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Dexmedetomidine

PrescriptionCDSCO approved

Alpha-2 adrenergic agonist (sedative/analgesic)

Last reviewed 19 Apr 2026 · PetCare.AI Editorial Team

Species

Dog, Cat

Brands

4 available

Interactions

10 documented

Formulations

Mechanism of action

Highly selective alpha-2 adrenoceptor agonist; produces dose-dependent sedation, analgesia, and anxiolysis by inhibiting noradrenaline release in the CNS (locus coeruleus)

At a glance

Class

Alpha-2 adrenergic agonist (sedative/analgesic)

Schedule

Prescription

Storage

Store below 25°C. Atipamezole (reversal agent) must always be available when using dexmedetomidine.

CDSCO (India)

Vet-approved — 2007-01

Dosing

🐕

Dog

Sedation/restraint (IM)

Dose

5–20 mcg/kg

Route

IM, IV

Frequency

Single dose

Max dose

500 mcg

Duration: 20-40 min sedation; reversible with atipamezole

Pre-anaesthetic (with opioid)

Dose

2–10 mcg/kg

Route

IM, IV

Frequency

Single dose

Max dose

250 mcg

Duration: Give 10-15 min before induction

Noise phobia (oromucosal gel — Sileo)

Dose

125 mcg/m2 BSA

Route

Oromucosal

Frequency

As needed (max BID)

Max dose

125 mcg/m2/dose; 250 mcg/m2/day

Duration: As needed for noise events

🐈

Cat

Sedation/restraint

Dose

10–40 mcg/kg

Route

Frequency

Single dose

Max dose

250 mcg

Duration: 30-45 min sedation; reverse with atipamezole

Pre-anaesthetic

Dose

5–20 mcg/kg

Route

Frequency

Single dose

Max dose

125 mcg

Duration: Give 10-15 min before induction

Educational reference only

This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →

Formulations

💉

Injectable — 2

Strength

0.1mg/mL (100mcg/mL)

Available in India

Strength

0.5mg/mL (500mcg/mL)

Available in India

💊

Oromucosal gel — 1

Strength

0.1mg/mL

Storage

Store below 25°C. Atipamezole (reversal agent) must always be available when using dexmedetomidine.

Safety

Absolute contraindications — do not use

Severe cardiac disease (AV block, bradyarrhythmias)
Causes profound bradycardia and increased afterload — dangerous in cardiac patients
Severe hepatic or renal disease
Altered metabolism and excretion

Use with caution

Paediatric patients (<12 weeks)
Limited safety data in very young animals
Diabetic patients
Alpha-2 agonists inhibit insulin release — transient hyperglycaemia

Adverse effects

Common

Profound bradycardia

Initial hypertension (then hypotension)

Vomiting (especially cats)

Hypothermia

Pale mucous membranes

Serious

AV block (1st/2nd degree)

Cardiac arrest (severe overdose or pre-existing disease)

Profound respiratory depression

Monitoring parameters

Heart rateBlood pressureECGSpO2TemperatureSedation score

Educational reference only

Interactions

Major — 1

Clonidine

major

Both are alpha-2 adrenergic agonists: additive bradycardia, hypotension, and sedation. Profound cardiovascular depression possible.

Management: Do not combine. Allow clonidine to be discontinued before dexmedetomidine sedation.

Moderate — 8

Atropine

moderate

Atropine counters dexmedetomidine-induced bradycardia but may cause hypertension due to increased cardiac output against alpha-2 vasoconstriction

Management: Avoid routine atropine premedication with dexmedetomidine. Use only for clinically significant bradycardia.

Atipamezole

moderate

Atipamezole reverses all dexmedetomidine effects including analgesia. If ketamine was co-administered, removing alpha-2 sedation may unmask ketamine excitation.

Management: Give IM (not IV) for smooth reversal. Provide alternative analgesia after reversal. Monitor for resedation if dexmedetomidine dose was high.

