This page shows what was measured, who it was measured in, and what that does not settle.
What Dexmedetomidine does in the body
Dexmedetomidine binds a receptor on those cells that tells them to stop releasing it.
A small cluster of cells in the brainstem keeps you awake by spraying noradrenaline over the rest of the brain. With that wakefulness signal turned down, the brain's own sleep switch is released and the patient drifts into something much closer to real sleep than to anaesthesia — they can be woken by voice, will follow a command, and go back to sleep afterwards. Because none of this touches the brainstem centres that drive breathing, they keep breathing on their own.
Why people take it. Keeping someone calm and drowsy on a ventilator or during a procedure, without stopping them breathing
What happened in people
Days alive without delirium or coma of 10.7 against propofol's 10.8 in ventilated adults with sepsis, with no difference in death or six-month cognition
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
The only sedative in routine intensive care use that does not depress respiration, which makes possible techniques — awake fibreoptic intubation, sedation without a ventilator — that no GABA-A drug supports
Where it acts
Alpha-2A adrenoceptors on locus coeruleus neurons in the pons, and presynaptic alpha-2 receptors on sympathetic nerve terminals
Kind of result
Living longer, or avoiding a major event
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · 1018WH7F9I · read 2026-08-29
Its recorded molecular formula is C13H16N2•HCl, weighing 236.7.
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-30
Where each sentence above came from
A person wrote this explanation into the record, with the studies named in the path below.
The recorded use, written for a reader without medical training. Not signed off.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 136 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Comparator
A comparator is whatever the treatment was measured against.
A picture of it, and where the picture fails
It is like the other runner in a race.
Where that stops being true. A race has one winner. A study can show both arms improved.
What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.
The control condition against which the experimental intervention is assessed.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Absolute difference
An absolute difference is how many more people in a hundred were affected.
A picture of it, and where the picture fails
It is like counting heads in two rooms of a hundred.
Where that stops being true. Heads are easy to count. Study results carry a margin of error too.
What people get wrong. It is confused with a percentage change, which can look far larger.
The arithmetic difference in event rates between arms.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Death from any cause at 90 days
✗ The study did not show it
Who was studied
SPICE III — early sedation with dexmedetomidine in critically ill patients
29.1% (566/1,948) with dexmedetomidine versus 29.1% (569/1,956) with usual care; adjusted risk difference 0.0 percentage points, 95% CI -2.9 to 2.8
Repeated elsewhere
Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Reported and decisive: 64% of the dexmedetomidine group needed supplemental propofol in the first two days, 3% midazolam and 7% both, so the intervention arm was largely dexmedetomidine plus the comparator. Bradycardia, hypotension and overall adverse events were more common on dexmedetomidine.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Sterile solution for continuous intravenous infusion, as a concentrate for dilution and as premixed ready-to-use bags in sodium chloride; a sublingual film formulation is separately approved for agitation
Interval reported. 95% CI -2
Written into the record, not signed off as a reviewed claim.
Adjusted median 10.7 versus 10.8 days; odds ratio 0.96, 95% CI 0.74 to 1.26. Ventilator-free days 23.7 versus 24.0; death at 90 days 38% versus 39%, hazard ratio 1.06 (95% CI 0.74 to 1.52)
Repeated elsewhere
Unreplicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Median exposure was only 3 days at a median sedation score of -2, so the trial tests light sedation over a short period rather than prolonged deep sedation. Six-month cognition also did not differ.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Sterile solution for continuous intravenous infusion, as a concentrate for dilution and as premixed ready-to-use bags in sodium chloride; a sublingual film formulation is separately approved for agitation
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Co-primary: new-onset atrial fibrillation, and delirium, between intensive care admission and postoperative day 5 or discharge
✗ The study did not show it
Who was studied
DECADE — dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (NCT02004613)
How many people
798
Study design
Randomised, placebo-controlled, fully masked trial at six academic hospitals
Compared against
A dummy treatment
Kind of result
A number that stands in for health
What was found
Atrial fibrillation 30% versus 34%, relative risk 0.90 (97.8% CI 0.72 to 1.15, P=0.34); delirium 17% versus 12%, relative risk 1.48 (97.8% CI 0.99 to 2.23)
Repeated elsewhere
Unreplicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Serious adverse events in 21 of 394 (5%) on dexmedetomidine against 8 of 396 (2%) on placebo. The trial was funded by Hospira, which markets the drug, and stopped per protocol at the last designated interim analysis.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Sterile solution for continuous intravenous infusion, as a concentrate for dilution and as premixed ready-to-use bags in sodium chloride; a sublingual film formulation is separately approved for agitation
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Percentage of time within the target Richmond Agitation-Sedation Scale range
✗ The study did not show it
Who was studied
SEDCOM — dexmedetomidine versus midazolam for sedation of critically ill patients
How many people
375
Study design
Prospective double-blind randomised trial at 68 centres in 5 countries
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Primary endpoint not different: 77.3% versus 75.1%, difference 2.2 percentage points (95% CI -3.2 to 7.5), P=0.18. Secondary: delirium 54% versus 76.6%, difference 22.6 points (95% CI 14 to 33), P<0.001; time to extubation 1.9 days shorter, P=0.01
Repeated elsewhere
Partially Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. The result the drug is known for is a secondary endpoint of a trial whose primary endpoint was neutral. Intensive care length of stay did not differ significantly.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Sterile solution for continuous intravenous infusion, as a concentrate for dilution and as premixed ready-to-use bags in sodium chloride; a sublingual film formulation is separately approved for agitation
Interval reported. 95% CI -3
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 4 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Dexmedetomidine
What a person takes: Sterile solution for continuous intravenous infusion, as a concentrate for dilution and as premixed ready-to-use bags in sodium chloride; a sublingual film formulation is separately approved for agitation.
