Sufentanil
Also called Sufentanyl, Sufenta, Chronogesic, Zalviso, IDS-NS-001, Sulfentanil
Dosage
Intravenous bands as drawn from PsychonautWiki's ranges below. The table is the source of truth.
Intravenous
Oral
TripSit dose text
TripSit's factsheet also states its doses as text.
Light: 1-5ug Common: 5-10ug Strong: 10-25ug. TS
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Duration
| Route · source | Onset | Come-up | Peak | Offset | Total | After-effects |
|---|---|---|---|---|---|---|
| Intravenous · PsychonautWiki | 1–2 minutes PW | – | 5–10 minutes PW | – | – | 1–12 hours PW |
TripSit factsheet
Mixing
For best safety practice, don't mix this drug with other depressants.
Why: respiratory depression. PsychonautWiki says:
- “Respiratory depression (also known as hypoventilation) can be described as a reduced urge to breathe that can be fatal depending on its intensity.” (PsychonautWiki, Respiratory depression, revision 150612)
- “... otherwise safe dosages of these compounds can become fatal when combined with even small amounts of other classes of depressant. For example, benzodiazepines combined with opioids are an extremely common cause of fatal respiratory depression. It is therefore strongly discouraged to combine these depressants at any dosage range.” (PsychonautWiki, Respiratory depression, revision 150612)
- “The most common cause of substance-related deaths is the combination of depressants (such as opiates, benzodiazepines, or alcohol) with other depressants.” (PsychonautWiki, Responsible drug use, revision 168206)
- “This combination potentiates the muscle relaxation, amnesia, sedation, and respiratory depression caused by one another. At higher doses, it can lead to a sudden, unexpected loss of consciousness along with a dangerous amount of depressed respiration.” (PsychonautWiki, dangerous interactions table, "Depressants" row, revision 156847)
Quotes from PsychonautWiki, CC BY-SA 4.0.
Acute combinations: what happens when these are taken close together. Entries backed by a medical journal or agency are listed first.
Backed by medical journals
PsychonautWiki also lists dangerous combinations shared across a whole group (opioids, serotonin syndrome) in a table this page does not copy. Read that list on PsychonautWiki.
TripSit combination chart
TripSit rates each pairing. Only pairings with a number carry a citation from TripSit. See the whole chart; TripSit's own notes are on combo.tripsit.me.
Risks and toxicity
Recreational use of sufentanil by individuals without opioid tolerance is extremely dangerous due to its potency. It is potentially fatal at heavy dosages and even those with opiate tolerances are at high risk for overdoses. Once the sufentanil is in the user's system, it is extremely difficult to stop its course because of the nature of absorption. Because of the extremely high strength of pure sufentanil powder, it is very difficult to dilute appropriately, and often the resulting mixture may be far too strong and, therefore, very dangerous. It is also potentially lethal when mixed with depressants like alcohol or benzodiazepines. PW
Like most opioids, unadulterated sufentanil at appropriate dosages does not cause many long-term complications other than dependence and constipation. Outside of the extremely powerful addiction and physical dependence, the harmful or toxic aspects of opioid usage are exclusively associated with not taking the necessary precautions in regards to its administration, overdosing and using impure products. PW
It is important to consider that particular care must be taken with sufentanil due to its extreme potency and ability to be absorbed through the skin. This means that simply unintentionally spilling a very small amount of sufentanil on one's skin could result in a fatal overdose. PW
Heavy dosages of sufentanil can result in respiratory depression, leading onto fatal or dangerous levels of anoxia (oxygen deprivation). This occurs because the breathing reflex is suppressed by agonism of µ-opioid receptors proportional to the dosage consumed. PW
Sufentanil can also cause nausea and vomiting; a significant number of deaths attributed to opioid overdose are caused by aspiration of vomit by an unconscious victim. This is when an unconscious or semi-conscious user who is lying on their back vomits into their mouth and unknowingly suffocates. It can be prevented by ensuring that one is lying on their side with their head tilted downwards so that the airways cannot be blocked in the event of vomiting while unconscious (also known as the recovery position). In case of overdose, it is advised to administer a dose of naloxone intravenously or intramuscularly to reverse the effects of opioid agonism. It has been noted that naloxone is not very effective for the management of opioid overdoses in cases where extremely potent opioids like sufentanil have been used. In the case of sufentanil, naltrexone should be used in case of an overdose. PW
It is strongly recommended that one use harm reduction practices when using this drug. PW
Tolerance and addiction potential
As with other opioids, the chronic use of sufentanil can be considered extremely addictive with a high potential for abuse and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and withdrawal symptoms may occur if a person suddenly stops their usage. PW
