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| Category | POM-V |
| Temperature | Ambient |
| MA/VM/EU No: | 16849/4009 |
| Species |
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| VMD Link | https://www.vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_178042.PDF |
| NOAH Link | |
| Dosage | ous and subcutaneous routes in the dog, and by the intramuscular or subcutaneous route in the cat. Dosage The following dose ranges are recommended: Dog: Dose µg/kg Effect Volume ml/10 kg 10-30 Slight sedation 0.1-0.3 30-80 Moderate to deep sedation and analgesia 0.3-0.8 10-20 Pre-anaesthesia 0.1-0.2 Cat: Dose µg/kg Effect Volume ml/5 kg 50-100 Moderate sedation 0.25-0.5 100-150 Deep sedation 0.5-0.75 Maximal effect is obtained within 10-15 minutes. The clinically useful effect is dose-dependent, lasting 30-180 minutes, but may be repeated if necessary. Animals should be fasted for 12 hours prior to anaesthesia. An appropriately graduated syringe must be used to allow accurate administration of the required dose volume. This is particularly important when injecting small volumes. Premedication dosing guide: Medetomidine has marked anaesthetic-sparing effects. It is essential to reduce appropriately the dose of anaesthetic induction and maintenance agents in animals that have been given the product. Dosing guide Medetomidine as a premedicant before thiopentone in dogs Anaesthesia is maintained with halothane, with or without nitrous oxide. Medetomidine is administered at least 20 minutes before thiopentone (inducing agent) to allow sedation to develop. Guideline doses of thiopentone are as follows: Medetomidine Thiopentone Dose µg/kg Volume of product ml/10 kg Dose of thiopentone mg/kg 10 20 40 0.1 0.2 0.4 6.9 4.5 2.4 The dose of thiopentone may vary considerably in different animals. The optimum dose of medetomidine is in the range 20-40 μg/kg and is dependent on the temperament of the dog. At higher doses of medetomidine, thiopentone may not be required for intubation. Thiopentone is administered slowly as a dilute solution, intravenously to effect, over a period of 30-45 seconds. Once jaw relaxation is adequate, tracheal intubation can be undertaken. Onset of unconsciousness may be delayed for up to 1 minute following injection of thiopentone, slow intravenous injection is therefore required as indicated above. After intubation, anaesthesia may be maintained with halothane in oxygen (with or without nitrous oxide) administered to effect. Recovery from anaesthesia may take from 20 to more than 60 minutes. For recoveries in excess of 1 hour it is advisable to administer atipamezole. Medetomidine as a premedicant before propofol in dogs Medetomidine is administered either intravenously at least 10 minutes before intravenous propofol (induction agent) or intramuscularly at least 20 minutes before propofol to allow sedation to develop. Medetomidine may be administered at a dose rate of 10, 20 or 40 micrograms/kg. The following table is a guideline for doses: Medetomidine Propofol (Induction) Dose µg/kg Volume of product ml/10 kg Dose of Propofol mg/kg 10 20 40 0.1 0.2 0.4 1.5 1.1 1.0 Following premedication with medetomidine, doses of propofol of up to 4 mg/kg administered intravenously have been safely used when a greater depth of anaesthesia is required. NB: The induction time is increased following premedication, so propofol should be administered by slow intravenous injection and up to 2.5 minutes should be allowed before a further dose is given. Once jaw relaxation is adequate, tracheal