What is Dexelex?
Dexelex is a sedative that is used to sedate a patient who is under intensive medical care and needs a mechanical ventilator (breathing machine).
Before a ventilator is used, a breathing tube must be inserted through the mouth and into the patient's airway, a procedure called intubation. The tube is then attached to the ventilator, which pumps air slowly into the lungs to control the patient's breathing. Sedation with Dexelex can help keep the patient relaxed and comfortable while the ventilator and tube are in place.
Dexelex is also used during anesthesia to get a patient ready for a surgery or other medical procedure.
Dexelex may also be used for purposes not listed in this medication guide.
Dexelex indications
Treat the symptoms of eczema & (allergic) skin irritations. Relieves itch & treats damaged, red & dry skin. Supports the skin's natural healing process & neutralises harmful bacteria. Refreshes & conditions the skin. Cream Treat small areas of skin affected by eczema or skin irritation. Foam For large areas of irritated skin.
Uses of Dexelex in details
Use: Labeled Indications
Intensive care unit sedation: Sedation of initially-intubated and mechanically-ventilated patients during treatment in an intensive care setting
Procedural sedation: Procedural sedation prior to and/or during awake fiberoptic intubation; sedation prior to and/or during surgical or other procedures of nonintubated patients
Off Label Uses
Sedation during awake craniotomy
Data from controlled studies indicate that Dexelex can be used successfully to provide sedation during awake craniotomy and may help reduce length of stay as well as the need for other perioperative pharmacological interventions. Additional trials may be necessary to further define the role of Dexelex in this condition.
Dexelex description
An agonist of receptors, adrenergic alpha-2 that is used in veterinary medicine for its analgesic and sedative properties. It is the racemate of Dexelex. [PubChem]
Dexelex dosage
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution,
Intravenous:
Generic: 400 mcg/4 mL (4 mL); 1000 mcg/10 mL (10 mL)
Solution,
Intravenous [preservative free]:
Precedex: 400 mcg/100 mL (100 mL); 200 mcg/2 mL (2 mL) [additive free, latex free]
Precedex: 200 mcg/50 mL (50 mL) [latex free]
Precedex: 80 mcg/20 mL (20 mL)
Generic: 80 mcg/20 mL (20 mL); 200 mcg/50 mL (50 mL); 400 mcg/100 mL (100 mL); 200 mcg/2 mL (2 mL); Dexelex 200 mcg/50 mL in Dextrose 5% (50 mL); Dexelex 400 mcg/100 mL in Dextrose 5% (100 mL)
Dosing: Adult
Note: Errors have occurred due to misinterpretation of dosing information. Maintenance dose expressed as mcg/kg/hour. Individualized and titrated to desired clinical effect. At recommended doses, Dexelex does not provide adequate and reliable amnesia (when necessary); therefore, use of additional agents with amnestic properties (eg, benzodiazepines) may be necessary (Ebert 2000).
ICU sedation: IV: Initial: Loading infusion (optional; see "Note" below) of 1 mcg/kg over 10 minutes, followed by a maintenance infusion (see "Note" below) of 0.2 to 0.7 mcg/kg/hour; adjust rate to desired level of sedation; titration no more frequently than every 30 minutes may reduce the incidence of hypotension (Gerlach 2009)
Note: Loading infusion: The loading dose may be omitted for this indication if patient is either being converted from another sedative and patient is adequately sedated or there are concerns for hemodynamic compromise. Maintenance infusion: Dosing ranges between 0.2 to 1.5 mcg/kg/hour have been reported during randomized controlled clinical trials (Pandharipande 2007; Riker 2009). Although infusion rates as high as 2.5 mcg/kg/hour have been used, it is thought that doses >1.5 mcg/kg/hour do not add to clinical efficacy (Venn 2003). Manufacturer recommends duration of infusion should not exceed 24 hours; however, randomized clinical trials have demonstrated efficacy and safety comparable to lorazepam and midazolam with longer-term infusions of up to ~5 days (Pandharipande 2007; Riker 2009).
