Feline Dosing Chart

DEXDOMITOR (dexmedetomidine) - 0.5 mg/mL ®

Preanesthesia and sedation in cats IM ADMINISTRATION

Feline Weight 40 mcg/kg

lb kg mcg/kg mL
2–4 1–2 40 0.1
4.1–7 2.1–3 40 0.2
7.1–9 3.1–4 40 0.3
9.1–13 4.1–6 40 0.4
13.1–15 6.1–7 40 0.5
15.1–18 7.1–8 40 0.6
18.1–22 8.1–10 40 0.7

Body Surface Area dosing may be a

consideration for cats of smaller body weight.

IMPORTANT SAFETY INFORMATION:

Do not use DEXDOMITOR in dogs or cats, and ANTISEDAN in dogs, with cardiovascular disease, respiratory disorders, liver or kidney
diseases, or in conditions of shock, severe debilitation, or stress due to extreme heat, cold or fatigue. DEXDOMITOR should not be
administered in the presence of preexisting hypotension, hypoxia, or bradycardia. As with all α2-adrenoceptor agonists, the potential
for isolated cases of hypersensitivity, including paradoxical response (excitation), exists with DEXDOMITOR. The use of DEXDOMITOR
as a preanesthetic in dogs and cats significantly reduces the amount of induction and maintenance anesthetic requirements. Careful
patient monitoring is necessary to avoid anesthetic overdose. Arrhythmias, bradycardia, apnea, emesis, convulsions, hypersalivation
may occur with DEXDOMITOR use. Severe dyspnea and respiratory crackles due to acute or delayed pulmonary edema could develop
in cats. DEXDOMITOR has not been evaluated for use in breeding, pregnant, or lactating dogs or cats; in dogs younger than 16 weeks
of age or in cats younger than 12 weeks of age; or in geriatric dogs or cats. Occasional vomiting may occur with ANTISEDAN use.
Rarely, a brief state of excitement or apprehensiveness may be seen in ANTISEDAN-treated dogs. Other potential side effects of
α2-antagonists, such as ANTISEDAN, include hypersalivation, diarrhea, and tremors. See accompanying full Prescribing Information.

DEXDOMITOR and ANTISEDAN are trademarks owned by Orion Corporation and Orion Pharma. These products are developed and manufactured by Orion
Corporation Orion Pharma Finland and distributed by Zoetis Inc. ©2014 Zoetis Inc. All rights reserved. April 2014. DEX0114004
Package Insert Table 2: CANINE PREANESTHESIA DOSE TABLE: Intramuscular (IM) dosing
NADA 141-267, Approved by FDA. on the basis of body weight.