intubation can be undertaken. It is advisable to administer oxygen during anaesthesia. For maintenance of anaesthesia the dose of propofol is markedly reduced by medetomidine premedication. Infusion doses of 0.06-0.35 mg/kg/minute will provide stable anaesthesia for dogs sedated with between 40 and 10 μg/kg medetomidine respectively. For intermittent bolus administration, a dose of 1 mg/kg of propofol at intervals of between 4-12 minutes will provide stable anaesthesia. Recovery from anaesthesia may take from 20->60 minutes. Food should be withheld for 12 hours prior to anaesthesia. Atipamezole administered in the post-operative phase will hasten the recovery from anaesthesia. Medetomidine with butorphanol for canine sedation Medetomidine and butorphanol can be administered together in the same syringe, by intramuscular or intravenous injection. Dose rate: Medetomidine 10-25 μg/kg, depending on the degree of sedation required, plus 0.1 mg/kg butorphanol. Allow 20 minutes for sedation to develop before commencing the procedure. Reversal with an equal volume of atipamezole to that of the product used results in sternal recumbency approximately 5 minutes later and standing approximately a further 2 minutes later. Medetomidine with butorphanol followed by thiopentone anaesthesia for canine sedation Dose rate: Medetomidine 10 μg/kg and butorphanol 0.1 mg/kg. Medetomidine and butorphanol can be administered together in the same syringe, by intramuscular or intravenous injection. Allow 20 minutes for sedation to develop before administering thiopentone. Atipamezole administered in the post-operative phase will hasten recovery from anaesthesia. Canine doses (ml) for mild sedation, or premedication prior to thiopentone: Weight (kg) 1 3 5 Sedator 1 mg/ml (dose of medetomidine 10 µg/kg) 0.01 0.03 0.05 Butorphanol 10 mg/ml (dose of butorphanol 0.1 mg/kg) 0.01 0.03 0.05 cont... 10 15 20 25 30 35 40 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.10 0.15 0.20 0.25 0.30 0.35 0.40 Canine doses (ml) for deep sedation: Weight (kg) 1 3 5 Sedator 1 mg/ml (dose of medetomidine 25 µg/kg) 0.03 0.08 0.13 Butorphanol 10 mg/ml (dose of butorphanol 0.1 mg/kg) 0.01 0.03 0.05 cont... 10 15 20 25 30 35 40 0.25 0.38 0.50 0.63 0.75 0.88 1.00 0.10 0.15 0.20 0.25 0.30 0.35 0.40 Medetomidine with butorphanol for feline sedation Medetomidine and butorphanol can be administered together in the same syringe, by intramuscular or subcutaneous injection. Dose rate: Medetomidine 50 μg/kg, depending on the degree of sedation required, plus 0.40 mg/kg butorphanol. Allow 20 minutes for sedation to develop before commencing the procedure. Local anaesthetic infiltration should be used for wound suturing. Reversal with half volume of atipamezole 5 mg/ml to that of product used, results in sternal recumbency approximately 4 minutes later and standing approximately a further 2 minutes later. Feline doses (ml) for medetomidine/butorphanol sedation: Weight (kg) 1 1.5 2 Sedator 1 mg/ml (dose of medetomidine 50 µg/kg) 0.05 0.08 0.10 Butorphanol 10 mg/ml (dose of butorphanol 0.4 mg/kg) 0.04 0.06 0.08 cont... 2.5 3 3.5 4 4.5 5 0.13 0.15 0.18 0.20 0.23 0.25 0.10 0.12 0.14 0.16 0.18 0.20 Medetomidine with ketamine in cats The agents may be given concomitantly, in the same syringe, by the intramuscular route. To minimise the risk of cross-contamination between vials, insert separate needles into each vial for withdrawal. A dose of 80 μg/kg is recommended for medetomidine, with 2.5-7.5 mg/kg ketamine giving onset of anaesthesia in 3-4 