Procedural sedation: IV: Initial: Loading infusion of 1 mcg/kg (or 0.5 mcg/kg for less invasive procedures [eg, ophthalmic]) over 10 minutes, followed by a maintenance infusion of 0.6 mcg/kg/hour, titrate to desired effect; usual range: 0.2 to 1 mcg/kg/hour
Fiberoptic intubation (awake): IV: Initial: Loading infusion of 1 mcg/kg over 10 minutes, followed by a maintenance infusion of 0.7 mcg/kg/hour until endotracheal tube is secured (Bergese 2010).
Craniotomy (awake) (off-label use): IV: Initial: Loading infusion of 0.5 to 1 mcg/kg over 10 to 20 minutes, followed by a maintenance infusion of 0.5 mcg/kg/hour, titrate to desired effect (Bekker 2001; Bekker, 2008; Piccioni 2008; Shen 2013); usual range: 0.1 to 0.7 mcg/kg/hour (Piccioni 2008)
Dosing: Geriatric
ICU sedation: IV: Refer to adult dosing. Consider dosage reduction. No specific guidelines available. Dose selections should be cautious, at the low end of dosage range; titration should be slower, allowing adequate time to evaluate response.
Procedural sedation: IV: Refer to adult dosing: Initial: Loading infusion of 0.5 mcg/kg over 10 minutes; Maintenance infusion: Dosage reduction should be considered.
Dosing: Pediatric
Note: Errors have occurred due to misinterpretation of dosing information. Maintenance dose expressed as mcg/kg/hour. Individualize and titrate to desired clinical effect. At recommended doses, Dexelex does not provide adequate and reliable amnesia (when necessary); therefore, use of additional agents with amnestic properties (eg, benzodiazepines) may be necessary (Ebert 2000).
ICU sedation: Infants, Children, and Adolescents: Limited data available:
Loading dose (Optional): IV: 0.5 to 1 mcg/kg/dose over 10 minutes (Chrysostomou 2009; Walker 2006); use of loading dose is dependent upon concomitant sedation agents and patient
Dexelex interactions
See also:
What other drugs will affect Dexelex?
Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When amifostine is used at chemotherapy doses, blood pressure lowering medications should be withheld for 24 hours prior to amifostine administration. If blood pressure lowering therapy cannot be withheld, amifostine should not be administered. Consider therapy modification
Amisulpride (Oral): May enhance the hypotensive effect of Hypotension-Associated Agents. Monitor therapy
Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Monitor therapy
Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Beta-Blockers: Alpha2-Agonists may enhance the AV-blocking effect of Beta-Blockers. Sinus node dysfunction may also be enhanced. Beta-Blockers may enhance the rebound hypertensive effect of Alpha2-Agonists. This effect can occur when the Alpha2-Agonist is abruptly withdrawn. Management: Closely monitor heart rate during treatment with a beta blocker and clonidine. Withdraw beta blockers several days before clonidine withdrawal when possible, and monitor blood pressure closely. Recommendations for other alpha2-agonists are unavailable. Exceptions: Levobunolol; Metipranolol. Consider therapy modification
Blood Pressure Lowering Agents: May enhance the hypotensive effect of Hypotension-Associated Agents. Monitor therapy
Bradycardia-Causing Agents: May enhance the bradycardic effect of other Bradycardia-Causing Agents. Monitor therapy
Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Avoid combination