The measurement behind this step
Premixed bags exist because the drug is given as a continuous infusion titrated over hours and dilution errors at the bedside are an avoidable hazard. The rate of administration is pharmacologically meaningful rather than merely practical: the label distinguishes slow from rapid intravenous administration when describing receptor selectivity, and rapid administration produces a transient pressor response from peripheral vasoconstriction. The approved intensive care indication specifies infusion not exceeding 24 hours, which is a labelling limit rather than a statement about what happens on day two.
Getting in
Infused slowly, because speed changes which receptor it hits
Given slowly it acts on one kind of adrenaline receptor. Given fast it hits others too, and can briefly push blood pressure up instead of down.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The label states that alpha-2 selectivity is seen with slow intravenous infusion of low and medium doses, while both alpha-1 and alpha-2 activity appear at high doses or with rapid administration. The transient hypertension of a rapid load is peripheral alpha-2B-mediated vasoconstriction preceding central sympatholysis, which is a dose-rate phenomenon rather than a paradox.
It silences the brainstem cells that keep you awake
A small cluster of cells in the pons sprays noradrenaline over the brain to maintain wakefulness. This drug binds a receptor on those cells that tells them to stop.
╌╌Measured in animals. A result in animals says what to test next. It does not say what happens in people.
The measurement behind this step
Alpha-2A adrenoceptors on locus coeruleus neurons are inhibitory autoreceptors coupled to Gi. Agonist occupancy hyperpolarises the neuron and reduces noradrenaline release. In mice lacking a functional alpha-2A receptor, dexmedetomidine produces no sedative response at all.
The wakefulness cells were holding down the brain's sleep switch. With them quiet, the switch flips, and the same cells that fire during natural deep sleep light up.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Reduced noradrenergic tone disinhibits the ventrolateral preoptic nucleus, whose c-Fos expression rises, matching the pattern of normal non-rapid-eye-movement sleep. Lesioning that nucleus bilaterally attenuates the sedative response, establishing it as a required node rather than a correlate.
That switch shuts down the histamine centre through GABA
The sleep switch works by releasing an inhibitory signal onto the brain's histamine centre, which is the last relay that keeps the cortex alert.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The ventrolateral preoptic nucleus inhibits the tuberomammillary nucleus GABAergically. Gabazine given systemically or directly into the tuberomammillary nucleus shifts the dexmedetomidine dose-response curve to the right, and lesions and gabazine alter c-Fos in the tuberomammillary nucleus but not the locus coeruleus — which fixes the order of events rather than leaving it inferred.
Sedation you can wake someone out of, and breathing that continues
The patient is deeply drowsy but will open their eyes to a voice, follow an instruction, and drift off again. And they keep breathing on their own, because nothing has touched the respiratory centres.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Because the sedation is produced by recruiting an endogenous sleep pathway rather than by generalised cortical depression, arousability is preserved. Respiratory drive is essentially unaffected at sedative concentrations, which is the property that distinguishes this drug from every GABA-A sedative and the reason it can be used in non-intubated patients. Amnesia is correspondingly weaker than with a benzodiazepine.
The heart slows and the pressure falls, for exactly the same reason
The receptor that quietens the brain also quietens the nerves driving the heart and blood vessels. The bradycardia and low blood pressure are not a side effect of a different action; they are the same action elsewhere.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Presynaptic alpha-2 agonism at sympathetic terminals and central sympatholysis reduce heart rate and vascular tone. There is no receptor-level separation to exploit between the wanted and unwanted effects, which is why bradycardia and hypotension were more frequent than usual care in SPICE III and why serious adverse events were 5% against 2% versus placebo in DECADE. Elimination is hepatic, by glucuronidation and CYP-mediated oxidation, and clearance falls in hepatic impairment.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Intubated adults in intensive care, patients having awake fibreoptic intubation or procedural sedation, and increasingly children and adults as an adjunct in the operating theatre.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “Sedation for Non-Invasive Procedures The safety and effectiveness of dexmedetomidine have not been established in pediatric patients less than 1 month of age.”
