dexmedetomidine hydrochloride at a glance
Medicine class
Selective alpha-2 adrenergic receptor agonist and sedative.
Usual setting
Intensive care, operating rooms and monitored diagnostic-procedure areas.
Administration
Diluted intravenous infusion through a controlled infusion device, given by trained healthcare professionals.
Sedation profile
Patients are often readily rousable and may be able to communicate during sedation.
What is dexmedetomidine hydrochloride used for?
The selected UK product is licensed in adults for:
Sedation in intensive care when no deeper than light-to-moderate, verbally rousable sedation is required.
Sedation of non-intubated adults before or during diagnostic or surgical procedures, often called procedural or awake sedation.
How does dexmedetomidine hydrochloride work?
Dexmedetomidine activates alpha-2 receptors and reduces noradrenaline release within the nervous system. This lowers sympathetic activity and produces sedation, some pain-modifying effects and reduced anaesthetic requirements. It can also slow the heart and alter blood pressure.
dexmedetomidine hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 4 micrograms/mL, 100 micrograms/mL
How to take dexmedetomidine hydrochloride
This is not self-administered. A healthcare professional dilutes the concentrate and gives it as a controlled intravenous infusion in a closely monitored clinical setting.
It must not be given as a rapid intravenous bolus.
Heart rate and blood pressure are monitored continuously. Breathing is also monitored, particularly in non-intubated patients.
After procedural sedation, do not drive, operate machinery, drink alcohol or undertake hazardous tasks until the clinical team says the sedative effects have resolved.
dexmedetomidine hydrochloride side effects
Common or expected effects
- Slow heartbeat
- Low or high blood pressure
- Reduced or altered breathing
- Nausea, vomiting or dry mouth
- Low or high blood glucose
- Agitation
- Raised temperature
- Symptoms after stopping treatment
Get urgent medical advice
- Clinically significant slow heartbeat, heart block or cardiac arrest
- Severe low blood pressure or collapse
- Chest pain, reduced blood supply to the heart or heart attack
- Breathing stopping or severe respiratory depression
- Sustained unexplained high temperature
- Excessive urination and thirst suggesting diabetes insipidus
dexmedetomidine hydrochloride in pregnancy
Human pregnancy data are limited, and animal studies identified reproductive toxicity. Dexmedetomidine should generally be avoided during pregnancy unless the woman's clinical condition requires it. The anaesthetic or intensive-care team should assess the individual benefits and risks.
dexmedetomidine hydrochloride while breastfeeding
Dexmedetomidine passes into breast milk, and a risk to the infant cannot be excluded. The clinical team should make an individual decision about breastfeeding and treatment, considering the mother's need for sedation and the benefits of breastfeeding.
dexmedetomidine hydrochloride interactions
Additive sedative and cardiovascular effects are the main practical interaction concern.
Anaesthetics, including isoflurane
Sedative, anaesthetic and cardiorespiratory effects may be enhanced, requiring close clinical titration and monitoring.
Sedatives and hypnotics, including propofol and midazolam
Combined use can deepen sedation and increase cardiorespiratory effects.
Opioids, including alfentanil, fentanyl and morphine
Sedation and breathing or cardiovascular effects may be increased.
Common questions about dexmedetomidine hydrochloride
Answers are fully visible for fast scanning and source review.
Why can someone still wake up while receiving dexmedetomidine hydrochloride?
Its characteristic sedation is often light and sleep-like, allowing patients to be roused by speech or stimulation. This does not necessarily mean it is ineffective.
Does dexmedetomidine hydrochloride provide pain relief?
It has pain-modifying and anaesthetic-sparing effects, but painful procedures may still require local anaesthesia or separate analgesia.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.