Last update Aug. 19, 2021

Dexmedetomidine Hydrochloride

Compatible

Safe substance and/or breastfeeding is the best option.

Dexmedetomidine is a selective alpha2-adrenergic receptor agonist, with anxiolytic, analgesic, and sedative properties.
It is used for the sedation of patients in intensive care (intubation) and in medical or surgical procedures, such as caesarean sections.
Administration by intravenous infusion.

Its pharmacokinetic data (large volume of distribution and high percentage of protein binding) explain the negligible passage to breastmilk observed (Yoshimura 2021 and 2017, Nakanishi 2017).

No problems have been observed in infants of mothers to whom it was administered, nor problems with lactation or breastmilk production in lactogenesis II (Wang 2017).

Its tiny excretion in breast milk and its short elimination half-life means that the mother can breastfeed as soon as she is awake and healthy.

Alternatives

  • Etomidate (Safe substance and/or breastfeeding is the best option.)
  • Midazolam (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Dexmedetomidine Hydrochloride in other languages or writings:

Group

Dexmedetomidine Hydrochloride belongs to this group or family:

Tradenames

Main tradenames from several countries containing Dexmedetomidine Hydrochloride in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 237 daltons
Protein Binding 94 %
VD 1.2 - 2.2 l/Kg
pKa 14.09 -
1.5 - 2 hours
M/P ratio 0.57–0.86 -
Theoretical Dose 0.000013 - 0.000089 mg/Kg/d
Relative Dose 0.034 (0.020–0.062) %

References

  1. Yoshimura M. Dexmedetomidine in breast milk. Anaesthesia. 2021 Feb;76(2):289. Abstract
  2. Dodd SE, Hunter Guevara LR, Datta P, Rewers-Felkins K, Baker T, Hale TW. Dexmedetomidine Levels in Breast Milk: Analysis of Breast Milk Expressed During and After Awake Craniotomy. Breastfeed Med. 2021 Jun 18. Abstract
  3. Wang Y, Fang X, Liu C, Ma X, Song Y, Yan M. Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial. Drug Des Devel Ther. 2020 Mar 11;14:1083-1093. Abstract
  4. Nakanishi R, Yoshimura M, Suno M, Yamamoto K, Ito H, Uchimine Y, Toriumi T, Kurosawa A, Sugawara A, Kunisawa T. Detection of dexmedetomidine in human breast milk using liquid chromatography-tandem mass spectrometry: Application to a study of drug safety in breastfeeding after Cesarean section. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jan 1;1040:208-213. Abstract
  5. Yoshimura M, Kunisawa T, Suno M, Sugawara A, Kurosawa A, Nakanishi R, Aoki K, Toriumi T. Intravenous dexmedetomidine for cesarean delivery and its concentration in colostrum. Int J Obstet Anesth. 2017 Nov;32:28-32. Abstract
  6. AEMPS. Dexmedetomidina. Ficha técnica. 2016 Full text (in our servers)
  7. FDA. Dexmedetomidine. Drug Summary. 2015 Full text (in our servers)

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