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-30
On older people, the label states: “Intensive Care Unit Sedation A total of 729 patients in the clinical studies were 65 years of age and over.”
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary Available data from published randomized controlled trials and case reports over several decades of use with intravenously administered dexmedetomidine during pregnancy have not identified a drug-associated risk of major birth defects and miscarriage; however, the reported exposures occurred after the first trimester.”
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary Available published literature reports the presence of dexmedetomidine in human milk following intravenous administration (see Data ) .”
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-30
On people with reduced liver function, the label states: “Since dexmedetomidine clearance decreases with increasing severity of hepatic impairment, dose reduction should be considered in patients with impaired hepatic function [see Dosage and Administration ( 2.2 , 2.3 ), Clinical Pharmacology ( 12.3 )] .”
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-30
Where the result stopped carrying
SPICE III: no mortality difference at 90 days in 4,000 patients, with more adverse events on the drug
MENDS2: no advantage over propofol on delirium-free days, ventilator-free days, 90-day death or six-month cognition
DECADE: no reduction in atrial fibrillation, delirium numerically worse, serious adverse events more than doubled, and an explicit authors' recommendation against the indication
Even SEDCOM missed its own primary endpoint; the delirium result everyone quotes was secondary
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (11)
It was studied for a different goal
The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Given by a clinician
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Sterile solution for continuous intravenous infusion, as a concentrate for dilution and as premixed ready-to-use bags in sodium chloride; a sublingual film formulation is separately approved for agitation
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
RNAWiki has not recorded a supervision or regulatory status for this substance.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
No register row and no identity class settled the question.
No source is stored against this line.
What is in the pack
Premixed bags exist because the drug is given as a continuous infusion titrated over hours and dilution errors at the bedside are an avoidable hazard.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold. The rest of the recorded wording: The rate of administration is pharmacologically meaningful rather than merely practical: the label distinguishes slow from rapid intravenous administration when describing receptor selectivity, and rapid administration produces a transient pressor response from peripheral vasoconstriction. The approved intensive care indication specifies infusion not exceeding 24 hours, which is a labelling limit rather than a statement about what happens on day two.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Bradycardia and hypotension are the dominant adverse effects and are mechanistically inseparable from the sedative action; both were more common than usual care in SPICE III, and serious adverse events were 5% against 2% versus placebo in DECADE. Transient hypertension can occur with rapid administration. The drug does not meaningfully depress respiration, which is its distinguishing property and also means it does not guarantee airway protection. Amnesia is weak compared with a benzodiazepine and recall is common. Clearance falls in hepatic impairment. Withdrawal-type agitation and rebound hypertension have been described after abrupt cessation of prolonged infusion. No dosing guidance appears on this page.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Sterile solution for continuous intravenous infusion, as a concentrate for dilution and as premixed ready-to-use bags in sodium chloride; a sublingual film formulation is separately approved for agitation
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
A recorded note compares this form with the others that are sold. It is kept below, word for word.
§ A fixed RNAWiki sentence
Where this came from
Wording RNAWiki always uses, not a finding about this substance.
The recorded note, unchanged: The rate of administration is pharmacologically meaningful rather than merely practical: the label distinguishes slow from rapid intravenous administration when describing receptor selectivity, and rapid administration produces a transient pressor response from peripheral vasoconstriction. The approved intensive care indication specifies infusion not exceeding 24 hours, which is a labelling limit rather than a statement about what happens on day two.
No source is stored against this line.
What is recorded as being sold
99 products list this as an active ingredient in the United States drug directory. 99 of them contain it and nothing else.
FDA National Drug Code directory · 0781-3495 · read 2026-08-29
They are sold as film, injection, injection, solution, injection, solution, concentrate and powder, taken intravenous and sublingual.
FDA National Drug Code directory · 0781-3495 · read 2026-08-29
The regulator's established pharmacologic class for it is adrenergic alpha2-agonists [moa], central alpha-2 adrenergic agonist [epc] and general anesthesia [pe].
FDA National Drug Code directory · 0781-3495 · read 2026-08-29
44 published labels name it as an active ingredient. 44 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-29
Dexmedetomidine Hydrochloride in 0.9% Sodium Chloride is intravenous at 3 DOSAGE FORMS AND STRENGTHS Dexmedetomidine hydrochloride in 0.9% sodium chloride injection is a clear and colorless solution, ready to use., recorded as fda label in effect 2023-10-06 in the United States.
US prescribing information · a99335d0-1e87-4180-bde3-cbb12bf91a52 · read 2026-08-30
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.
