Clinically significant episodes of bradycardia, sinus arrest and hypotension have been associated with Precedex infusion and may necessitate medical intervention.
Moderate blood pressure and heart rate reductions should be anticipated when initiating sedation with Precedex.
Overall, the most common treatment-emergent adverse reactions occurring in >2% of patients in both ICU and procedural sedation studies include1:
- Dry mouth
Transient hypertension has been observed primarily during loading infusion; treatment has generally not been necessary, though reducing the loading dose or administration rate may be necessary.1
Some patients receiving Precedex have been observed to be arousable and alert when stimulated. This alone should not be considered as evidence of lack of efficacy in the absence of other clinical signs and symptoms.1
Coadministration of Precedex with anesthetics, sedatives, hypnotics and opioids is likely to lead to an enhancement of effects. Specific studies have confirmed these effects with sevoflurane, isoflurane, propofol, alfentanil and midazolam. Therefore, a decrease in the dosage of Precedex or the concomitant agent may be required in patients already sedated with other anesthetics, sedatives, hypnotics or opioid analgesics. Also, in patients already sedated with other agents, a loading dose may not be necessary.1
Use of dexmedetomidine beyond 24 hours has been associated with tolerance, tachyphylaxis and a dose-related increase in adverse reactions.1