Tolerance to many of the effects of sufentanil develops with prolonged and repeated use. The rate at which this occurs develops at different rates for different effects, with tolerance to the constipation-inducing effects developing particularly slowly for instance. This results in users having to administer increasingly large doses to achieve the same effects. It is unknown how long it takes for sufentanil tolerance to decrease to baseline (no distinguishable tolerance). Sufentanil presents cross-tolerance with all other opioids, meaning that after the consumption of sufentanil all opioids will have a reduced effect. PW
The risk of fatal opioid overdoses rise sharply after a period of cessation and relapse, largely because of reduced tolerance. To account for this lack of tolerance, it is safer to only dose a fraction of one's usual dosage if relapsing. It has also been found that the environment one is in can play a role in opioid tolerance. In one scientific study, rats with the same history of heroin administration were significantly more likely to die after receiving their dose in an environment not associated with the drug in contrast to a familiar environment.[3]
Median lethal dose (LD50) in animals
Quoted from PubChem's Non-Human Toxicity Values, which come from the Hazardous Substances Data Bank (HSDB). PubChem describes them as: “Quantitative non-human toxicity values (e.g., lethal dose) for this compound. The data shown here are mostly for lab animals (e.g., rat, mouse, guinea pig, and rabbit).” and defines the “LD50 (median lethal dose, the estimated amount of a chemical expected to kill 50% of test animals in a single dose)”. PC
| LD50 (as the source gives it) | Reference |
|---|---|
| LD50 Mouse iv 16.8-18.7 mg/kg PC | American Society of Health-System Pharmacists 2017; Drug Information 2017. Bethesda, MD. 2017, p. 2279 (via HSDB record 6760) |
| LD50 Guinea pig iv 11.8-13 mg/kg PC | American Society of Health-System Pharmacists 2017; Drug Information 2017. Bethesda, MD. 2017, p. 2279 (via HSDB record 6760) |
| LD50 Dog iv 10.1-19.5 mg/kg PC | American Society of Health-System Pharmacists 2017; Drug Information 2017. Bethesda, MD. 2017, p. 2279 (via HSDB record 6760) |
| LD50 Rat iv 9.3-12.5 mg/kg PC | American Society of Health-System Pharmacists 2017; Drug Information 2017. Bethesda, MD. 2017, p. 2279 (via HSDB record 6760) |
Testing
Effects
Overview
Sufentanil, also known as sufentanyl and by the brand name Sufenta, is an extremely potent synthetic anilidopiperidine opioid analgesic. Sufentanil has a rapid onset and short mechanism and is used medically as an analgesic in surgical procedures or for the management of post-operative pain. Sufentanil is roughly 500 to 1,000 times more potent than pharmaceutical grade morphine and is approximately 10 times more potent than pharmaceutical grade fentanyl. The subjective effects of sufentanil are similar to those of heroin, with the exception that many users report a significantly less euphoric "high" associated with the drug and stronger respiratory depression, sedation and pain relief. Sufentanil is the most potent opioid analgesic currently used in human medicine. PW
An synthetic analgesic drug that is roughly between 5-10x the potency of it's parent drug, (Fentanyl); It's use is very contained to surgery and post-operative pain. TS
Sufentanil, sold under the brand names Sufenta among others, is a synthetic opioid analgesic drug approximately 5 to 10 times as potent as its parent drug, fentanyl, and 500 to 1,000 times as potent as morphine. Structurally, sufentanil differs from fentanyl through the addition of a methoxymethyl group on the piperidine ring (which increases potency but is believed to reduce duration of action), and the replacement of the phenyl ring by thiophene. Sufentanil first was synthesized at Janssen Pharmaceutica in 1974.[1]
History
Legal status
- Germany: Sufentanil is a controlled substance under Anlage III of the BtMG. It can only be prescribed on a narcotic prescription form.[5] PW
- Russia: Sufentanil is a Schedule II controlled substance.[6] PW
- Switzerland: Sufentanil is a controlled substance specifically named under Verzeichnis A. Medicinal use is permitted.[7] PW
- United States: Sufentanil is classified as a Schedule II Controlled Substance under the Controlled Substances Act.[8] PW
Brand names
Sufentanil is marketed under various brand names including Dsuvia, Dzuveo, Sufenta, and Sufentil.[9] WP
Pharmacology
Chemistry
User reports
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References
- Journal / agency Vucković S, Prostran M, Ivanović M, Dosen-Mićović Lj, Todorović Z, Nesić Z, Stojanović R, Divac N, Miković Z. Fentanyl analogs: structure-activity-relationship study. Current Medicinal Chemistry. 2009. doi:10.2174/092986709788682074 · PMID 19601792
- Journal / agency Niemegeers CJ, Schellekens KH, Van Bever WF, Janssen PA. Sufentanil, a very potent and extremely safe intravenous morphine-like compound in mice, rats and dogs. Arzneimittel-Forschung. 1976. PMID 12772
- Other Why Heroin Relapse Often Ends In Death - Lauren F Friedman (Business Insider)
- Journal / agency Siegel, S., Hinson, R. E., Krank, M. D., McCully, J. Heroin “Overdose” Death: Contribution of Drug-Associated Environmental Cues. Science. 23 April 1982. doi:10.1126/science.7200260
- Other Anlage III BtMG - Einzelnorm
- Other Постановление Правительства РФ от 01.10.2012 N 1002 (ред. от 09.08.2019)
- Other Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien
- Other Controlled Drugs
- Other Silverman E. Despite criticism and concerns, FDA approves a new opioid 10 times more powerful than fentanyl. 2 November 2018
Text and values on this page are quoted from PsychonautWiki (CC BY-SA 4.0), Wikipedia (CC BY-SA 4.0), TripSit factsheets, PubChem (public domain). Each value links to the exact revision it came from.