Questions worth asking
Which of the trials of Dexmedetomidine studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That dexmedetomidine reduces delirium as a property of the drug — it beats midazolam, ties propofol and did not beat placebo
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That preserved arousability and respiratory drive, which are real and measured, translate into any survival or organ-failure benefit
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That an alpha-2 agonist protects the heart after cardiac surgery; the placebo-controlled trial found no reduction in atrial fibrillation and its authors advised against using it for that
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That SPICE III compared dexmedetomidine with other sedatives, when two thirds of the dexmedetomidine arm received propofol as well
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That bradycardia and hypotension are avoidable side effects rather than the same receptor action expressed outside the brain
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Dexmedetomidine are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
It recruits the brain's own sleep pathway, and the knockout mouse proves it
In plain words
Researchers showed the drug switches on the same brain cells that switch on during natural deep sleep, and switches off the ones that keep you awake. Mice engineered without the receptor did not become sedated at all.
What was measured
c-Fos expression across locus coeruleus, tuberomammillary nucleus and ventrolateral preoptic nucleus, with alpha-2A knockout, antagonist, lesion and local GABA-A antagonist controls
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Nelson and colleagues mapped c-Fos expression across sleep-regulating nuclei after dexmedetomidine and found a pattern qualitatively similar to normal non-rapid-eye-movement sleep: decreased in the locus coeruleus and tuberomammillary nucleus, increased in the ventrolateral preoptic nucleus. The pattern was attenuated by the alpha-2 antagonist atipamezole and was absent in mice lacking functional alpha-2A adrenoceptors, which show no sedative response to the drug. Bilateral lesions of the ventrolateral preoptic nucleus attenuated sedation, and the dose-response curve shifted right when the GABA-A antagonist gabazine was given systemically or directly into the tuberomammillary nucleus. Lesions and gabazine altered c-Fos in the tuberomammillary nucleus but not the locus coeruleus, establishing a hierarchical sequence: alpha-2A agonism silences the locus coeruleus, which disinhibits the ventrolateral preoptic nucleus, which then GABAergically inhibits the tuberomammillary nucleus. This is why the sedation is rousable, and it is a properly controlled mechanistic result rather than a mechanistic story.
Written into the record, not signed off as a reviewed claim
SPICE III: identical 90-day mortality, more harm, and most patients needed propofol anyway
In plain words
Four thousand critically ill patients were randomised to have this drug as their main sedative or to usual care. After ninety days, 29.1% of each group had died. Two thirds of the dexmedetomidine group had needed propofol added on top to keep them comfortable.
What was measured
Death from any cause at 90 days, and supplemental sedative use in the first two days
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Shehabi and colleagues enrolled critically ill adults ventilated for less than 12 hours and expected to need ventilation beyond the next calendar day, randomising them open-label to dexmedetomidine as sole or primary sedative or to usual care with propofol, midazolam or other agents, targeting a Richmond Agitation-Sedation Scale score of -2 to +1. Four thousand patients were enrolled at a median 4.6 hours from eligibility. In the modified intention-to-treat analysis of 3,904 patients, death from any cause at 90 days occurred in 566 of 1,948 (29.1%) on dexmedetomidine and 569 of 1,956 (29.1%) on usual care — adjusted risk difference 0.0 percentage points, 95% CI -2.9 to 2.8. The ancillary finding matters as much as the primary: to reach the prescribed sedation level, 64% of the dexmedetomidine group received supplemental propofol in the first two days, 3% midazolam and 7% both. Bradycardia and hypotension were more common on dexmedetomidine, and more adverse events overall were reported in that group. A trial in which two thirds of the intervention arm receives the comparator drug is not a clean comparison of two sedatives, and the authors report it plainly.
Written into the record, not signed off as a reviewed claim
MENDS2: no better than propofol on delirium, ventilation, death or cognition
In plain words
Against propofol, in ventilated patients with sepsis, this drug produced the same number of days free of delirium or coma, the same ventilator-free days, the same death rate at three months and the same cognitive scores at six.
What was measured
Days alive without delirium or coma over 14 days, with ventilator-free days, 90-day death and 6-month cognition as secondary endpoints
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Hughes and colleagues ran a multicentre double-blind trial in mechanically ventilated adults with sepsis, randomising to dexmedetomidine or propofol with doses adjusted by bedside nurses to clinician-set Richmond Agitation-Sedation Scale targets. Of 432 randomised, 422 received a trial drug and were analysed: 214 on dexmedetomidine at a median 0.27 micrograms per kilogram per hour, 208 on propofol at a median 10.21 micrograms per kilogram per minute, for a median 3 days, at a median score of -2. The primary endpoint, days alive without delirium or coma over the 14-day intervention period, was 10.7 against 10.8 (odds ratio 0.96, 95% CI 0.74 to 1.26). Ventilator-free days at 28 days were 23.7 against 24.0 (odds ratio 0.98, 95% CI 0.63 to 1.51). Death at 90 days was 38% against 39% (hazard ratio 1.06, 95% CI 0.74 to 1.52). Age-adjusted cognition on the Telephone Interview for Cognitive Status at six months did not differ either. The trial was designed around a hypothesis that the two drugs differ in arousability, immunity and inflammation. On every outcome it measured, they did not.
