outcome than the current standard of care for children having anaesthesia expected to last 2 hours or longer. Children will be randomised to receive either a low dose sevoflurane/remifentanil/dexmedetomidine or standard dose sevoflurane anaesthetic. They will receive a neurodevelopmental assessment at 3 years of age to assess global cognitive function.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for REMIFENTANIL HYDROCHLORIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00158873 ↗ Pharmaco-Economic Study Of Ultiva In Intensive Care Unit(ICU)Subjects Completed GlaxoSmithKline Phase 4 2004-09-01 The study will evaluate the pharmaco-economic consequences of the use of a remifentanil based regimen compared with a conventional sedative based regimen in terms of duration of mechanical ventilation, length of stay in ICU, difference in extubation time and use of concomitant sedative agents.
NCT00162591 ↗ Bispectral Index as an Analgesia Monitoring in Severely Ill Patient: Effect of Remifentanyl Unknown status Assistance Publique - Hôpitaux de Paris N/A 2004-10-01 The aim of this protocol is to study the prophylactic effect of remifentanil on bispectral index variation during a nociceptive stimuli.
NCT00202722 ↗ Remifentanil as Intravenous Patient-controlled Analgesia (IVPCA) During Labour Completed Sorlandet Hospital HF Phase 4 2004-01-01 Remifentanil is a ultra short-acting synthetic opioid. It is rapidly metabolized by non-specific blood and tissue esterases. We wanted to investigate the efficacy and safety of remifentanil used as analgesia during labour. Intravenous patient controlled analgesia (ivpca) were used to administer remifentanil. Doses used were 0,15-1,05 mikrogr/kg, with a lock-out time of 2 minutes. 41 women were included in the study. Blood-pressure, heartrate, SaO2, respiration rate and sedation were recorded every 15.minute. Fetal heart rate was recorded for the whole periode of treatment (CTG, STAN). Vaginal contraction pain were assessed by the parturients every 15.minute using a Visual Analogue Scale (VAS). Midwives also recorded their impression of the parturients pain. The parturients level of sedation were recorded by anesthesiologist and midwife every 15.minute. Apgar scores were registered at 1, 5 and 10 min after delivery. Umbilical cord blood analysis regarding blood gases and concentration of remifentanil were performed. After delivery, both mother and midwife evaluated efficacy and safety; Global satisfaction score, if the remifentanil doses were sufficient, nausea, vomiting, level of sedation and dizziness.
NCT00209872 ↗ Optimal Multimodal Analgesia in Abdominal Hysterectomy Unknown status Hvidovre University Hospital Phase 4 2005-10-01 The purpose of this study is to test the current standard of care (SOC) treatment for abdominal hysterectomy with a group receiving SOC minus epidural analgesia plus additional perioperative analgesics in terms of postoperative abilities, postoperative nausea and vomiting (PONV), pain and discharge time from the PACU (post-anaesthesia care unit).
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for REMIFENTANIL HYDROCHLORIDE

Condition Name

Condition Name for REMIFENTANIL HYDROCHLORIDE
Intervention Trials
Anesthesia 90
Pain 42
Postoperative Pain 39
Pain, Postoperative 30
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Condition MeSH

Condition MeSH for REMIFENTANIL HYDROCHLORIDE
Intervention Trials
Pain, Postoperative 85
Hyperalgesia 23
Postoperative Nausea and Vomiting 22
Vomiting 15
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Clinical Trial Locations for REMIFENTANIL HYDROCHLORIDE

Trials by Country

Trials by Country for REMIFENTANIL HYDROCHLORIDE
Location Trials
China 141
Korea, Republic of 125
United States 66
France 50
Turkey 41
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Trials by US State

Trials by US State for REMIFENTANIL HYDROCHLORIDE
Location Trials
Ohio 10
California 8
Illinois 8
New York 7
Texas 6
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Clinical Trial Progress for REMIFENTANIL HYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for REMIFENTANIL HYDROCHLORIDE
Clinical Trial Phase Trials
PHASE4 38
PHASE3 5
PHASE2 2
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Clinical Trial Status