DexDOMItOr 0.5 mg/mL

(dexmedetomidine hydrochloride) Preanesthesia in dogs
Sterile Injectable Solution – 0.5 mg/mL Dog Dexmedetomidine Dexmedetomidine
Intramuscular and Intravenous use in Dogs Weight 125 mcg/m2 IM 375 mcg/m2 IM
Intramuscular use in Cats
lbs Kg mcg/kg mL mcg/kg mL
Sedative, Analgesic, Preanesthetic
4.4-7 2-3 9.4 0.04 28.1 0.12
caUtIOn: Federal law restricts this drug to use by or on the order of a licensed
veterinarian. 7.1-9 3.1-4 8.3 0.05 25 0.15
DescrIPtIOn: DEXDOMITOR (dexmedetomidine hydrochloride) is a synthetic 9.1-11 4.1-5 7.7 0.07 23 0.2
alpha2-adrenoreceptor agonist with sedative and analgesic properties. The chemical 11.1-22 5.1-10 6.5 0.1 19.6 0.29
name is (+)-4-[1-(2,3-dimethylphenyl) ethyl]-1H-imidazole monohydrochloride. It is a
white, or almost white, crystalline, water soluble substance having a molecular weight 22.1-29 10.1-13 5.6 0.13 16.8 0.38
of 236.7. The molecular formula is C13 H16 N2 •HCl and the structural formula is: 29.1-33 13.1-15 5.2 0.15 15.7 0.44
33.1-44 15.1-20 4.9 0.17 14.6 0.51
44.1-55 20.1-25 4.5 0.2 13.4 0.6
55.1-66 25.1-30 4.2 0.23 12.6 0.69
66.1-73 30.1-33 4 0.25 12 0.75
73.1-81 33.1-37 3.9 0.27 11.6 0.81
81.1-99 37.1-45 3.7 0.3 11 0.9
Each mL of DEXDOMITOR contains 0.5 mg dexmedetomidine hydrochloride,
1.6 mg methylparaben (NF), 0.2 mg propylparaben (NF), 9.0 mg sodium chloride 99.1-110 45.1-50 3.5 0.33 10.5 0.99
(USP), and water for injection (USP), q.s. 110.1-121 50.1-55 3.4 0.35 10.1 1.06
InDIcatIOns: DEXDOMITOR is indicated for use as a sedative and analgesic in 121.1-132 55.1-60 3.3 0.38 9.8 1.13
dogs and cats to facilitate clinical examinations, clinical procedures, minor surgical 132.1-143 60.1-65 3.2 0.4 9.5 1.19
procedures, and minor dental procedures. DEXDOMITOR is also indicated for
use as a preanesthetic to general anesthesia in dogs and cats. 143.1-154 65.1-70 3.1 0.42 9.3 1.26
DOsage anD aDMInIstratIOn: 154.1-176 70.1-80 3 0.45 9 1.35
Dogs: sedation and analgesia: 500 mcg/m2 intramuscularly (IM) or >176 >80 2.9 0.47 8.7 1.42
375 mcg/m2 intravenously (IV).
Preanesthesia: 125 or 375 mcg/m2 IM. the use of dexmedetomidine as a preanesthetic markedly reduces
The choice of preanesthetic dose depends on the duration and severity of the anesthetic requirements in dogs. Injectable induction drug requirements for
procedure, as well as the anesthetic regime. The following two tables may be intubation will be reduced between 30% and 60%, depending on the choice of
used to determine the correct dexmedetomidine dosage. note that the mcg/kg anesthetic and the dexmedetomidine preanesthetic dose. The concentration
dosage decreases as body weight increases. For example, dogs weighing of inhalation maintenance anesthetic will be reduced between 40% and 60%,
2 kg are dosed at 28.1 mcg/kg dexmedetomidine IV, compared to dogs weighing depending on the dose of dexmedetomidine. The anesthetic dose should always
80 kg that are dosed at 8.7 mcg/kg. Due to the small volume of administration, be titrated against the response of the patient. The choice of anesthetic is left to
accurate dosing is not possible in dogs weighing less than 2 kg (4.4 lb). the discretion of the veterinarian.
Table 1: CANINE SEDATION/ANALGESIA DOSE TABLE: Intravenous (IV) and Cats: sedation, analgesia and Preanesthesia: 40 mcg/kg intramuscularly (IM).
This dose can also be used as a preanesthetic and has been shown to markedly
intramuscular (IM) dosing on the basis of body weight. reduce anesthetic requirements in cats. Injectable anesthetic drug requirements
DexDOMItOr 0.5 mg/mL for intubation were reduced up to 49%, depending on the choice of induction drug.
The concentration of inhalation maintenance anesthetic was reduced between
35% and 44%, depending on the choice of induction drug. The anesthetic dose
sedation/analgesia in dogs should always be titrated against the response of the patient.
Dog Dexmedetomidine Dexmedetomidine The following table may be used to determine the correct dexmedetomidine dosage
Weight 375 mcg/m2 IV 500 mcg/m2 IM for cats based on body weight.
lbs Kg mcg/kg mL mcg/kg mL Table 3: FELINE DOSE TABLE: Intramuscular (IM) dosing on the basis of body
4.4-7 2-3 28.1 0.12 40 0.15 weight in cats.
7.1-9 3.1-4 25 0.15 35 0.2 DexDOMItOr 0.5 mg/mL
9.1-11 4.1-5 23 0.2 30 0.3
sedation/analgesia and preanesthesia in cats
11.1-22 5.1-10 19.6 0.29 25 0.4
Cat Dexmedetomidine
22.1-29 10.1-13 16.8 0.38 23 0.5 Weight 40 mcg/kg IM
29.1-33 13.1-15 15.7 0.44 21 0.6 lbs kg mcg/kg mL
33.1-44 15.1-20 14.6 0.51 20 0.7 2-4 1-2 40 0.1
44.1-55 20.1-25 13.4 0.6 18 0.8 4.1-7 2.1-3 40 0.2
55.1-66 25.1-30 12.6 0.69 17 0.9 7.1-9 3.1-4 40 0.3
66.1-73 30.1-33 12 0.75 16 1 9.1-13 4.1-6 40 0.4
73.1-81 33.1-37 11.6 0.81 15 1.1 13.1-15 6.1-7 40 0.5
81.1-99 37.1-45 11 0.9 14.5 1.2 15.1-18 7.1-8 40 0.6
99.1-110 45.1-50 10.5 0.99 14 1.3 18.1-22 8.1-10 40 0.7
110.1-121 50.1-55 10.1 1.06 13.5 1.4
121.1-132 55.1-60 9.8 1.13 13 1.5 It is recommended that dogs and cats be fasted for 12 hours before treatment
with DEXDOMITOR. An eye lubricant should be applied to cats to prevent
132.1-143 60.1-65 9.5 1.19 12.8 1.6 corneal desiccation that may result from a reduction in the blink reflex. Following
143.1-154 65.1-70 9.3 1.26 12.5 1.7 injection of DEXDOMITOR, the animal should be allowed to rest quietly for 15
minutes; sedation and analgesia occur within 5 to 15 minutes, with peak effects
154.1-176 70.1-80 9 1.35 12.3 1.8 at 30 minutes after dexmedetomidine.
>176 >80 8.7 1.42 12 1.9 cOntraInDIcatIOns: Do not use DEXDOMITOR in dogs or cats with
cardiovascular disease, respiratory disorders, liver or kidney diseases, or in
conditions of shock, severe debilitation, or stress due to extreme heat, cold or
fatigue.
As with all alpha2-adrenoceptor agonists, the potential for isolated cases of
hypersensitivity, including paradoxical response (excitation), exists.
WarnIngs:
Human safety: Not for human use. Keep out of reach of children.
Dexmedetomidine hydrochloride can be absorbed following direct exposure
to skin, eyes, or mouth, and may cause irritation. In case of accidental eye
exposure, flush with water for 15 minutes. In case of accidental skin exposure, Table 4: Adverse reactions during the canine sedation/analgesia field study
wash with soap and water. Remove contaminated clothing. Dexmedetomidine Medetomidine
Appropriate precautions should be taken while handling and using filled syringes. Total n=106 Total n=107
Accidental topical (including ocular) exposure, oral exposure, or exposure by Ausculted unidentified arrhythmias 19 20
injection could cause adverse reactions, including sedation, hypotension, and Severe bradycardia requiring treatment 1 1
bradycardia. Seek medical attention immediately.
Apnea requiring treatment 1 0
Users with cardiovascular disease (for example, hypertension or ischemic heart
disease) should take special precautions to avoid any exposure to this product. Slow onset of sedation (exceeding 30 1 1
minutes)
Caution should be exercised when handling sedated animals. Handling or Ineffectiveness (dog standing 3 2
