Dexmedetomidina
Dexmedetomidine
Dexmedetomidine Hydrochloride
También conocido como: Dexdomitor · Precedex · (S)-medetomidine · MPV 1440 · MPV 295 · MPV 785
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia de dosis v13 auditada
Evidencia revisada no calculableEvidencia revisada no calculable (2)
Solo evidencia; no apta para cálculo automático
Light sedation (often used for preanesthesia)
a) Light sedation (often used for preanesthesia): 5 – 15 µg/kg IV, IM, or SC
Contexto clínico obligatorio (7)
- 1. Dexmedetomidine dosages depend on the combination of drugs used and the dosage(s) of the other drug(s). Premedication with dexmedetomidine will significantly reduce the dose of the induction agent required and will reduce volatile anesthetic requirements for maintenance anesthesia. All anesthetic agents used for induction or maintenance of anesthesia should be administered to effect.
- 2. Dose adjustments will also need to be made to account for the degree of desired sedation; type, duration, and pain level of the procedure; and patient temperament and body weight/size.
- 3. Dosing based on body surface area (BSA; or allometric scaling) is not common in clinical practice but decreases the variability in drug response between giant/large and small/toy breed dogs. See Conversion Tables: Body Weight (kg) to Body Surface Area (m 2 ).
- 4. For all dosages, the low end of the dose range is generally appropriate for IV administration, whereas the mid-upper range is most appropriate for IM or SC administration. Higher dosages will provide more profound sedation and analgesia.
- 5. When SC administration is used, the speed of sedation is slower, and the level of sedation is lighter and inconsistent. For more predictable sedation, IM or IV administration is recommended.
- 6. The effects of dexmedetomidine can be reversed with atipamezole. It is most often dosed by volume at ½ or the same volume of dexmedetomidine that was administered and given IM. See Atipamezole.
- Store the injection at room temperature (ie, 15°C-30°C [59°F-86°F]); do not freeze. Discard unused product 90 days after first piercing the vial.
Solo evidencia; no apta para cálculo automático
Deep sedation
c) Deep sedation: 40 µg/kg IV, IM, or SC
Contexto clínico obligatorio (7)
- 1. Dexmedetomidine dosages depend on the combination of drugs used and the dosage(s) of the other drug(s). Premedication with dexmedetomidine will significantly reduce the dose of the induction agent required and will reduce volatile anesthetic requirements for maintenance anesthesia. All anesthetic agents used for induction or maintenance of anesthesia should be administered to effect.
- 2. Dose adjustments will also need to be made to account for the degree of desired sedation; type, duration, and pain level of the procedure; and patient temperament and body weight/size.
- 3. Dosing based on body surface area (BSA; or allometric scaling) is not common in clinical practice but decreases the variability in drug response between giant/large and small/toy breed dogs. See Conversion Tables: Body Weight (kg) to Body Surface Area (m 2 ).
- 4. For all dosages, the low end of the dose range is generally appropriate for IV administration, whereas the mid-upper range is most appropriate for IM or SC administration. Higher dosages will provide more profound sedation and analgesia.
- 5. When SC administration is used, the speed of sedation is slower, and the level of sedation is lighter and inconsistent. For more predictable sedation, IM or IV administration is recommended.
- 6. The effects of dexmedetomidine can be reversed with atipamezole. It is most often dosed by volume at ½ or the same volume of dexmedetomidine that was administered and given IM. See Atipamezole.
- Store the injection at room temperature (ie, 15°C-30°C [59°F-86°F]); do not freeze. Discard unused product 90 days after first piercing the vial.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La dexmedetomidina es un agonista adrenérgico alfa-2 potente y altamente específico, utilizado principalmente como sedante, analgésico y preanestésico en medicina veterinaria. Es el enantiómero dextrorrotatorio de la medetomidina, lo que la hace aproximadamente el doble de potente que la mezcla racémica.
Características clínicas clave:
- Respuesta cardiovascular bifásica: La vasoconstricción periférica inicial conduce a una hipertensión transitoria y una bradicardia refleja pronunciada. A esto le sigue un efecto simpaticolítico central que causa normotensión o hipotensión leve, mientras que la bradicardia persiste.
- Analgesia: Proporciona una excelente analgesia visceral y somática, a menudo sinérgica con opioides (por ejemplo, protocolos "kitty magic" o "doggie magic").
- Reversibilidad: Los efectos pueden revertirse rápida y completamente utilizando el antagonista alfa-2 específico atipamezol.
- Dosificación: En perros, la dosificación se basa exclusivamente en el área de superficie corporal (BSA) en lugar de estrictamente por peso, ya que los perros más pequeños requieren dosis por kg más altas para lograr niveles de sedación similares.
Mecanismo de acción
Dexmedetomidine acts as a highly selective agonist at pre-synaptic alpha-2 adrenergic receptors in the central and peripheral nervous systems.
