1 vial


  • Agitation
Note: Dexmedetomidine is an expensive drug with a limited evidence base to support its use. It should only be administered with ICU Consultant authorisation.
200mcg/2ml vial
Dexmedetomidine must be diluted in 0.9% sodium chloride solution prior to administration.
Preparation of solutions is the same, whether for the loading dose or maintenance infusion.
To prepare the infusion, withdraw 2 ml of dexmedetomidine and add to 48 ml of 0.9% sodium chloride injection to a total of 50 ml. Shake gently to mix well.
Dexmedetomidine has been shown to be compatible when administered with the following intravenous fluids and drugs:
Hartmanns, 5% Dextrose, 0.9% Sodium chloride
Handling Procedures: store at room temperature

Dexmedetomidine HCl should be administered using a controlled infusion device.
Dexmedetomidine dosing should be individualized and titrated to the desired clinical effect. It is generally initiated with:

A loading infusion of 1 mcg/kg over 10-20 minutes (optional)
followed by
A maintenance infusion of 0.2-0.7 mcg/kg/hr.

The rate of the maintenance infusion should be adjusted to achieve the desired level of sedation.
Note: doses of up to 1.4mcg/kg/hr are supported by clinical trial data.

Since dexmedetomidine clearance decreases with severity of hepatic impairment, dose reduction should be considered in patients with impaired hepatic function
There have been no clinical studies to establish the safety and efficacy of dexmedetomidine in paediatric patients below 18 years of age. Therefore, dexmedetomidine is not recommended for use in this population.
Dose as in normal renal function
Dexmedetomidine is a relatively selective alpha2-adrenoceptor agonist with sedative properties.
1. Severe bradycardia

Clinically significant episodes of bradycardia and sinus arrest have been associated with dexmedetomidine administration

Some patients receiving dexmedetomidine have been observed to be arousable and alert when stimulated. This alone should not be considered an evidence of lack of efficacy in the absence of other clinical signs and symptoms.
Caution should be exercised when administering dexmedetomidine to patients with advanced heart block and/or severe ventricular dysfunction. Because dexmedetomidine decreases sympathetic nervous system activity, hypotension and/or bradycardia may be expected to be more pronounced in hypovolemic patients and in those with diabetes mellitus or chronic hypertension and in the elderly.
In situations where other vasodilators or negative chronotropic agents are administered, co-administration of dexmedetomidine could have an additive pharmacodynamic effect and should be administered with caution.
Transient hypertension has been observed primarily during the loading dose in association with the initial peripheral vasoconstrictive effects of dexmedetomidine. Treatment of the transient hypertension has generally not been necessary, although reduction of the loading infusion rate may be desirable.

Laboratory Tests:
No tests in addition to routine ICU tests are indicated

Drug/Laboratory Test Interactions:
None known.
Co-administration of dexmedetomidine with anaesthetics, sedatives, hypnotics, and opioids is likely to lead to an enhancement of effects.
Body as a Whole:
Fever, rigors
Cardiovascular system:
Hypotension, hypertension, bradycardia, tachycardia, atrial fibrillation
Gastrointestinal system:
Respiratory system:
Hypoxia, dry mouth
Metabolic and endocrine system:
Hyperglycaemia, acidosis
Haematological system:
Thank you for your message. Someone will be in touch with you shortly.

Clinical responsibility for the choice, dose, route & frequency of any medication always remains with the prescribing doctor.
Content © 2015 Wellington ICU