any other sudden stimuli, including noise, may cause a defense reaction in an throughout the study)
animal that appears to be heavily sedated.
Severe hypothermia requiring treatment 2 0
The material safety data sheet (MSDS) contains more detailed occupational Prolonged recovery 1 4
safety information. To report adverse reactions in users or to obtain a copy of
the MSDS for this product call 1-888-963-8471. The occurrence of ausculted unidentified arrhythmias (some at multiple time
note to physician: This product contains an alpha2-adrenergic agonist. points) decreased following the administration of atipamezole.
animal safety: Dexmedetomidine should not be administered in the presence Canine preanesthesia field study: The preanesthesia field study safety analysis
of preexisting hypotension, hypoxia, or bradycardia. Due to the pronounced included 192 dogs, between 5 months and 15 years of age, representing 43 breeds
cardiovascular effects of dexmedetomidine, only clinically healthy dogs and enrolled for elective procedures conducted under general anesthesia. The following
cats (ASA classes I and II) should be treated. Animals should be frequently table shows the number of dogs within a treatment group that showed each clinical
monitored for cardiovascular function and body temperature during sedation sign (dogs may have experienced more than one adverse reaction).
or anesthesia. Dexmedetomidine sedation is not recommended for cats with Table 5: Adverse reactions during the canine preanesthesia field study
respiratory disease.
Treatment Groups
The use of dexmedetomidine as a preanesthetic in dogs and cats significantly
reduces the amount of induction and maintenance anesthetic requirements. Induction Anesthetic: Propofol Barbiturate
Careful patient monitoring during anesthetic induction and maintenance is Preanesthetic Dose: 0 125 375 0 125 375 mcg/m2
necessary to avoid anesthetic overdose. mcg/m mcg/m mcg/m mcg/m mcg/m2
2 2 2 2
n=32
n=32 n=32 n=32 n=32 n=32
PrecaUtIOns:
Apnea may occur with dexmedetomidine use. In the event of apnea, additional Emesis 4 7 4 2 3 6
oxygen should be supplied. Administration of ANTISEDAN (atipamezole) to
dogs is warranted when apnea is accompanied by bradycardia and cyanotic Ventricular pre- 0 2 0 4 1 0
mucous membranes. mature contractions
Adverse reaction reports for dexmedetomidine in cats include rare events Diarrhea 1 0 0 3 1 1
of severe dyspnea and respiratory crackles diagnosed as acute pulmonary Self trauma 0 2 1 2 1 0
edema. Dyspnea due to the delayed onset of pulmonary edema could develop Severe bradycardia 0 0 1 0 0 1
in rare instances up to three days after dexmedetomidine administration. Tachycardia 0 0 0 1 1 0
Some of these acute and delayed pulmonary edema cases have resulted in Urinary incontinence 0 0 0 0 0 1
death although this was not observed in the feline clinical field studies with Other clinical signs observed in dogs treated with dexmedetomidine include
dexmedetomidine. decreased respiratory rate and hypothermia.
In dogs, intramuscular ANTISEDAN (atipamezole) may be routinely used to Feline sedation/analgesia field study: The field study safety analysis included
rapidly reverse the effects of dexmedetomidine. Since analgesic as well as 242 cats (122 received dexmedetomidine; 120 received xylazine), 6 months to
sedative effects will be reversed, pain management may need to be addressed. 17 years of age, and representing 19 breeds. The following table shows the
In cats, ANTISEDAN (atipamezole) has not been evaluated as a routine number of cats reported with an adverse reaction (cats may have experienced
dexmedetomidine reversal agent. In cats, cases of dyspnea following more than one adverse reaction).
ANTISEDAN (atipamezole) administration have been reported. Table 6: Adverse reactions during the feline field study
Dexmedetomidine has not been evaluated in the presence of other
preanesthetics in cats. Although not observed in the feline field studies, death Dexmedetomidine Xylazine
has been reported in cats receiving dexmedetomidine in conjunction with n = 122 n = 120
ketamine and butorphanol. Vomiting 70 82
Analgesia resulting from preanesthetic dexmedetomidine may not provide Urinary incontinence 6 11
adequate pain control during the postoperative or postprocedural period. Hypersalivation 4 5
Additional pain management should be addressed as needed. Involuntary defecation 4 1
Following administration of dexmedetomidine, a decrease in body temperature Hypothermia 2 1
is likely to occur unless externally maintained. Once established, hypothermia Diarrhea 2 0
may persist longer than sedation and analgesia. To prevent hypothermia, Arrhythmia 1 2
treated animals should be kept warm and at a constant temperature during the Corneal ulcer 1 0
procedure, and until full recovery. Cyanosis 1 0
Nervous or excited animals with high levels of endogenous catecholamines may Dyspnea 1 0
exhibit a reduced pharmacological response to alpha2-adrenoceptor agonists like
dexmedetomidine (ineffectiveness). In agitated animals, the onset of sedative/ The most frequently observed adverse reaction was vomiting in both fasted and fed
analgesic effects could be slowed, or the depth and duration of effects could be cats. Other infrequent clinical signs observed in cats treated with dexmedetomidine
diminished or nonexistent. Therefore, allow dogs and cats to rest quietly for 10 included fatigue, anorexia, cystitis, and peripheral vascular disorder.
to 15 minutes after injection. Repeat dosing has not been evaluated. One incidence of dyspnea was reported, 43 minutes after dexmedetomidine admin-
Administration of anticholinergic agents in dogs or cats at the same time or istration during an oral examination/dental procedure. Prior to dexmedetomidine, the
after dexmedetomidine could lead to adverse cardiovascular effects (secondary cat was free of clinical signs, but had a history of asthma and respiratory infection.
tachycardia, prolonged hypertension, and cardiac arrhythmias1, 2, 3). However, The cat responded successfully to treatment.
an anticholinergic drug may be administered to dogs at least 10 minutes before Feline preanesthesia field study: The field study safety analysis included 184
dexmedetomidine for the prevention of the dexmedetomidine-induced reduction cats (116 received dexmedetomidine; 68 received saline), 12 weeks to 16 years
in heart rate. Therefore, the routine use of anticholinergics simultaneously with, of age, and representing 11 breeds. The following table shows the number of
or after dexmedetomidine in dogs or cats, is not recommended (see ANIMAL cats reported with an adverse reaction (cats may have experienced more than
SAFETY). one adverse reaction).
Spontaneous muscle contractions (twitching) can be expected in some dogs Table 7. Adverse reactions during the feline preanesthesia field study
sedated with dexmedetomidine.
Induction anesthetic ketamine Propofol
Dexmedetomidine has been evaluated only in fasted dogs; therefore, its