- CNS Effects: Activation of alpha-2 receptors in the locus coeruleus → decreased norepinephrine release → profound sedation, anxiolysis, and analgesia.
- Cardiovascular Effects: Activation of peripheral post-synaptic alpha-2B receptors in vascular smooth muscle → intense vasoconstriction → increased systemic vascular resistance (SVR) → reflex bradycardia mediated by baroreceptors. Central alpha-2A activation subsequently decreases sympathetic outflow.
- Other Effects: Decreases GI secretions, alters intestinal motility, induces diuresis (via inhibition of ADH), and causes mild muscle relaxation.
Seguridad y advertencias
Contraindicaciones
- Cardiovascular disease
- Respiratory disorders
- Liver or kidney diseases
- Shock or severe debilitation
- Stress due to extreme heat, cold, or fatigue
- Puppies < 16 weeks (US label) or < 6 months (UK label)
- Kittens < 12 weeks (US label) or < 5 months (UK label)
- Hypersensitivity to the active substance
Efectos adversos
- Bradycardia (profound)
- Occasional AV blocks
- Decreased respiration / Apnea
- Hypothermia
- Urination
- Vomiting
- Hyperglycemia
- Pain on injection (IM)
- Prolonged sedation
- Paradoxical excitation
- Hypersensitivity
- Pulmonary edema
- Death from circulatory failure (rare)
- Muscle tremors
- Transient hypertension
- Reduced tear production
Precauciones
Cardiovascular Warning: Due to pronounced cardiovascular effects (bradycardia, vasoconstriction), only clinically healthy dogs and cats should be treated.
- Seizure Disorders: Use with caution in animals with or prone to developing seizures; may lower the seizure threshold.
- Ocular Care: Blinking may be impaired and tear production reduced; eye lubricants should be applied during sedation.
- Pregnancy/Nursing: Not recommended for use in pregnant or breeding animals unless benefits clearly outweigh risks (FDA Category C). Safe use during nursing is not established.
Interacciones farmacológicas
Effects may be additive; dosage reduction of one or both agents may be required. General anesthetic requirements may be reduced between 30-60%.
Can significantly increase arterial blood pressure and heart rate; use together is not recommended in dogs due to increased cardiac workload.
Possesses alpha agonist effects; do not use to treat cardiac effects caused by dexmedetomidine.
May reverse the effects, but atipamezole is preferred for clinical use.
Monitorización
- Level of sedation and analgesia
- Heart rate and rhythm
- Blood pressure
- Respiration rate and pulse oximetry
- Body temperature (monitor for hypothermia)
Farmacocinética
Vida media
Absorción
Dogs: IM bioavailability 60%, peak plasma levels in ~35 minutes. Cats: IM peak plasma levels in ~15 minutes. OTM (buccal) administration provides similar clinical effects to IM.
Distribución
Dogs: Vd is 0.9 L/kg. Cats: Vd is 2.2 L/kg.
Metabolismo
Primarily metabolized in the liver via glucuronidation and N-methylation. No active metabolites.
Eliminación
Eliminated primarily in the urine and to a lesser extent in the feces.
Sobredosis
Single doses of up to 5X (IV) and 10X (IM) were tolerated in dogs, but adverse effects (heart block, PVCs, tachycardia, profound sedation) can occur.
Important: Treatment of dexmedetomidine-induced bradycardia with anticholinergic agents (atropine or glycopyrrolate) is usually not recommended due to the risk of severe hypertension and arrhythmias.
Atipamezole is the safest and most effective choice to reverse any dexmedetomidine-induced effects or overdose.
Productos disponibles
Formulaciones
- Injection: 0.5 mg/mL (500 mcg/mL)
- Concentrated Solution for Injection: 100 mcg/mL
Veterinario
- Dexmedetomidine HCl 0.5 mg/mL (500 micrograms/mL) in 10 mL multidose vials (Dexdomitor)
Etiquetado para humanos
- Dexmedetomidine HCl Concentrated Solution for Injection: 100 micrograms/mL in 2 mL vials (Precedex)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store the injection at room temperature (15-30°C); do not freeze. Can be mixed in the same syringe with butorphanol, ketamine, buprenorphine, hydromorphone, or morphine with no pharmacological risk.
Información para el cliente
- Solo para uso profesional: Este medicamento debe ser administrado y monitoreado únicamente por profesionales veterinarios.
- Cuidados post-sedación: Mantenga a su mascota en un ambiente tranquilo, cálido y cómodo después de regresar a casa. Es posible que permanezca ligeramente aturdida.
- Riesgos: Tenga en cuenta los posibles efectos adversos, especialmente si su perro es mayor o tiene condiciones preexistentes de corazón, hígado o riñón.
- Dieta: Siga las instrucciones de su veterinario con respecto al ayuno antes del procedimiento y cuándo reanudar la alimentación posteriormente.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.