デクスメデトミジン
Dexmedetomidine
Dexmedetomidine Hydrochloride
別名: Dexdomitor · Precedex · (S)-medetomidine · MPV 1440 · MPV 295 · MPV 785
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
監査済み v13 用量エビデンス
確認済み・計算対象外のエビデンス確認済み・計算対象外のエビデンス (2)
エビデンス表示のみ（自動計算対象外）
Light sedation (often used for preanesthesia)
a) Light sedation (often used for preanesthesia): 5 – 15 µg/kg IV, IM, or SC
必ず考慮する臨床コンテキスト (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.
エビデンス表示のみ（自動計算対象外）
Deep sedation
c) Deep sedation: 40 µg/kg IV, IM, or SC
必ず考慮する臨床コンテキスト (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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
デクスメデトミジンは、獣医療において主に鎮静薬、鎮痛薬、麻酔前投薬として使用される強力で特異性の高いアルファ2アドレナリン受容体作動薬です。メデトミジンの右旋性エナンチオマーであり、ラセミ混合物の約2倍の効力を持ちます。
作用機序
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.
安全性・警告
禁忌
- 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
有害事象
- 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
注意事項
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.
医薬品相互作用
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.
監視
- Level of sedation and analgesia
- Heart rate and rhythm
- Blood pressure
- Respiration rate and pulse oximetry
- Body temperature (monitor for hypothermia)
薬物動態
半減期
吸収
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.
分布
Dogs: Vd is 0.9 L/kg. Cats: Vd is 2.2 L/kg.
代謝
Primarily metabolized in the liver via glucuronidation and N-methylation. No active metabolites.
消失
Eliminated primarily in the urine and to a lesser extent in the feces.
過剰投与
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.
製品
製剤
- Injection: 0.5 mg/mL (500 mcg/mL)
- Concentrated Solution for Injection: 100 mcg/mL
動物用医薬品
- Dexmedetomidine HCl 0.5 mg/mL (500 micrograms/mL) in 10 mL multidose vials (Dexdomitor)
ヒト用医薬品
- Dexmedetomidine HCl Concentrated Solution for Injection: 100 micrograms/mL in 2 mL vials (Precedex)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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.
飼主向け情報
この薬は獣医療専門家によってのみ投与および監視されるべきです。飼い主は、特に高齢や基礎疾患のある犬において、潜在的な副作用について知っておく必要があります。鎮静後はペットを暖かく静かに保ってください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。