Written into the record, not signed off as a reviewed claim
DECADE: no reduction in atrial fibrillation, and delirium went the wrong way
In plain words
A placebo-controlled trial after cardiac surgery tested whether this drug prevents the two commonest complications. Atrial fibrillation was not reduced, delirium was numerically higher on the drug, and serious adverse events were more than twice as common.
What was measured
Co-primary incidence of new-onset atrial fibrillation and of delirium between intensive care admission and postoperative day 5 or discharge
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Turan and colleagues randomised 798 patients having cardiac surgery with cardiopulmonary bypass at six academic hospitals in the United States, 1:1, masked to patients, caregivers and evaluators, to a dexmedetomidine infusion started before incision and continued for 24 hours or to saline placebo. The trial was stopped per protocol after the last designated interim analysis; 794 were analysed. Atrial fibrillation occurred in 121 of 397 (30%) on dexmedetomidine and 134 of 395 (34%) on placebo — relative risk 0.90, 97.8% CI 0.72 to 1.15, P=0.34. Delirium was non-significantly increased, from 12% on placebo to 17% on dexmedetomidine, relative risk 1.48, 97.8% CI 0.99 to 2.23. Serious adverse events as determined by clinicians occurred in 21 of 394 (5%) on dexmedetomidine against 8 of 396 (2%) on placebo. The authors' conclusion is unusually direct: dexmedetomidine should not be infused to reduce atrial fibrillation or delirium in patients having cardiac surgery. The trial was funded by Hospira, which markets the drug.
Written into the record, not signed off as a reviewed claim
The one comparison it clearly wins is against a benzodiazepine
In plain words
Against midazolam, the drug reached the same sedation targets but delirium fell from 77% to 54% and patients came off the ventilator nearly two days sooner.
What was measured
Percentage of time within target sedation range, prevalence of delirium during treatment, and time to extubation
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
SEDCOM was a prospective double-blind randomised trial at 68 centres in five countries among 375 medical and surgical intensive care patients expected to need more than 24 hours of ventilation, comparing dexmedetomidine (n=244) with midazolam (n=122) titrated to light sedation until extubation or 30 days. The primary endpoint, percentage of time within the target Richmond Agitation-Sedation Scale range, did not differ: 77.3% versus 75.1%, difference 2.2 percentage points, 95% CI -3.2 to 7.5, P=0.18. Delirium prevalence during treatment was 54% (132 of 244) against 76.6% (93 of 122) — a difference of 22.6 percentage points, 95% CI 14 to 33, P<0.001. Median time to extubation was 1.9 days shorter, 3.7 against 5.6 days, P=0.01, while intensive care length of stay was similar, 5.9 against 7.6 days, P=0.24. This audit is filed as measured and is the strongest positive result on the page. It is also worth reading against MENDS2: the delirium advantage exists against midazolam and disappears against propofol, which suggests the finding is as much about benzodiazepines being bad as about alpha-2 agonism being good.
Written into the record, not signed off as a reviewed claim
The delirium reputation was built on a comparator, not on an effect
In plain words
This drug is widely described as delirium-sparing. It beat midazolam on delirium by 23 percentage points, tied with propofol, and in a placebo-controlled trial after cardiac surgery delirium was numerically higher on the drug than on saline.
What was measured
That dexmedetomidine has an intrinsic delirium-reducing effect, rather than a delirium advantage that exists only relative to benzodiazepines
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Read the three trials together and the picture is consistent rather than contradictory. Against midazolam, delirium was 54% versus 76.6%. Against propofol, days alive without delirium or coma were 10.7 versus 10.8. Against placebo in cardiac surgery, delirium was 17% versus 12%, relative risk 1.48 with a 97.8% confidence interval of 0.99 to 2.23. A drug that beats a benzodiazepine, ties with propofol and does not beat saline is not exerting an anti-delirium effect; it is avoiding a pro-delirium one. That is still clinically useful — benzodiazepines really are associated with delirium, and replacing them really does help — but it is a different claim from the one usually made, and the difference matters when the alternative on offer is propofol rather than midazolam. This entry is filed as an inference because the sentence "dexmedetomidine reduces delirium" is true only with the comparator supplied, and the comparator is almost never supplied.