effects on fed dogs (for example, the occurrence of vomiting) have not been Preanesthetic saline Dexmedetomidine saline Dexmedetomidine
characterized. In cats, there is a high frequency of vomition whether fed or n=37 n=64 n=31 n=52
fasted; therefore, fasting is recommended to reduce stomach contents. Emesis 2 20 1 12
Dexmedetomidine has not been evaluated in dogs younger than 16 weeks of Pale mucous 11 9
age, in cats younger than 12 weeks of age, or in geriatric dogs and cats. membranes
Dexmedetomidine has not been evaluated for use in breeding, pregnant, or Decreased body 4
lactating dogs or cats. temperature
Retching 1 1 3
aDVerse reactIOns:
Heart murmur 2
Canine sedation/analgesia field study: In the field study safety analysis, 106 Loose stool 2
dogs received dexmedetomidine and 107 received medetomidine. Dogs ranged
from 16 weeks to 16 years of age, representing 49 breeds. The following table Corneal injury 1
shows the number of dogs displaying each clinical observation (some dogs Apnea 1
experienced more than one adverse reaction). Behavioral change 1
Fluid in endotracheal 1
tube
One case of apnea was reported in a cat that received ketamine as the induction Cardiac arrhythmias were monitored by ECG. Dexmedetomidine-treated dogs
agent. This cat required artificial ventilation from the start of the procedure until were more frequently observed with at least one incidence of arrhythmia compared
30 minutes into recovery when the cat began to breathe on its own. The cat to saline controls. The most commonly observed arrhythmias were bradycardia,
recovered without further problems. 1st and 2nd degree AV block, and sinus arrest. Other less frequently observed
POst aPPrOVaL exPerIence: The following adverse events were obtained arrhythmias included ventricular premature complexes (VPCs), supraventricular
from post-approval adverse drug events reported for DEXDOMITOR sterile premature complexes, 3rd degree AV block, and sinus pause.
injectable solution from 2007-2009. Not all adverse reactions are reported. Some Adverse events included bradycardia, tachycardia, VPCs, vomiting, diarrhea,
adverse reactions occurred when DEXDOMITOR was used alone for sedation; urinary incontinence, and self trauma (see ADVERSE REACTIONS).
most occurred when DEXDOMITOR was used in the presence of anesthetics The results of the preanesthesia field study demonstrate that dexmedetomidine
and/or other preanesthetics. It is not always possible to reliably estimate the provided anesthetic dose-sparing, sedation, and analgesia during procedures
frequency of an adverse event or to establish a causal relationship to the drug, conducted under general anesthesia.
especially when multiple drugs are administered. The following reported adverse Feline sedation/analgesia field study: DEXDOMITOR was evaluated in a
events are listed in decreasing order of frequency: masked, controlled, multiple site field study, using parallel treatment groups.
Dogs: ineffective for sedation, death, bradycardia, cardiac arrest, apnea, convul- Effectiveness was evaluated in 242 client-owned cats, ranging in age between
sions, vomiting, prolonged sedation, elevated temperature, and delayed sedation. 6 months and 17 years, and in size between 2.3 and 9.6 kg (5 and 21 lbs). Cats
Cats: ineffective for sedation, death, cardiac arrest, vomiting, apnea, prolonged admitted to veterinary clinics for various procedures requiring restraint, sedation,
sedation, hypersalivation, hypothermia, bradycardia, cyanotic mucous membranes, and/or analgesia were randomized to treatment group and given dexmedetomidine
sedation too brief, and dyspnea. (122 cats) or xylazine (120 cats) once by IM injection. Procedures performed
InFOrMatIOn FOr OWners: Owners should notify their veterinarian using dexmedetomidine included dental care, radiography, minor superficial
immediately if their cat experiences difficulty breathing due to the rare possibility surgery, otitis treatment, blood or urine sample collection, tattooing, microchip
of delayed onset of pulmonary edema which has been associated with adminis- placement, and grooming.
tration of alpha2-adrenergic agonists in cats. Sedation and analgesia occurred within 5 to 15 minutes and peak effects were
cLInIcaL PHarMacOLOgY: Dexmedetomidine is a potent non-narcotic alpha2- observed 30 minutes after dexmedetomidine. The procedure was easily performed
adrenoceptor agonist which produces sedation and analgesia. These effects are in 91% of cats beginning 30 minutes after dexmedetomidine. Sedative and
dose dependent in depth and duration. Blood pressure is initially increased due analgesic effects waned by three hours after dexmedetomidine.
to peripheral vasoconstriction, subsequently dropping to normal or slightly below Signs of sedation were deeper for cats receiving dexmedetomidine compared to
normal levels. Vasoconstriction may cause mucous membranes to appear pale those receiving xylazine. No clinically relevant differences were observed between
or mildly cyanotic. This initial vasopressor response is accompanied by a dexmedetomidine and xylazine with respect to analgesia or physiological variables.
compensatory marked decrease in heart rate mediated by a vagal baroreceptor. Heart rate, respiratory rate, and rectal temperature decreased. Bradycardia
The peripheral pulse may feel weak and a transient change in the conductivity of was observed within 5 to 15 minutes and heart rates of ≤70 beats/minute were
the cardiac muscle may occur, as evidenced by first and second degree atrioven- seen in 18% of cats. The most commonly observed arrhythmias assessed with
tricular blocks. Other arrhythmias may occur. Dexmedetomidine also decreases the ECG were atrioventricular dissociation and escape rhythms, followed by a few
respiratory rate and decreases body temperature. The magnitude and duration of incidences of premature complexes and one incidence of atrioventricular block.
the decrease in body temperature is dose dependent. Dexmedetomidine causes Oxygen saturation, mucous membrane color, capillary refill time, pulse character,
depression of gastrointestinal motility due to decrease in smooth muscle activity, respiratory depth and pattern, and response of the animal to injection were clini-
increases in blood glucose levels due to inhibition of insulin release, and increases cally satisfactory. All cats recovered from changes induced by dexmedetomidine.
in production of urine. Spontaneous muscle contractions (twitching) can be expected Ninety-seven adverse events were reported after dexmedetomidine. The most
in some dogs sedated with dexmedetomidine. Vomiting in cats has been associated frequently reported adverse reactions included vomiting (70), urinary incontinence
with alpha2-adrenergic agonist central stimulation of the brain4. (6), hypersalivation (4), involuntary defecation (4), hypothermia (2), and diarrhea
eFFectIVeness: (2) (see ADVERSE REACTIONS).
Canine sedation/analgesia field study: Dexmedetomidine was evaluated The results of this field study demonstrate that dexmedetomidine produces satis-