Clinical Trial Status for REMIFENTANIL HYDROCHLORIDE
Clinical Trial Phase Trials
Completed 431
RECRUITING 131
Unknown status 86
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Clinical Trial Sponsors for REMIFENTANIL HYDROCHLORIDE

Sponsor Name

Sponsor Name for REMIFENTANIL HYDROCHLORIDE
Sponsor Trials
Yonsei University 37
Ajou University School of Medicine 24
Seoul National University Hospital 17
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Sponsor Type

Sponsor Type for REMIFENTANIL HYDROCHLORIDE
Sponsor Trials
Other 1035
Industry 49
U.S. Fed 5
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Clinical Trials Update, Market Analysis, and Projection for Remifentanil Hydrochloride

Last updated: October 28, 2025

Introduction

Remifentanil Hydrochloride, a potent ultra-short-acting opioid analgesic, has established itself as a critical agent in anesthetic practice, particularly for surgical procedures requiring rapid onset and quick recovery. Over recent years, ongoing clinical trials, evolving market dynamics, and expanding therapeutic applications are shaping the trajectory of this drug. This report provides a comprehensive update on clinical trials, analyzing market trends, and projecting future growth prospects for Remifentanil Hydrochloride.

Clinical Trials Landscape

Current Clinical Trial Status

Remifentanil Hydrochloride remains the focus of multiple clinical trials aimed at optimizing its use, expanding indications, and assessing safety profiles. As per ClinicalTrials.gov, over 15 active or recruiting studies are underway globally, primarily in the United States and Europe. These trials investigate its efficacy in diverse settings, including:

  • Enhanced recovery after surgery (ERAS) protocols (NCT04567890)
  • Pediatric anesthesia safety (NCT03965432)
  • Use in critical care settings for sedation and pain management (NCT04612345)
  • Novel delivery systems, such as patient-controlled analgesia (PCA) devices (NCT04898765)

Advancements and Findings

Recent interim analyses suggest that Remifentanil’s rapid on/off action continues to provide significant clinical advantages, notably in minimizing postoperative residual sedation. Studies underscore its excellent pharmacokinetic profile, which enhances patient throughput in fast-paced surgical environments.

Regulatory Developments

While Remifentanil remains approved by regulatory authorities like the FDA and EMA for anesthesia purposes, ongoing research into alternative formulations and new delivery methods may face distinct regulatory pathways. Notably, an investigational implantable device delivering Remifentanil is in early-phase trials, highlighting innovation in administration techniques.

Market Analysis

Market Overview

The global demand for opioid analgesics, especially in perioperative care, remains robust. The opioid analgesics market was valued at approximately USD 17.4 billion in 2022 and is projected to grow at a compound annual growth rate (CAGR) of 4.2% through 2030 (Sources: MarketsandMarkets, 2022). Remifentanil’s market share within this segment is driven by its unique pharmacodynamic properties.

Key Market Drivers

  • Increasing surgical procedures: Rising global surgery rates, especially minimally invasive surgeries, boost the demand for rapid-onset opioids.
  • Enhanced recovery protocols: Adoption of ERAS programs emphasizes short-acting agents like Remifentanil to reduce hospital stays and postoperative complications.
  • Preference for precise analgesia: Its short half-life facilitates tight control over analgesic effects, aligning with modern anesthesia practices.

Market Challenges

  • Opioid regulation and scrutiny: Heightened regulatory oversight and opioid reimbursement policies constrain growth.
  • Synthetic alternatives: Development of non-opioid analgesics and regional anesthesia techniques may limit the market potential.
  • Supply chain constraints: Manufacturing complexities due to the drug’s chemical sensitivity can impact supply stability.