minutes and a duration of 30-50 minutes for surgical procedures. Anaesthesia may be prolonged, if required, with halothane and oxygen, with or without nitrous oxide. Atropine is not normally necessary when using a medetomidine/ketamine combination. Food should be withheld for 12 hours prior to anaesthesia. Medetomidine, butorphanol and ketamine for feline anaesthesia a) Intramuscular Dosage: Medetomidine 80 μg/kg, butorphanol 0.4 mg/kg and ketamine 5 mg/kg can be given in a single syringe. Cats become recumbent in 2-3 minutes following injection. Loss of pedal reflex occurs 3 minutes post injection. Reversal by 200 μg/kg atipamezole results in return of pedal reflex 2 minutes later, sternal recumbency 6 minutes later and standing 31 minutes later. Feline doses (ml) for intramuscular medetomidine/butorphanol/ketamine anaesthesia: Weight (kg) 1 1.5 2 Sedator 1 mg/ml (dose of medetomidine 80 µg/kg) 0.08 0.12 0.16 Butorphanol 10 mg/ml (dose of butorphanol 0.4 mg/kg) 0.04 0.06 0.08 Ketamine 100 mg/ml (dose of ketamine 5 mg/kg) 0.05 0.075 0.10 cont... 2.5 3 3.5 4 4.5 5 0.20 0.24 0.28 0.32 0.36 0.40 0.10 0.12 0.14 0.16 0.18 0.20 0.125 0.15 0.175 0.20 0.225 0.25 b) Intravenous Dosage: Medetomidine 40 μg/kg, butorphanol 0.1 mg/kg and ketamine from 1.25-2.5 mg/kg (depending on depth of anaesthesia required). Reversal by 100 μg/kg of atipamezole results in return of pedal reflex 4 minutes later, sternal recumbency 7 minutes later and standing 18 minutes later. Feline doses (ml) for intravenous medetomidine/butorphanol/ketamine anaesthesia: Weight (kg) 1 1.5 2 Sedator 1 mg/ml (dose of medetomidine 40 µg/kg) 0.04 0.06 0.08 Butorphanol 10 mg/ml (dose of butorphanol 0.1 mg/kg) 0.01 0.02 0.02 EITHER Ketamine 100 mg/ml (dose of ketamine 1.25 mg/kg) 0.01 0.02 0.03 OR Ketamine 100 mg/ml (dose of ketamine 2.5 mg/kg) 0.03 0.04 0.05 cont... 2.5 3 3.5 4 4.5 5 0.10 0.12 0.14 0.16 0.18 0.20 0.03 0.03 0.04 0.04 0.05 0.05 0.03 0.04 0.04 0.05 0.06 0.06 0.06 0.08 0.09 0.10 0.11 0.13 Approximate time scales in intravenous medetomidine/butorphanol/ketamine anaesthesia: Ketamine dose Time to recumbency Time to loss of pedal reflex Time to return of pedal reflex Time to sternal recumbency Time to standing 1.25 mg/kg 32 secs 62 secs 26 mins 54 mins 74 mins 2.5 mg/kg 22 secs 39 secs 28 mins 62 mins 83 mins Medetomidine followed by alphaxalone/alphadolone for general anaesthesia Dosage: Administer medetomidine 80 μg/kg by intramuscular or subcutaneous injection. 15-60 minutes later administer 2.5-5.0 mg/kg alphaxalone/alphadolone intravenously. Anaesthesia may be maintained by further intravenous injections of alphaxalone/alphadolone, or by administration of halothane in oxygen. Feline doses (ml) for medetomidine/alphaxalone/alphadolone anaesthesia: Weight (kg) 1 1.5 Sedator 1 mg/ml (medetomidine) 80 µg/kg 0.08 0.12 Alphaxalone 9 mg/ml /Alphadolone 3 mg/ml minimum dose = 2.5 mg/kg 0.21 0.31 Alphaxalone 9 mg/ml /Alphadolone 3 mg/ml maximum dose = 5 mg/kg 0.42 0.63 cont... 2 2.5 3 3.5 4 4.5 5 0.16 0.20 0.24 0.28 0.32 0.36 0.40 0.42 0.52 0.63 0.73 0.83 0.94 1.04 0.83 1.04 1.25 1.46 1.67 1.88 2.08 Overdose In cases of overdosage, or if the effects of medetomidine become life-threatening, the appropriate dose of atipamezole is recommended provided that reversal of sedation and analgesia is not dangerous to the patient. For example, atipamezole does not reverse the effects of ketamine. If it is imperative to reverse bradycardia but to maintain sedation, atropine may be used. |
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