Dexmedetomidine

Dexmedetomidine

Clinical data
Trade names	Precedex, Dexdor, Dexdomitor, Sileo
AHFS/Drugs.com	Monograph
Pregnancy category	US: C (Risk not ruled out)
Routes of administration	Intravenous infusion
ATC code	N05CM18 (WHO)
Legal status
Legal status	US: ℞-only ℞ (Prescription only)
Pharmacokinetic data
Protein binding	94%
Metabolism	Near complete hepatic metabolism to inactive metabolites
Biological half-life	2 hours
Excretion	Urinary
Identifiers
IUPAC name (S)-4-[1-(2,3-Dimethylphenyl)ethyl]-3H-imidazole
CAS Number	113775-47-6 Y
PubChem (CID)	68602
IUPHAR/BPS	521
DrugBank	DB00633 Y
ChemSpider	4470605 Y
UNII	67VB76HONO Y
KEGG	D00514 Y
ChEBI	CHEBI:4466 Y
ChEMBL	CHEMBL778 Y
ECHA InfoCard	100.119.391
Chemical and physical data
Formula	C13H16N2
Molar mass	200.28 g/mol
3D model (Jmol)	Interactive image
SMILES n1cc(nc1)[C@H](c2c(c(ccc2)C)C)C
InChI InChI=1S/C13H16N2/c1-9-5-4-6-12(10(9)2)11(3)13-7-14-8-15-13/h4-8,11H,1-3H3,(H,14,15)/t11-/m0/s1 Y Key:CUHVIMMYOGQXCV-NSHDSACASA-N Y

Dexmedetomidine, sold under the trade names Precedex among others, is an anxiety reducing, sedative, and pain medication. Dexmedetomidine is notable for its ability to provide sedation without risk of respiratory depression (unlike other commonly used sedatives such as propofol, fentanyl, and midazolam) and can provide cooperative or semi-arousable sedation.

Similar to clonidine, it is an agonist of α₂-adrenergic receptors in certain parts of the brain. Dexmedetomidine hydrochloride is also used in veterinary medicine for dogs and cats. The drug was developed by Orion Pharma.

Dexmedetomidine is most often used in the intensive care setting for light to moderate sedation. It is not recommended for long term deep sedation. A unique feature of dexmedetomidine is that it has analgesic properties in addition to its role as a hypnotic, but is opioid sparing, and is therefore not associated with significant respiratory depression (unlike propofol).

Many studies suggest dexmedetomidine for sedation in mechanically ventilated adults may reduce time to extubation and ICU stay. People on dexmedetomidine are rousable and cooperative, and as such are able to actively cooperate with various procedures.

Compared with other sedatives, some studies suggest dexmedetomidine may be associated with less delirium. However, this finding is not consistent across multiple studies. At the very least, when aggregating many study results together, usage of dexmedetomidine appears to be associated with less neurocognitive dysfunction compared to other sedatives. Whether this has beneficial psychological impact is unclear. From an economic perspective, dexmedetomidine is associated with lower ICU costs. These decreased costs are largely due to a shorter time to extubation.

Dexmedetomidine can also be used as sedoanalgesic for procedural sedation, such as during colonoscopy. It can be used as an adjunct with other sedatives like benzodiazepines, opioids, and propofol to enhance sedation and help maintain hemodynamic stability by decreasing the requirement of other sedatives. Dexmedetomidine is also used for procedural sedation in children.