Medetomidine is a veterinary anesthetic drug with potent sedative effects and emerging illicit drug adulterant.
It is a racemic mixture of two stereoisomers, levomedetomidine and dexmedetomidine.
Dexmedetomidine is the isomer with the pharmacologic effect as an alpha 2- adrenergic agonist.
Effects can be reversed using atipamezole.
Medetomidine Is often used as the hydrochloride salt, medetomidine hydrochloride, a crystalline white solid that can be administered as an intravenous drug solution with sterile water.
In veterinary anesthesia it is used as both a surgical and analgesic in combinations with opioids as premedication.
It can be given by intramuscular injection (IM), subcutaneous injection (SC) or intravenous injection (IV).
When delivered intravenously, a significantly decreased dose is used.
Some authors suggest a sublingual route is also effective. It is not recommended for diabetics, it is contraindicated in patients with cardiac disease.
Due to its potent sedative effects it is commonly used in more aggressive animals.
Following administration, marked peripheral vasoconstriction and bradycardia are noted.
Often the dosage of induction agents may be drastically reduced, as may the volumes of anesthetic gases used to maintain general anesthesia.
Its effects can be reversed using atipamezole.
Medetomidine has been found as a component in street drug mixtures in the US.
Medetomidine containing synthetic opioids in a similar manner as xylazine-fentanyl, such mixtures have been nicknamed “tranq” (short for tranquilizer).
The combination of α2 adrenergic agonists with opioids are believed to greatly increase the sedative effects of each drug.
Recently identified is a synthetic opioid blend containing fentanyl and medetomidine.
Additionally medetomidine has been found in a mixture containing fentanyl and xylazine.
Medetomidine does not respond to naloxone.
Overdose patients reportedly associated with low heart rates.