Source
Riker RR et al. JAMA 2009;301:489-499; Hughes CG et al. N Engl J Med 2021;384:1424-1436; Turan A et al. Lancet 2020;396:177-185
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
contested
Review state
Written into the record, not signed off as a reviewed claim
Bradycardia and hypotension are the price, and they were measured in every trial
In plain words
A slow heart rate and low blood pressure are not rare side effects here; they are the predictable consequence of turning down the body's own noradrenaline signalling, and every large trial recorded more of both.
What was measured
Incidence of bradycardia, hypotension and serious adverse events against comparator and against placebo in randomised trials
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
SPICE III reported that bradycardia and hypotension were more common in the dexmedetomidine group and that more adverse events overall were reported in that group. DECADE recorded clinically important bradycardia requiring treatment and hypotension among its prespecified safety outcomes, with serious adverse events in 5% on dexmedetomidine against 2% on placebo. The mechanism is direct and unavoidable: alpha-2 agonism at presynaptic sympathetic terminals reduces noradrenaline release, lowering heart rate and vascular tone, and that is the same receptor action producing the sedation. There is no separation to engineer. The label also records the biphasic pattern — a transient rise in blood pressure with rapid administration, from peripheral alpha-2B vasoconstriction before central sympatholysis dominates — which is why it distinguishes slow from rapid infusion in describing alpha-2 selectivity.
Source
Shehabi Y et al. N Engl J Med 2019;380:2506-2517; Turan A et al. Lancet 2020;396:177-185; FDA-approved US prescribing information for dexmedetomidine hydrochloride injection, Clinical Pharmacology
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
How many documents were read
40 documents were read for this substance.
RNAWiki source record
40 of them state the same halfLife, and they agree.
RNAWiki source record
39 of them state the same proteinBinding, and they agree.
RNAWiki source record
40 of them state the same volumeOfDistribution, and they agree.
RNAWiki source record
Where else this substance is registered
FDA substance identifier (UNII)
1018WH7F9I
RxNorm concept
309710
Checks this page had to pass
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no quarantine open
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Trial roles classified for highlighted evidence
No registered study is classified as testing this substance.
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Canonical metadata present
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What is missing or unclear◇Read from sources, not yet reviewed
How this medicine reached us
Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.
What the approval register records
35 approved applications cover products containing this substance. The earliest was NDA021038, approved 19991217 to HOSPIRA.
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What is not here
7 questions this page could not answer
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Felt, measured, or meaningful — found nothing in the sources checked.
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Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A selective alpha-2A agonist that sedates by recruiting the brain's own non-REM sleep pathway rather than by depressing it, and which in 3,904 ventilated critically ill patients produced 90-day mortality of 29.1% against 29.1% on usual care, with more bradycardia and hypotension and with two thirds of patients needing propofol on top anyway.
Recorded evidence blocks (11)
Q1
On the Dexmedetomidine label: indicated for what?
"Dexmedetomidine Injection is a alpha 2 -adrenergic receptor agonist indicated for: Sedation of initially intubated and mechanically ventilated adult patients during treatment in an intensive care setting. Administer Dexmedetomidine Injection by continuous infusion not to exceed 24 hours.": indications and usage on Dexmedetomidine's label. DailyMed label · eee6145b-d83f-4596-92d3-733934d8a3a4 · 2026-08-05
Q2
1291 registered trials of Dexmedetomidine — at which phases?
Registered studies posting no result
1142 of 1291
1291 registered studies of Dexmedetomidine: 452 phase4, 411 na, 200 phase3, 164 phase2, 72 phase1, 48 na or unstated, 30 early phase1. CLINICALTRIALS_SNAPSHOT · 2026-09-01
"Closed due to lack of enrollment"; 92 of 1291 registered studies
Show the evidence
Trial
NCT00335972
terminated; "Closed due to lack of enrollment"
NCT00409344
terminated; "Surgical approach changed therefore subject enrollment not possible."
NCT00455143
terminated; "Pilot study initiated to provide support data for main grant GCO 06-0217 funded. only baseline characteristic data collected. no results for this study."
NCT00460473
terminated; "The incidence of post-operative delirium observed from interim blinded data was significantly lower than the current literature in this population."
NCT00464451
withdrawn; "Unable to obtain approval from FDA for use of chloral hydrate"
NCT00464490
terminated; "Lack of eligible participants"
14 further recorded trials
NCT00464763
withdrawn; "The incidence of post-operative delirium observed from interim blinded data in DEX-06-09 was significantly lower than the current literature in this population."
NCT00608231
withdrawn; "Intraoperative recording could not be maintained for required period"
NCT00691886
withdrawn; "PI left institution prior to enrollment"
NCT00778063
terminated; "Difficulty enrolling patients"
NCT00826553
terminated; "poor recruitment"
NCT00852046
withdrawn; "PI resigned."