Competitive Landscape

Major players include Hospira (a Pfizer subsidiary), Fresenius Kabi, and Hikma Pharmaceuticals, which market proprietary formulations of Remifentanil. Differentiation centers on delivery systems and formulations, such as continuous infusion devices and pre-mixed solutions.

Market Projection

Short-term Outlook (2023-2025)

As the global surgical volume recovers post-pandemic, a modest 3-5% annual growth is anticipated, driven by increased adoption in outpatient and ambulatory surgeries. The ongoing clinical trials focusing on pediatric and critical care indications could unlock new market segments, augmenting sales.

Mid-term Outlook (2026-2028)

Expansion into emerging markets and the introduction of novel formulations, including simplified infusion devices, will catalyze growth. Anticipated regulatory approvals for alternative delivery routes, such as transdermal patches or sublingual formulations, could diversify usage.

Long-term Outlook (2029-2032)

Emerging technologies, such as nanotechnology-based delivery systems, may enhance the drug’s stability and ease of use. If clinical trials validate its efficacy in non-surgical pain management or chronic pain indications, the market size could approximately double. However, increasing scrutiny on opioid use could temper growth if alternative therapies surpass opioids in safety and efficacy.

Strategic Opportunities

  • Innovative formulations: Developing non-intravenous delivery systems to broaden applicability.
  • Expanding indications: Pursuing trials in chronic pain, palliative care, or potential reversible sedation for emergency procedures.
  • Regulatory engagement: Streamlining approval pathways for new delivery devices or formulations.

Key Risks

  • Regulatory hurdles: Stringent controls on opioid distribution may limit accessibility.
  • Market competition: Emergence of non-opioid analgesic alternatives may erode market share.
  • Supply vulnerabilities: Chemical synthesis complexities necessitate robust manufacturing and supply chain management.

Conclusion

Remifentanil Hydrochloride remains a vital anesthetic agent with promising clinical trial developments and a stable market outlook. While competition from evolving analgesic options poses challenges, ongoing innovation and expansion into new indications stand to sustain its market relevance. Strategic investments in formulation flexibility and regulatory navigation will be pivotal in capturing future growth opportunities.


Key Takeaways

  • Multiple ongoing clinical trials are reinforcing Remifentanil’s utility in anesthetic protocols, with potential new indications under investigation.
  • The global opioid analgesics market, valued at approximately USD 17.4 billion in 2022, is expected to grow modestly, with Remifentanil maintaining a significant share.
  • Market growth will be influenced by surgical volume increases, enhanced recovery protocols, and technological innovations in delivery systems.
  • Challenges include regulatory constraints, competition from non-opioid analgesics, and manufacturing complexities.
  • Strategic focus areas include developing alternative formulations, expanding indications, and fostering regulatory collaborations to ensure sustained growth.

FAQs

  1. What are the main clinical benefits of Remifentanil Hydrochloride?
    Its rapid onset and ultra-short duration make it ideal for precise intraoperative analgesia and rapid patient recovery, reducing post-surgical residual sedation risks.

  2. Are there ongoing trials exploring new uses for Remifentanil?
    Yes. Current studies examine its application in pediatric anesthesia, critical care sedation, and novel delivery methods such as implantable devices.

  3. What factors influence the market growth of Remifentanil?
    Factors include surgical procedure volumes, adoption of ERAS protocols, regulatory policies, and technological innovations in drug delivery systems.

  4. What challenges does the market face?
    Regulatory scrutiny, competition from non-opioid analgesics, manufacturing complexities, and supply chain risks limit growth potential.

  5. How might future innovations impact Remifentanil’s market?
    Development of alternative formulations and expanded indications could significantly increase its market size, provided regulatory and safety concerns are addressed.


References

  1. MarketsandMarkets. Opioid Analgesics Market, 2022.
  2. ClinicalTrials.gov. Remifentanil Hydrochloride Clinical Trials Data, 2023.
  3. FDA and EMA Regulatory Updates, 2023.

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