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Mirfentanil is a synthetic fentanyl derivative and piperidine compound with high selectivity for the μ-opioid receptor. At lower doses, it acts as an antagonist to the analgesic effects of alfentanil and can substitute for naloxone in morphine-treated animal models; it also reverses naloxone-precipitated withdrawal in certain behavioral assays. At higher doses, mirfentanil exhibits analgesic activity that is not fully reversed by opioid antagonists, indicating both opioid and non-opioid mechanisms of action. It has modest respiratory depressant effects and can antagonize the respiratory depression caused by other opioids like alfentanil. Mirfentanil was developed as an experimental centrally acting analgesic agent but has not been approved for clinical use[1][2][3][4][5].
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