in a masked, controlled, multi-site field study, using parallel treatment groups. factory levels of sedation and analgesia for clinical examinations and procedures,
Effectiveness was evaluated in 200 (of 213) healthy client-owned dogs, ranging minor surgical procedures, and minor dental procedures.
in age between 16 weeks and 16 years of age, and in size between 4.8 lbs and Feline preanesthesia field study: The use of dexmedetomidine as a
141 lbs (2.2 kg and 64 kg). Dogs admitted to veterinary clinics for various pro- preanesthetic was evaluated in a masked, controlled, multi-site field study, using
cedures requiring sedation and/or analgesia received either dexmedetomidine parallel treatment groups. Effectiveness was evaluated in 182 healthy, client-
or medetomidine once, by IV or IM injection. Procedures included dental care, owned cats, between 12 weeks and 16 years of age, weighing 2.10 to 18.8
radiography, minor skin tumor removal, and treatment of otitis. lbs (0.9 kg to 8.5 kg). Preanesthetic/induction drug regimens included saline/
Sedation and analgesia occurred within 5 minutes after IV dexmedetomidine, and ketamine, dexmedetomidine/ketamine, saline/propofol, and dexmedetomidine/
within 15 minutes after IM dexmedetomidine, with peak effects approximately at propofol. All cats were intubated prior to the procedure. Inhalant anesthesia
15 or 30 minutes, respectively. Effects waned by approximately two hours after (isoflurane) was added during longer procedures (>15 minutes) and could be added
IV administration, and by three hours using the IM route. Dexmedetomidine and during shorter procedures if the veterinarian deemed it necessary. Procedures
medetomidine showed comparable clinical effects. included ovariohysterectomy, orchiectomy, onychectomy, and dental cleaning.
Cardiac rhythms were evaluated by auscultation. Bradycardia occurred within 5 Dexmedetomidine IM administered at 40 mcg/kg prior to induction with ketamine
to 15 minutes after IV dexmedetomidine or medetomidine, and within 15 to 30 resulted in a significantly higher proportion of cats that were successfully intubated
minutes after either drug given IM. Sixty-four dexmedetomidine-treated dogs and compared to saline (success rates of 89.5% and 10.7%, respectively).
50 medetomidine-treated dogs were observed with bradycardia. Cats preanesthetized with dexmedetomidine IM required 48.9% less propofol for
Adverse reactions during the field study included ausculted unidentified arrhythmias, successful intubation compared to cats that received saline. Inhalant anesthetic
apnea, hypothermia, and ineffectiveness (see ADVERSE REACTIONS). requirements were 35-44% less for dexmedetomidine preanesthetized cats.
Eleven dogs received concomitant medication during the field study, including Recovery times following ketamine and propofol induction averaged 36 and 38
amoxicillin, cephalexin, triamcinolone, methyl-prednisolone acetate, neomycin, minutes to extubation and 161 and 131 minutes to standing, respectively for
nystatin, thiostrepton, acepromazine, atropine, and atipamezole. dexmedetomidine-treated groups.
The results of this field study demonstrate that dexmedetomidine produces satis- Dexmedetomidine (followed by ketamine or propofol) resulted in the following
factory levels of sedation and analgesia for clinical examinations and procedures, ECG abnormalities (in decreasing order of frequency): sinus bradycardia, sinus
minor surgical procedures, and minor dental procedures. arrhythmia, 1st degree atrioventricular (AV) block, long QT interval, sinus pauses,
ventricular premature depolarizations, 2nd degree AV block, escape beats/rhythms,
Canine preanesthesia field study: The use of dexmedetomidine as a preanesthetic
and supraventricular premature depolarizations. Dexmedetomidine-treated cats
was evaluated in a controlled, multi-site field study, using parallel treatment groups.
had a lower mean heart rate, respiratory rate, and body temperature compared
Effectiveness was evaluated in 192 healthy, client-owned dogs, between 5 months
to saline controls continuing through the recovery period.
and 15 years of age, weighing 4 to 196 lbs (2 kg to 89 kg). Dogs received IM
dexmedetomidine or saline as a preanesthetic to general anesthesia. All dogs Sixty-six adverse events were reported after dexmedetomidine. The most
were induced by an injectable anesthetic; half of the dogs were maintained with frequently reported adverse events were: vomiting (32), pale mucous membranes
an inhalation anesthetic. Procedures included orchiectomy, ovariohysterectomy, (20), decreased body temperature (4), and retching (4). (See ADVERSE
skin surgery, radiography, physical examination, dental procedures, ear cleaning, REACTIONS).
anal sac treatment, and grooming. anIMaL saFetY:
Compared to saline controls, dexmedetomidine IM reduced induction drug require- Canine safety study: In the multiple dose safety study, dexmedetomidine was
ments by 30-36% (at 125 mcg/m2) and by 38-61% (at 375 mcg/m2). Inhalation administered at 0, 1, 3 or 5 times (X) the recommended IV and IM doses on 3
anesthetic requirements were 40-60% less for dexmedetomidine-preanesthetized consecutive days to a total of 36 healthy, young beagles. Two additional groups
dogs. The number of dogs with clinical signs of pain was less for at least 30 were given a 3X dose of dexmedetomidine (IV or IM) followed by three 1X doses
minutes after the procedure in dogs treated with 375 mcg/m2 dexmedetomidine, of the reversal agent, atipamezole (ANTISEDAN), every 30 minutes. This was
compared to saline controls. repeated for a total of 3 days. No deaths occurred during the study.
Recovery times were dose dependent, averaging 15-32 minutes to extubation 1X dose group: At the recommended dose, sedation lasted less than 3 hours. During
and 71-131 minutes to standing recovery (longer times correspond to higher sedation, muscle twitches occurred intermittently, and decreases in temperature,
dexmedetomidine dose). Recovery times also depended on the induction anes- respiratory rate and heart rate were observed in all animals. A slow pupil response
thetic. Recovery times following barbiturate induction were longer (30 minutes to to light was seen transiently about 15 minutes after dosing in one of twelve dogs.
extubation and 118 minutes to standing), compared to dogs induced with propofol Second degree atrioventricular (AV) blocks were observed in one of twelve dogs.
(23 minutes to extubation and 84 minutes to standing).
3X dose group: At 3 times the recommended dose, the duration of sedation was not related to dose; however, more cats were affected by cardiac arrhythmias
between two and eight hours. During sedation, muscle twitches occurred, and on the third day of treatment, compared to the first two days of the study. The
temperature, respiratory rate, and heart rate decreased in all dogs. The pupil- decrease in respiratory rate, but not the duration, was dose dependent. The rectal