Morphine Sulfate

moderate

Synergistic sedation and analgesia. Dexmedetomidine reduces opioid MAC-sparing by additional 40-60%. Additive bradycardia.

Management: Intended combination — reduce opioid dose by 30-50%. Monitor heart rate. Profound bradycardia may require glycopyrrolate.

Butorphanol

moderate

Standard sedation combination. Synergistic sedation and analgesia. Additive cardiovascular depression (bradycardia from alpha-2; mild cardiac depression from butorphanol).

Management: Common clinical combination at reduced doses of each. Monitor heart rate. Fully reversible (atipamezole + naloxone).

Isoflurane

moderate

Dexmedetomidine premedication reduces isoflurane MAC by 50-90%. Profound MAC reduction means very low vaporizer settings needed.

Management: Reduce isoflurane significantly when dexmedetomidine is on board. Monitor depth closely — over-anesthesia and hypotension risk.

Maropitant

moderate

Maropitant inhibits CYP2D6 and CYP3A4, potentially increasing dexmedetomidine plasma levels modestly.

Management: Usually clinically insignificant. May contribute to slightly prolonged sedation.

Sevoflurane

moderate

Dexmedetomidine premedication reduces sevoflurane MAC by 50-90%.

Management: Significantly reduce sevoflurane. Monitor depth closely to prevent over-anesthesia.

Glycopyrrolate

moderate

Glycopyrrolate prevents or treats alpha-2 agonist-induced bradycardia. However, concurrent use may cause initial hypertension (alpha-2 vasoconstriction + tachycardia from anticholinergic).

Management: Use glycopyrrolate judiciously with alpha-2 agonists — treat symptomatic bradycardia rather than routine prophylaxis. Monitor blood pressure.

Minor — 1

Ketamine

minor

Synergistic sedation/anaesthesia; intended combination for balanced anaesthesia

Management: Reduce ketamine dose by 50% when combined with dexmedetomidine. Monitor cardiovascular function.

Educational reference only

Brands

International

Dexdomitor

Zoetis

Sileo

Zoetis

India

Dexmid

Intas

Dextomid

Neon Labs

FAQs

Frequently asked questions

›What is Dexmedetomidine?

Dexmedetomidine is a alpha-2 adrenergic agonist (sedative/analgesic) used in pets. Highly selective alpha-2 adrenoceptor agonist; produces dose-dependent sedation, analgesia, and anxiolysis by inhibiting noradrenaline release in the CNS (locus coeruleus)

›What is Dexmedetomidine used for in pets?

Dexmedetomidine is used in veterinary medicine for: Sedation/restraint (IM); Pre-anaesthetic (with opioid); Noise phobia (oromucosal gel — Sileo); Sedation/restraint; Pre-anaesthetic.

›What is the Dexmedetomidine dose for dogs?

For dogs, Dexmedetomidine is typically dosed as follows — Sedation/restraint (IM): 5–20 mcg/kg IM/IV Single dose; Pre-anaesthetic (with opioid): 2–10 mcg/kg IM/IV Single dose; Noise phobia (oromucosal gel — Sileo): 125 mcg/m2 BSA Oromucosal As needed (max BID). Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.

›What is the Dexmedetomidine dose for cats?

For cats, Dexmedetomidine is typically dosed as follows — Sedation/restraint: 10–40 mcg/kg IM Single dose; Pre-anaesthetic: 5–20 mcg/kg IM Single dose. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.

›What are the side effects of Dexmedetomidine?

Common: Profound bradycardia, Initial hypertension (then hypotension), Vomiting (especially cats), Hypothermia, Pale mucous membranes. Serious (call your vet immediately): AV block (1st/2nd degree), Cardiac arrest (severe overdose or pre-existing disease), Profound respiratory depression.

›Does Dexmedetomidine need a prescription?

Yes. Dexmedetomidine is a prescription medication and should only be administered under veterinary supervision.

›When should Dexmedetomidine not be used?

Do not use Dexmedetomidine if: Severe cardiac disease (AV block, bradyarrhythmias); Severe hepatic or renal disease.

Educational reference only