Dosing in Special Patient Populations
Geriatric use
Precedex is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in elderly patients, and it may be useful to monitor renal function.1
Hepatic impairment
Since Precedex clearance decreases with severity of hepatic impairment, dose reduction should be considered in patients with impaired hepatic function.1
Renal impairment
Precedex pharmacokinetics (Cmax, Tmax, AUC, t½, CL, and Vss) were not significantly different in patients with severe renal impairment (creatinine clearance <30 mL/min) compared to healthy subjects. However, the pharmacokinetics of the metabolites of Precedex have not been evaluated in patients with impaired renal function. Since the majority of metabolites are excreted in the urine, it is possible that the metabolites may accumulate upon long-term infusions in patients with impaired renal function.1
Pregnancy
There are no adequate and well-controlled studies in pregnant women. Precedex should be used during pregnancy only if the potential benefits justify the potential risk to the fetus.1
Labor and delivery
The safety of Precedex during labor and delivery has not been studied. Therefore, Precedex is not recommended during labor and delivery including cesarean section deliveries.1
Nursing mothers
It is not known whether Precedex is excreted in human milk. Radio-labeled Precedex administered subcutaneously to lactating female rats was excreted in milk. Because many drugs are excreted in human milk, caution should be exercised when Precedex is administered to a nursing woman.1
Pediatric use
There have been no clinical studies to establish the safety and efficacy of Precedex in pediatric patients below 18 years of age. Therefore, Precedex should not be used in this population.1