lary light reflex was transiently decreased for up to 90 minutes in four of twelve temperature decreased in all dexmedetomidine-treated groups, with the lowest
dogs. Vomiting was seen in two of twelve dogs. One dog experienced first and temperatures in the 5X group at 8 hours on all three days. Two cats vomited
second degree AV blocks; second degree AV block was observed in three of (40 and 120 mcg/kg). Corneal opacity was noted in all dexmedetomidine-dose
twelve dogs. Elevated concentrations of alanine aminotransferase (ALT) were groups, was transient, related to dose and duration of sedation, and was attrib-
observed in one dog, without histological changes to the liver. uted to lack of lubrication with decreased blinking during sedation. Hematology
5X dose group: At 5 times the recommended dose, the duration of sedation was and blood chemistry were unaffected by treatment. Injection site tolerance
between four and eight hours. Muscle twitches, decreases in temperature, respira- was good, with mild inflammatory lesions representative of the IM injection
tory rates, and heart rates were seen in all dogs. No pupil response was noted procedure. Gross and histological examination of all other tissues did not reveal
in six of twelve dogs (IV) for up to 1.5 hours; decreased transient pupillary light any abnormalities related to DEXDOMITOR administration.
reflex was seen for up to 60 minutes in two of twelve dogs (IM). Vomiting was Dexmedetomidine demonstrated dose dependent effects related to its
seen in one of twelve dogs. First and second degree AV blocks were observed pharmacology when administered IM to healthy cats at doses up to five times
in one of twelve dogs. Elevated concentrations of ALT were observed in 3 of 12 the recommended dose.
dogs, without histological changes to the liver. Feline acute tolerance study: IM DEXDOMITOR was administered once at
Dexmedetomidine demonstrated dose dependent effects related to its pharma- 10X (400 mcg/kg) the recommended dose of 40 mcg/kg to 3 female and 3 male
cology when administered IV or IM to healthy dogs at doses up to five times 7 month old cats. No mortality was observed. Sedation was observed within 15
the recommended dose. minutes of dosing and lasted for at least 4 hours with full recovery noted between
Canine safety study with an anticholinergic: In another laboratory safety 8 and 24 hours after dosing. Transient observations of corneal dehydration and
study, one of three doses of an IM anticholinergic drug or saline was administered opacity, miosis, pale skin and gingiva, salivation, and watery ocular discharge
10 minutes before, at the same time, or 15 minutes after 500 mcg/m2 IM were observed in some animals. Vomiting was observed 7 to 11 hours after
dexmedetomidine. The anticholinergic drug was given for the prevention or dosing in all but one animal. Decreases in heart rate accompanied by prolonged
treatment of dexmedetomidine-induced reduction in heart rate. In a cross- PQ and QT intervals were most pronounced 2 to 4 hours after dosing. No
over design, 18 dogs were used in a total of 72 trials, to evaluate the safety of atrioventricular (AV) blocks or escape rhythms were noted. In one cat, incidental
dexmedetomidine used with an anticholinergic drug. and reversible premature junctional complexes were seen at 1 and 2 hours
after dosing which were considered secondary to bradycardia. Slightly lower
Dogs were instrumented for the accumulation of continuous ECG data. The
respiratory rate and reduced rectal temperature were observed 4 to 8 hours
following arrhythmias were recorded during the study (some dogs experienced
after dosing. Observations had returned to normal by 24 hours after dosing.
more than one arrhythmia).
Mild inflammatory lesions observed histologically at the injection site were
Table 8: Arrhythmias recorded during the canine laboratory safety study* representative of the IM injection procedure. No treatment related changes
Type of arrhythmia Number of dogs (of 18) were observed in hematology. Mild elevations in some clinical ALT, AST, and
Second degree AV block 18 CK, were observed 24 hours after dosing, with a trend towards recovery by
Supraventricular tachycardia (SVT) or 16 48 hours. Total protein, albumin and globulin levels were slightly lowered in one
SVPCs cat 48 hours after dosing.
Ventricular escape beats 16 stOrage InFOrMatIOn: Store at controlled room temperature 15-30°C
Ventricular premature contractions 14 (59-86°F). Protect from freezing.
Third degree AV block 6 HOW sUPPLIeD:
DEXDOMITOR 0.5 mg/mL is supplied in 10-mL, multidose vials containing
Idioventricular rhythm 1 0.5 mg of dexmedetomidine hydrochloride per mL.
Paroxysmal VT 1
reFerences:
Ventricular bigeminy; SVPCs; pulse 1 (1) Ko JCH, Fox SMF, Mandsager RE. Effects of preemptive atropine adminis-
alternans
tration on incidence of medetomidine-induced bradycardia in dogs. J Am Vet
Junctional escape beat 1 Med Assoc 2001; 218:52-58.
*Table does not relate arrhythmias to the presence or absence of anticholinergic (2) Alibhai HIK, Clarke KW, Lee YH, et al. Cardiopulmonary effects of combina-
The occurrence of arrhythmias was not related to the presence or absence tions of medetomidine hydrochloride and atropine sulphate in dogs. Vet Rec
of the anticholinergic drug. Arrhythmias were transient (although frequent over 1996; 138:11-13.
time in some dogs), returning toward baseline levels within 55 minutes after (3) Short, CE. Effects of anticholinergic treatment on the cardiac and respiratory
dexmedetomidine. No dogs required treatment related to these arrhythmias, systems in dogs sedated with medetomidine. Vet Rec 1991; 129:310-313.
and none of these arrhythmias persisted or adversely affected the overall (4) Hikasa Y, Akiba T, Iino Y et al. Central alpha-adrenoceptor subtypes involved
clinical status of any dog in the study. in the emetic pathway in cats. Eur J Pharmacol 1992; 229:241-251.
Dexmedetomidine without anticholinergic: Without the anticholinergic drug, U.S. Patent No. 4,910,214
and in addition to arrhythmias, dexmedetomidine produced clinically relevant DEXDOMITOR® is a trademark of Orion Corporation.
sedation accompanied by a statistically significant reduction in heart rate,
respiratory rate, cardiac output, pulmonary arterial temperature, and mixed
venous oxygen tension. A statistically significant increase in arterial blood
pressure, pulmonary capillary wedge pressure, central venous pressure,
and systemic vascular resistance was noted. No dogs experienced hypoten-
sion. Dexmedetomidine tended to increase pulmonary vascular resistance.
Dexmedetomidine alone had no statistically significant effect on mean Mfd by:
Developed and manufactured by:
pulmonary arterial pressure, arterial pH, arterial carbon dioxide tension, and
arterial oxygen tension.
Dexmedetomidine plus anticholinergic: Either of the two higher anticholinergic
doses was effective in the prevention or treatment of the dexmedetomidine- Orion Corporation
induced reduction in heart rate. Anticholinergic (higher doses) given after Espoo, Finland