Ceritinib: Bradycardia-Causing Agents may enhance the bradycardic effect of Ceritinib. Management: If this combination cannot be avoided, monitor patients for evidence of symptomatic bradycardia, and closely monitor blood pressure and heart rate during therapy. Exceptions are discussed in separate monographs. Consider therapy modification
Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Monitor therapy
Fexinidazole [INT]: Bradycardia-Causing Agents may enhance the arrhythmogenic effect of Fexinidazole [INT]. Avoid combination
Herbs (Hypotensive Properties): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Monitor therapy
Ivabradine: Bradycardia-Causing Agents may enhance the bradycardic effect of Ivabradine. Monitor therapy
Lacosamide: Bradycardia-Causing Agents may enhance the AV-blocking effect of Lacosamide. Monitor therapy
Levodopa-Containing Products: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Containing Products. Monitor therapy
Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Midodrine: May enhance the bradycardic effect of Bradycardia-Causing Agents. Monitor therapy
Mirtazapine: May diminish the antihypertensive effect of Alpha2-Agonists. Management: Consider avoiding concurrent use. If the combination cannot be avoided, monitor for decreased effects of alpha2-agonists if mirtazapine is initiated/dose increased, or increased effects if mirtazapine is discontinued/dose decreased. Consider therapy modification
Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Monitor therapy
Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Consider therapy modification
Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Monitor therapy
Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Monitor therapy
Ruxolitinib: May enhance the bradycardic effect of Bradycardia-Causing Agents. Management: Ruxolitinib Canadian product labeling recommends avoiding use with bradycardia-causing agents to the extent possible. Monitor therapy
Serotonin/Norepinephrine Reuptake Inhibitors: May diminish the antihypertensive effect of Alpha2-Agonists. Monitor therapy
Siponimod: Bradycardia-Causing Agents may enhance the bradycardic effect of Siponimod. Management: Avoid coadministration of siponimod with drugs that may cause bradycardia. Consider therapy modification
Solriamfetol: May enhance the hypertensive effect of Hypertension-Associated Agents. Monitor therapy
Terlipressin: May enhance the bradycardic effect of Bradycardia-Causing Agents. Monitor therapy
Tofacitinib: May enhance the bradycardic effect of Bradycardia-Causing Agents. Monitor therapy
Tricyclic Antidepressants: May diminish the antihypertensive effect of Alpha2-Agonists. Management: Consider avoiding this combination. If used, monitor for decreased effects of the alpha2-agonist. Exercise great caution if discontinuing an alpha2-agonist in a patient receiving a TCA. Consider therapy modification
Dexelex side effects
See also:
What are the possible side effects of Dexelex?
Applies to Dexelex: parenteral injection concentrate
Side effects include:
Hypotension, hypertension, nausea, bradycardia, fever, vomiting, hypoxia, tachycardia, anemia.
Dexelex contraindications
See also:
What is the most important information I should know about Dexelex?
There are no contraindications listed in the US manufacturer's labeling.
Canadian labeling: Hypersensitivity to Dexelex or any component of the formulation.
Active ingredient matches for Dexelex:
Dexmedetomidine in India.
Unit description / dosage (Manufacturer) | Price, USD |
100 mcg x 2 mL x 1's | |
