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Sufentanil Facts

Opioid; Depressant; Anilidopiperidine; Mu-opioid receptor agonist

Description

Sufentanil is a synthetic opioid of the anilidopiperidine class. It activates opioid receptors in the brain and spinal cord, suppressing pain and depressing the drive to breathe.

Subjective effects include complete pain suppression, heavy sedation, dissolution of anxiety, and a warm euphoria that compresses awareness into quiet stillness. The experience is defined by what it removes — pain and distress disappear, and consciousness narrows toward silence.

Physical dependence develops rapidly, and respiratory depression — breathing slowing to a stop — is the primary cause of death in overdose.[1] The margin between an analgesic dose and a fatal one is narrow in humans, even though preclinical studies give sufentanil the widest safety margin of any tested opioid.[1]

Dose and durationby route · individual sensitivity varies

Sublingual(µg)
Thresholdnot recordedLightnot recordedCommon30 – 30 µgStrongnot recordedHeavynot recorded

No duration recorded for this route.

Body and dependence

Acute toxicity
High
Chronic toxicity
Moderate
Physical dependence
High
Psychological dependence
Moderate
Withdrawal
Moderate · medical supervision
Compulsive redosing
High

Tolerance

Builds
Moderate
Fully resets after
Not recorded
Carries over to
morphine; fentanyl; DADLE; other mu-opioid receptor agonists

Effectslikely at a common dose

Perception
none likely · 6 possible, including Spatial disorientation, Vestibular distortion, Visual acuity suppression
Body
Pain suppression; Respiratory depression; Sedation; Pupil constriction; Breathing alteration; Constipation; Physical fatigue; Body high; Bodily heaviness; +15 possible, including Motor control impairment, Nausea, Dizziness
Thinking
none likely · 17 possible, including Cognitive impairment, Information processing suppression, Analysis suppression
Feeling
Euphoria; +3 possible, including Empathy suppression
Self
none likely · 6 possible, including Craving, Communication suppression, Social disconnection
Time
none likely · 2 possible, including Temporal disorientation

Who shouldn't take it

Absolute
Hypersensitivity to sufentanil or other opioid agonists; Absence of resuscitation equipment and trained personnel
Relative
Respiratory depression or obstructive airway disease; Head injury or raised intracranial pressure; Acute alcoholism or delirium tremens; Hepatic impairment; Neonatal population; Concurrent strong CYP3A4 inhibitors; Paralytic ileus; Concurrent MAOI use

Combinations62 recorded

Lethal (6)
Benzodiazepines, Barbiturates; GHB, Baclofen; GHB, GBL; Ketamine; Local anesthetics; Tramadol
Dangerous (28)
Alpha-2 adrenergic receptor antagonist; Amphetamines; Anticholinergics; Antihistamines; Antipsychotics; Benzodiazepines; Buprenorphine, Kratom; Cannabis, THC; Clonidine, Guanfacine; Gabapentin, Pregabalin; MAOIs; MDMA, Amphetamines; MDMA, MDA; Naltrexone; NRIs; SNRIs; SSRIs; Stimulants; Synthetic cannabinoids; THC; Caffeine; CBD; Glutamate modulator; Huperzine A; and 4 more, see full page
Caution (19)
See full page: psychedex.org/substances/sufentanil
Not graded (9)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^abNiemegeers CJ, Schellekens KH, Van Bever WF, Janssen PA (1976) Sufentanil, a very potent and extremely safe intravenous morphine-like compound in mice, rats and dogs — Arzneimittel-Forschung PMID:12772
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