dexmedetomidine caused marked increases in the occurrence of various
cardiac arrhythmias, especially second degree AV block. When the higher
doses of anticholinergic drug were given at the same time or 15 minutes after Dist by:
dexmedetomidine, large increases in heart rate (p<0.01) and blood pressure
(p<0.05) were seen. Increases were dose related; the highest anticholinergic
dose elicited more frequent arrhythmias and larger increases in heart rate and
blood pressure. Zoetis Inc.
In conclusion, moderate doses of anticholinergic drug given prior to Kalamazoo, MI 49007
dexmedetomidine performed best for the prevention of dexmedetomidine-
induced reduction of heart rate in dogs. The routine use of anticholinergics given
simultaneously with, or after dexmedetomidine, is not recommended. Made in Finland
Feline safety study: In a multiple dose safety study, DEXDOMITOR was August 26, 2013
administered intramuscularly (IM) at 1X, 3X, and 5X (40, 120, and 200 mcg/kg)
the recommended dose of 40 mcg/kg on 3 consecutive days to healthy cats,
6 to 8 months old. A control group received the product vehicle as a placebo
(0X). No mortality was observed. The depth and duration of sedation was dose
dependent, lasting approximately 2 hours in the 1X group, 2 to 4 hours in the
3X group, and greater than 8 hours in the 5X group. The lowest recorded
individual heart rate was 60 beats/minute and occurred in the 5X dose group
(2 cats). Cardiac arrhythmias characterized by isolated junctional escape
complexes with episodes of junctional escape rhythm were observed during
periods of low heart rate or following sinus pauses in all dexmedetomidine
dose groups. In most cases the arrhythmia was no longer observed after 1 to 2
hours. Atrioventricular block was not observed. Incidences of arrhythmias were 122691US-5A&P
NADA #141-033, Approved by FDA Table 2: Atipamezole dosing for reversal of IM dexmedetomidine- or serum concentration is reached in approximately 10 minutes. Onset of
medetomidine-induced sedation/analgesia: arousal is usually apparent within 5 to 10 minutes of injection, depending
on the depth and duration of dexmedetomidine or medetomidine-
induced sedation. Elimination half-life from serum is less than 3 hours.
Dose table for Antisedan (5000 mcg/m2) when Atipamezole undergoes extensive hepatic biotransformation, with excretion
dexmedetomidine or medetomidine is given IM of metabolites primarily in urine.
(atipamezole hydrochloride) For # lbs For # KG dose=mcg/kg volume=mL Dexmedetomidine or medetomidine activation of peripheral and central
Antisedan alpha2-adrenergic receptors induces a pattern of pharmacological responses
Sterile Injectable Solution—5.0 mg/mL that include sedation, reduction of anxiety, analgesia, and bradycardia.
4-7 2-3 400 0.15
Blood pressure is initially increased due to peripheral vasoconstriction and
Dexmedetomidine and Medetomidine Reversing Agent 7-9 3-4 350 0.2 thereafter drops to normal or slightly below normal levels.
A transient, decrease in systolic blood pressure occurs immediately after
For intramuscular use in dogs only 9-11 4-5 300 0.3
administration of atipamezole to dexmedetomidine- or medetomidine-
11-22 5-10 250 0.4 sedated dogs, followed by a transient increase in arterial pressure within
CAUTION: Federal law restricts this drug to use by or on the order of a 10 minutes compared to pre-atipamezole levels. This is the opposite of the
licensed veterinarian. 22-29 10-13 230 0.5 response to alpha2-agonist treatment, and is probably due to atipamezole-
29-33 13-15 210 0.6 induced peripheral vasodilation.
DESCRIPTION: Antisedan (atipamezole hydrochloride) is a synthetic Atipamezole administration rapidly abolishes dexmedetomidine-
a2-adrenergic antagonist. The chemical name is 4-(2-ethyl-2,3-dihydro- 33-44 15-20 200 0.7 or medetomidine-induced bradycardia, usually within 3 minutes.
1H-inden-2-yl)-1H-imidazole hydrochloride. The molecular formula is 44-55 20-25 180 0.8 The magnitude of the effect of atipamezole on heart rate is greater
C14H16N2•HCl and structural formula is: when dexmedetomidine is administered intravenously compared to
55-66 25-30 170 0.9 intramuscularly. Dogs receiving medetomidine or IM dexmedetomidine may
66-73 30-33 160 1.0 not return to pre-sedative heart rates after atipamezole administration and
some dogs briefly show heart rate elevations above baseline. Respiratory
73-81 33-37 150 1.1 rate increases following atipamezole injection.
81-99 37-45 145 1.2
CH2CH3 EFFECTIVENESS: One hundred and nine dogs received atipamezole in the
99-110 45-50 140 1.3 field study (55 dogs received the reversal agent following dexmedetomidine;
110-121 50-55 135 1.4 54 following medetomidine). The mean age was 5.9 years and ranged
between 17 weeks and 16 years. The mean weight was 45.5 lbs (20.7
121-132 55-60 130 1.5 kg), ranging from 4.8 lbs to 117 lbs (2.2 kg to 53.2 kg). Atipamezole was
N
132-143 60-65 128 1.6 administered by the IM route of administration, within a range of 39-57
minutes after administration of either dexmedetomidine (IV and IM) or
HCl 143-154 65-70 125 1.7 medetomidine (IV and IM).
154-176 70-80 123 1.8 Atipamezole reversed the effects of dexmedetomidine and medetomidine
N in all cases. In dexmedetomidine treated dogs, the onset of reversal was
H >176 >80 120 1.9 evident within 5 minutes after administration of atipamezole (57% could
stand). Within 15 minutes, 96% of dexmedetomidine treated dogs were
CONTRAINDICATIONS: Since atipamezole is always used concomitantly standing, 92% responded normally to sound, 86% had a normal muscle
Each mL of Antisedan contains 5.0 mg atipamezole hydrochloride, 1.0 tone of jaw, and >90% had a normal pedal reflex response. Responses in
with dexmedetomidine or medetomidine, it should not be used in dogs
mg methylparaben (NF), 8.5 mg sodium chloride (USP), and water for dogs treated with medetomidine were similar or slightly later.
with the following conditions: cardiac disease, respiratory disorders, liver or
injection (USP). Following atipamezole, heart rate increased between 0 and 5 minutes
kidney diseases, dogs in shock, severely debilitated dogs, or dogs stressed
due to extreme heat, cold or fatigue. Administration of atipamezole is following either alpha2-agonist (IV dexmedetomidine dogs had heart
INDICATIONS: Antisedan is indicated for the reversal of the sedative and rates from 60 to 85 bpm, and IV medetomidine dogs from 51 to 67 bpm;
contraindicated in dogs with a known hypersensitivity to the drug.
analgesic effects of Dexdomitor (dexmedetomidine hydrochloride), and IM dexmedetomidine dogs had heart rates from 45 to 73 bpm, and IM
Domitor (medetomidine hydrochloride) in dogs. medetomidine dogs from 52 to 79 bpm). Bradycardia resolved more
HUMAN WARNINGS: Not for human use. Keep out of reach of children.
Atipamezole hydrochloride can be absorbed and may cause irritation slowly in the IM treatment groups. The body temperature remained at
DOSAGE AND ADMINISTRATION: the same level during the 120 minutes of follow-up after atipamezole