NCT00878345
withdrawn; "Study was never opened"
NCT00894751
terminated; "low enrollment and high participant withdraw"
NCT00909935
terminated; "unable to enroll enough patients"
NCT00932386
withdrawn; "unable to secure funding for analysis of laboratory data."
NCT01007773
withdrawn; "Study will not be intiated"
NCT01017237
terminated; "Protocol proved to be ineffective for adequate sedation for third molar surgery."
NCT01059929
terminated; "drug and placebo unavailable"
NCT01072643
terminated; "Study was terminated due to increased PVR in one subject from T0-T1 reaching the level of a predetermined stopping rule"
recorded 2026-09-01 · last checked 2026-09-04
Q4
Human studies of Dexmedetomidine used Precedex, Dexdor Titrated 0.1 to 0.5 ug.kg.h-1 — over how long?
Human studies of Dexmedetomidine used "Precedex, Dexdor Titrated 0.1 to 0.5 ug.kg.h-1". ClinicalTrials.gov · 2026-09-01
20 recorded entries; human; also "Dexmedetomidine 0.75 mcg/kg", "Dexmedetomidine 1 mcg/kg", "Precedex® 100μg/1ml vial: DMDTIA"
Show the evidence
human
NCT00345384
Precedex, Dexdor Titrated 0.1 to 0.5 ug.kg.h-1
NCT01057381
Dexmedetomidine 0.75 mcg/kg
NCT01057381
Dexmedetomidine 1 mcg/kg
NCT01404689
Precedex® 100μg/1ml vial: DMDTIA
NCT01688648
Dexmedetomidine hydrochloride 118 mcg/ml
NCT01789385
Precedex 200 mcg 2 ml
14 more recorded rows
humanNCT01837290
Precedex 200mcg/2ml
humanNCT01918917
precedex, 100mcg/ml
humanNCT01921361
Precedex, 100 mcg/ml, Abbott
humanNCT02270281
Dexmedetomidine 0.7 Mcg/kg/h
humanNCT02327156
Precedex, 200 μg per 2 mL; Hospira, USA
humanNCT02845661
Dexmedetomidine 0.9 µg/kg
humanNCT02845661
Dexmedetomidine 1.0 µg/kg
humanNCT02845661
Dexmedetomidine 1.1 µg/kg
humanNCT02996058
Dexmedetomidine 0.35µg/kg /h
humanNCT02996058
Dexmedetomidine 0.5µg/kg /h
humanNCT03064633
dexmedetomidine 80 µg
humanNCT03064633
precedex 100 µg/ml
humanNCT03065530
Dexmedetomidine 0.03ug/kg/h
humanNCT03065530
Dexmedetomidine 0.05ug/kg/h
recorded 2026-09-01 · last checked 2026-09-04
Q5
Dexmedetomidine's half-life is 6 minutes — which schedules were studied?
6 minutes, the half-life Dexmedetomidine's label states: "Following intravenous administration to adults, dexmedetomidine exhibits the following pharmacokinetic parameters: a rapid distribution phase with a distribution half-life (t 1/2 ) of approximately 6 minutes; a terminal elimination half-life (t 1/2 ) of approximately 2 hours; and steady-state volume of distribution (V…" DailyMed label · eee6145b-d83f-4596-92d3-733934d8a3a4 · 2026-08-05
Show the evidence
half lifepharmacokinetics
6 minutes; Following intravenous administration to adults, dexmedetomidine exhibits the following pharmacokinetic parameters: a rapid distribution phase with a distribution half-life (t 1/2 ) of approximately 6 minutes; a terminal elimination half-life (t 1/2 ) of approximately 2 hours; and steady-state volume of distribution (V ss ) of approximately 118 liters.
metabolismpharmacokinetics
Elimination Metabolism Dexmedetomidine undergoes almost complete biotransformation with very little unchanged dexmedetomidine excreted in urine and feces.
recorded 2026-08-05 · last checked 2026-09-04
Q6
Which running trial of Dexmedetomidine could settle lifespan?
NCT04204798 measures Overall survival after surgery, reading out 2026-06-04.
5 open trials; n 1410; "Dexmedetomidine and Outcomes of Elderly Admitted to ICU After Surgery"
Show the evidence
Trial
NCT04204798
"Dexmedetomidine and Outcomes of Elderly Admitted to ICU After Surgery"; n 1410; "Overall survival after surgery"; 2026-06-04
NCT07271459
"Effect of Total Intravenous Anesthesia vs Inhalational Anesthesia on the Level of Inflammatory Markers"; n 40; "IL-6 level 24 hours postoperatively compared to baseline value"; 2026-10
NCT07743853
"Intravenous Dexmedetomidine as a Perioperative Autonomic-Immune Neuromodulator"; n 90; "Change in the Systemic Immune-Inflammation Index (SII)"; 2026-12-01
NCT06251375
"Early Sedation With Dexmedetomidine vs. Placebo in Older Ventilated Critically Ill Patients"; n 300; "Mortality"; 2028-01-31
NCT06030804
"Perioperative Dexmedetomidine and Long-term Survival After Cancer Surgery"; n 4532; "Progression-free survival after surgery"; 2028-10
Q7
Which 498 trials of Dexmedetomidine posted no result?
