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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
3

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
IM
Frequency
Single dose
Max dose
250 mcg
Duration: 30-45 min sedation; reverse with atipamezole
Pre-anaesthetic
Dose
5–20 mcg/kg
Route
IM
Frequency
Single dose
Max dose
125 mcg
Duration: Give 10-15 min before induction

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

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.

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.

References

References

Textbooks & handbooks

  • Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
  • Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
  • Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
  • National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
  • The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

  • Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
  • American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

  • Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
  • Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
  • ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

  • Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

  • Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/
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 →

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