following direct exposure to skin, eyes, or mouth. In case of accidental
Antisedan is administered intramuscularly regardless of the route used administration. Respiratory rates increased toward normal between 0 and
eye exposure, flush with water for 15 minutes. In case of accidental skin
for Dexdomitor or Domitor. The atipamezole dose for the reversal of IV 5 minutes after the administration of atipamezole in all treatment groups.
exposure, wash with soap and water. Remove contaminated clothing. If
Dexdomitor or Domitor is 3750 mcg/m2. The atipamezole dose for the Mucous membranes were described as normal after 5 minutes in 91% of
irritation or other adverse reaction occurs (for example, increased heart
reversal of IM Dexdomitor or Domitor is 5000 mcg/m2. The concentration dexmedetomidine dogs (IV or IM). By 120 minutes, 96% were normal (after
rate, tremor, muscle cramps), seek medical attention. In case of accidental
of Antisedan is formulated so that the volume of injection is the same (mL IV dexmedetomidine) or 100% were normal (after IM dexmedetomidine).
oral exposure or injection, seek medical attention. Caution should be used
for mL) as the recommended dose of Dexdomitor or Domitor. Many physiological responses were slightly slower to return toward normal
while handling and using filled syringes.
The dosage of Antisedan is calculated based on body surface area. Use when dogs were treated with medetomidine IV or IM. No adverse events
Users with cardiovascular disease (for example, hypertension or ischemic
the following tables to determine the correct injection volume or the correct were reported in the atipamezole treated dogs.
heart disease) should take special precautions to avoid any exposure
Antisedan dosage on the basis of kilograms of body weight. Note that the
to this product.
mcg/kg dosage decreases as body weight increases. ANIMAL SAFETY: Atipamezole was tolerated in healthy dogs receiving
The material safety data sheet (MSDS) contains more detailed occupational
safety information. 10X the recommended dose and in dogs receiving repeated doses
Table 1: Atipamezole dosing for reversal of IV dexmedetomidine- or at 1, 3, and 5X the recommended dose, in the absence of an alpha2-
To report adverse reactions in users or to obtain a copy of the MSDS for
medetomidine-induced sedation/analgesia: agonist. Signs were dose-related and included excitement, panting,
this product call 1-800-366-5288.
Note to Physician: This product contains an alpha 2-adrenergic trembling, vomiting, soft or liquid feces and scleral injection. At 10X
antagonist. the recommended dose, increases in creatine kinase, AST, and ALT
Dose table for Antisedan (3750 mcg/m2) when were noted. Creatine kinase also increased in 3 (of 6) dogs in the 3X
dexmedetomidine or medetomidine is given IV treatment group. Localized skeletal muscle injury was seen at the injection
PRECAUTIONS:
For # lbs For # KG dose=mcg/kg volume=mL 1. Handling: Antisedan can produce an abrupt reversal of sedation; site but no associated clinical signs or complications were observed.
Antisedan Dogs receiving the recommended atipamezole dose in the absence of
therefore, dogs that have recently received Antisedan should be handled
4-7 2-3 300 0.1 with caution. The potential for apprehensive or aggressive behavior should medetomidine or dexmedetomidine exhibited no adverse clinical signs.
be considered in the handling of dogs emerging from sedation, especially In additional safety studies, adverse events were absent up to the 3X
7-9 3-4 250 0.15 dose of atipamezole when its administration followed medetomidine or
in dogs predisposed to nervousness or fright. Also, avoid situations
9-11 4-5 230 0.2 where a dog might fall. dexmedetomidine sedation.
2. Sedation relapse: While atipamezole does reverse the clinical signs In a separate safety study using a crossover design, 5 dogs received
11-22 5-10 200 0.3 atipamezole after dexmedetomidine (IV and IM). Dexmedetomidine’s effects
associated with medetomidine or dexmedetomidine sedation, complete
physiologic return to pretreatment status may not be immediate or may be on blood pressure, heart rate, respiratory rate, and cardiac conduction
22-33 10-15 170 0.4
temporary, and dogs should be monitored for sedation relapse. Sedation times were reversed by atipamezole. However, heart rate and cardiac
33-44 15-20 150 0.5 relapse is more likely to occur in dogs that receive an alpha2-agonist by the conduction times did not return to pre-dexmedetomidine values. Heart
IV route, compared to dogs that are sedated using the IM route. Animals rate increases after atipamezole were closer to baseline values in dogs
44-55 20-25 140 0.6
should be monitored closely for persistent hypothermia, bradycardia, and treated with dexmedetomidine IV (compared to IM).
55-66 25-30 130 0.7 depressed respiration, until signs of recovery persist.
3. Analgesia reversal: Atipamezole reverses analgesic effects as well STORAGE INFORMATION: Store protected from light at controlled room
66-81 30-37 120 0.8
as sedative effects. Additional procedures for the control of pain may temperature 15°–30°C (59°–86°F).
81-99 37-45 110 0.9 be required.
4. Debilitated dogs: The safety of atipamezole has not been evaluated in HOW SUPPLIED: Antisedan is supplied in 10-mL, multidose vials
99-110 45-50 105 1.0 containing 5.0 mg of atipamezole hydrochloride per mL.
dogs with compromised health. Geriatric, debilitated, and ill dogs are more
110-132 50-60 100 1.1 likely to experience adverse reactions associated with the administration
of alpha2-antagonists (as well as alpha2-agonists). Dogs with abnormalities Antisedan®, Dexdomitor®, and Domitor® are trademarks of Orion
132-143 60-65 95 1.2 Corporation.
associated with the cardiovascular system are especially at risk.
143-165 65-75 93 1.3 5. Breeding dogs: Antisedan has not been evaluated in breeding dogs;
165-176 75-80 91 1.4 therefore, the drug is not recommended for use in pregnant or lactating
dogs, or in dogs intended for breeding.
>176 >80 90 1.5 6. Minimum age and weight: Antisedan has not been evaluated in
dogs less than four months of age or in dogs weighing less than 4.4
lbs (2 kg).

ADVERSE REACTIONS: Occasional vomiting may occur. At times, a

period of excitement or apprehensiveness may be seen in dogs treated
with atipamezole. Other effects of atipamezole include hypersalivation,
diarrhea, and tremors. Distributed by:
Developed and manufactured by:

CLINICAL PHARMACOLOGY: Atipamezole is a potent alpha2-antagonist Pfizer Animal Health

which selectively and competitively inhibits alpha2-adrenergic receptors. Div. of Pfizer Inc
The result of atipamezole administration in the dog is the rapid recovery NY, NY 10017
from the sedative and analgesic effects produced by the alpha2-adrenergic
agonists dexmedetomidine or medetomidine. Atipamezole does not reverse
the effects of other classes of sedatives, anesthetics, or analgesics.
Atipamezole is rapidly absorbed following intramuscular injection; maximum
107237US-5