Posted no result
498 of 498 completed trials
Registrations
NCT00417664, NCT00318955, NCT00383890, NCT00398827, NCT00405847 and NCT00401206, and 492 more
Completion dates
oldest 2004-04; newest 2024-09-01
Show the evidence
Trial
NCT00417664
2004-04
NCT00318955
2006-08
NCT00383890
2007-03
NCT00398827
2007-05
NCT00405847
2007-05
NCT00401206
2007-06
14 further recorded trials
NCT00216190
2007-08
NCT00334360
2007-08
NCT00349245
2007-08
NCT00390871
2007-12
NCT00800826
2008-04
NCT00526760
2008-06
NCT00142493
2008-08
NCT00505804
2008-11
NCT00926705
2009-01
NCT00747721
2009-02
NCT00481312
2009-10
NCT00710437
2009-11
NCT00839605
2009-11
NCT04628559
2009-12-31
Q8
At the median, Dexmedetomidine's trials enrolled 70 people — anything larger?
Median enrolment
70
Largest enrolment
518043
Registered trials counted
1291
Q9
What do 773 spontaneous reports say about Dexmedetomidine — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Dexmedetomidine appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 773 reaction mentions were counted: bradycardia 182; hypotension 104; cardiac arrest 95; delirium 70. FAERS via Open Targets · CHEMBL2106195 · 2026-06-24
Show the evidence
bradycardia
182
hypotension
104
cardiac arrest
95
delirium
70
agitation
66
hyperthermia
64
4 more recorded rows
drug interaction
54
tachycardia
53
drug withdrawal syndrome
46
respiratory depression
39
recorded 2026-06-24 · last checked 2026-09-04
Q10
Which 10 reactions does Dexmedetomidine's label not list?
Biotransformation involves both direct glucuronidation as well as cytochrome P450 mediated metabolism.
pharmacokinetics
The major metabolic pathways of dexmedetomidine are: direct N-glucuronidation to inactive metabolites; aliphatic hydroxylation (mediated primarily by CYP2A6 with a minor role of CYP1A2, CYP2E1, CYP2D6 and CYP2C19) of dexmedetomidine to generate 3-hydroxy-dexmedetomidine, the glucuronide of 3-hydroxy-dexmedetomidine, and 3-carboxy-dexmedetomidine; and N-methylation of dexmedetomidine to generate…
pharmacokinetics
Drug Interaction Studies In vitro studies: In vitro studies in human liver microsomes demonstrated no evidence of cytochrome P450 mediated drug interactions that are likely to be of clinical relevance.
clinical_pharmacology
Biotransformation involves both direct glucuronidation as well as cytochrome P450 mediated metabolism.
clinical_pharmacology
The major metabolic pathways of dexmedetomidine are: direct N-glucuronidation to inactive metabolites; aliphatic hydroxylation (mediated primarily by CYP2A6 with a minor role of CYP1A2, CYP2E1, CYP2D6 and CYP2C19) of dexmedetomidine to generate 3-hydroxy-dexmedetomidine, the glucuronide of 3-hydroxy-dexmedetomidine, and 3-carboxy-dexmedetomidine; and N-methylation of dexmedetomidine to generate…
clinical_pharmacology
Drug Interaction Studies In vitro studies: In vitro studies in human liver microsomes demonstrated no evidence of cytochrome P450 mediated drug interactions that are likely to be of clinical relevance.
Dexmedetomidine accord, Precedex, Dexmedetomidine in Dextrose
Salt form
Dexmedetomidine hcl, Dexmedetomidine Hydrochloride in 0.9% Sodium Chloride, Dexmedetomidine Hydrochloride in Sodium Chloride, Precedex; also marketed as dexmedetomidine hydrochloride in sodium chloride, and as Igalmi sublingual film
ChEMBL 37 — CC BY-SA 3.0 Unported · ClinicalTrials.gov — US Government work · Open Targets 26.06 — CC0 · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work
✗ required summary fields resolved: 4 required field(s) not terminal: Why people use it, Best-supported result, Biggest unanswered question, Human evidence
✓ public claims reviewed: 0 reviewed claim(s); drafts are never rendered
✓ source coverage passed: 6 source rows
✓ no critical contamination: no quarantine open
✓ canonical metadata passed: slug and display name present
✓ no raw internal fields: enforced by the copy-contract test over the rendered page
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