Which opioids do not cause histamine release?

Which opioids do not cause histamine release?

• A. Fentanyl, sufentanil, alfentanil, remifentanil
• B. Morphine, meperidine
• C. Hydromorphone, oxycodone
• D. Methadone, buprenorphine

Answer: (A)

Histamine release from opioids happens when mast cells are directly stimulated by certain drugs, leading to vasodilation, itching, and sometimes hypotension or bronchospasm. Morphine is a classic example that triggers significant histamine release, whereas many synthetic opioids behave differently. Fentanyl and its closely related analogs—sufentanil, alfentanil, and remifentanil—do not provoke histamine release to a meaningful degree. This makes them the opioids of choice when you want to avoid histamine-mediated effects such as hypotension or itching. The other opioids can cause varying amounts of histamine release, so they’re less predictable in that regard.

Histamine release from opioids happens when mast cells are directly stimulated by certain drugs, leading to vasodilation, itching, and sometimes hypotension or bronchospasm. Morphine is a classic example that triggers significant histamine release, whereas many synthetic opioids behave differently.

Fentanyl and its closely related analogs—sufentanil, alfentanil, and remifentanil—do not provoke histamine release to a meaningful degree. This makes them the opioids of choice when you want to avoid histamine-mediated effects such as hypotension or itching. The other opioids can cause varying amounts of histamine release, so they’re less predictable in that regard.