DEXELEX 100MG INJECTION 1 vial / 2 ML injection each (Ranbaxy Laboratories Ltd) | $ 7.23 |
DEXELEX inj 100 mcg x 2 mL x 2ml (Ranbaxy) | |
Dexelex 100mg Injection (Sun Pharmaceutical Industries Ltd) | $ 3.61 |
List of Dexelex substitutes (brand and generic names): | |
Dexdor 400mcg/4ml (Switzerland) | |
DEXEM (India) | |
100 mcg x 1 mL x 0.5ml (Themis Medicare Ltd.) | $ 2.17 |
100 mcg x 1 mL x 1ml (Themis Medicare Ltd.) | $ 3.61 |
100 mcg x 1 mL x 2ml (Themis Medicare Ltd.) | $ 6.63 |
Dexem 100mcg x 1mL INJ / 0.5ml (Themis Medicare Ltd.) | $ 2.17 |
Dexem 100mcg x 1mL INJ / 1ml (Themis Medicare Ltd.) | $ 3.61 |
Dexem 100mcg x 1mL INJ / 2ml (Themis Medicare Ltd.) | $ 6.63 |
Dexem 100 mcg Injection (Themis Medicare Ltd.) | $ 4.34 |
Dexem 100 mcg 2 ml Injection (Themis Medicare Ltd.) | $ 3.31 |
Dexem 100 mcg 1 ml Injection (Themis Medicare Ltd.) | $ 3.61 |
DEXEM 100MCG INJECTION 1 vial / 2 ML injection each (Themis Medicare Ltd.) | $ 8.31 |
DEXEM 100MCG INJECTION 1 vial / 1 ML injection each (Themis Medicare Ltd.) | $ 4.22 |
DEXEM 50MCG INJECTION 1 vial / 1 ML injection each (Themis Medicare Ltd.) | $ 2.65 |
Dexem cream 60 g x 1's (Themis Medicare Ltd.) | $ 178.00 |
Dexem foam 100 mL x 1's (Themis Medicare Ltd.) | $ 178.00 |
DEXEM inj 100 mcg x 1 mL x 0.5ml (Themis Medicare Ltd.) | $ 2.17 |
DEXEM inj 100 mcg x 1 mL x 1ml (Themis Medicare Ltd.) | $ 3.61 |
DEXEM inj 100 mcg x 1 mL x 2ml (Themis Medicare Ltd.) | $ 6.63 |
Dexem 100mcg x 1mL INJ / 0.5ml (Themis Medicare Ltd.) | $ 2.17 |
Dexem 100mcg x 1mL INJ / 1ml (Themis Medicare Ltd.) | $ 3.61 |
Dexem 100mcg x 1mL INJ / 2ml (Themis Medicare Ltd.) | $ 6.63 |
Dexem cream 60 g x 1's (Themis Medicare Ltd.) | $ 178.00 |
Dexem foam 100 mL x 1's (Themis Medicare Ltd.) | $ 178.00 |
Dexem 100mcg Injection (Themis Medicare Ltd.) | $ 4.22 |
Dexem 50mcg Injection (Themis Medicare Ltd.) | $ 2.65 |
DEXGLAN | |
DEXGLAN 0.1MG INJECTION 1 vial / 2 ML injection each (Gland Pharma Limited) | $ 6.69 |
Dexmedetomidin-ratiopharm (Germany) | |
Dexmedetomidine (Argentina, Australia, Bulgaria, Canada, Czech Republic, Hong Kong, Indonesia, Japan, Malaysia, New Zealand, Oman, Philippines, Poland, Singapore, South Africa, Taiwan, Thailand, Turkey, United States, Venezuela, Vietnam) | |
Precedex 200 mcg/2 ml vial | $ 41.32 |
Dexmedetomidine injection, solution, concentrate 100 ug/mL (Akorn, Inc. (US)) | |
Dexmedetomidine Ever Pharma (Poland, United Kingdom) | |
Dexmedetomidine HCl (United States) | |
Dexmedetomidine HCL Putney (United States) | |
Dexmedetomidine Teva (Netherlands, Poland, Sweden) | |
DEXMEDINE | |
Dexmedine 100mcg Injection (Samarth Life Sciences Pvt Ltd) | $ 4.58 |
Dexmedine 200mcg Injection (Samarth Life Sciences Pvt Ltd) | $ 3.83 |
Dexmetin (Argentina) | |
Dexmetinova Dexmedetomidina (Colombia) | |
Dextroquillan (Italy) | |
Dhacort (Hong Kong, Singapore) | |
Dhacort 1 % x 15 g x 1's (DHA) | |
Dhacort 1 % x 450 g x 1's (DHA) | |
Dhacort 1 % x 15 g (DHA) | |
Dhacort 1 % x 450 g (DHA) | |
See 1747 substitutes for Dexelex |
References
- DailyMed. "CIPROFLOXACIN HYDROCHLORIDE; HYDROCORTISONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "hydrocortisone". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- PubChem. "DEXMEDETOMIDINE". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Dexelex are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Dexelex. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
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Information checked by Dr. Sachin Kumar, MD Pharmacology