Dexmedetomidine

By Krista Williams, BSc, DVM, CCRP

What is dexmedetomidine?

Dexmedetomidine is a sedative and tranquilizer (Sileo®) used in the treatment of fear and anxiety in dogs and as a sedative and pain medication (Dexdomitor®) in both dogs and cats.

It is also used off-label as a pre-anesthetic or tranquilizer in exotic pets.

How is dexmedetomidine given?

Dexmedetomidine is most often administered as an injection into the muscle, usually within the hospital setting.

It can also be given as a gel or liquid by mouth (in dogs only) that is absorbed by the gums (gingiva) and is not to be swallowed. Your veterinarian will recommend how to time the dose. It is best to avoid feeding your dog after administering the medication to help with absorption. Read the drug insert of the gel formulation carefully to prevent overdose. If using syringes that have been used to administer a dose before, only give the medication when there is enough remaining for a complete dose.

Gloves should be worn when administering the gel to prevent inadvertent human exposure. If you have any questions about giving this medication to your pet, consult your veterinarian prior to administering it.

What if I miss giving my pet the dexmedetomidine?

Typically, this medication is not given on a schedule. Your veterinarian will provide you with information specific to your pet with regard to missed doses.

Are there any potential side effects?

This drug is most commonly given to cause sedation, so extreme sedation/lethargy for a short period of time is an expected side effect. Pale gums and lowered heart and respiratory rates can occur. Rarely, vomiting, diarrhea, and collapse may occur. When injected into the muscle, this medication can cause temporary pain at the injection site.

This short-acting medication should stop working within 24 hours. Effects can last longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Dexmedetomidine should not be used in pets that have a sensitivity to it, have severe heart, lung, liver, or kidney problems, are severely debilitated, stressed due to extreme heat or cold, are pregnant or nursing, or in pets that are still sedated from a previously given dose.

The oral formulation is NOT to be used in cats.

Use this medication with caution in dogs younger than 16 weeks of age, animals that are senior or weak, and in dogs taking other behavior-modifying medications. Use the oral formulation with caution in dogs with dental or gingival problems.

Are there any drug interactions I should be aware of?

Dexmedetomidine can interact with many medications and should be used with caution with ACE inhibitors, such as enalapril (Enacard®) and benazepril (Fortekor®), acepromazine, amlodipine, anesthetics, atropine, glycopyrrolate, benzodiazepines, such as diazepam and midazolam, atenolol, metoprolol, epinephrine, opioids, such as morphine and tramadol, sildenafil, telmisartan (Semintra®), and yohimbine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Your veterinarian may regularly monitor your pet's heart rate, heart rhythm, and blood pressure while your pet is taking this medication. Body temperature should also be monitored, especially if the environmental temperature is warmer or colder than average room temperature.

How do I store dexmedetomidine?

Dexmedetomidine should be stored in its original container, protected from light, and at room temperature. Opened syringes of the gel formulation should be used within four weeks.

What should I do in case of an emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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