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HomeEfficacyEfficacyIntensive Care Unit SedationProcedural SedationAdult PatientsPediatric PatientsSafetyDosing and AdministrationDosing and
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Prescribing Information Indication
Dosing and Administration

Adult Patients

Pediatric Patients

Tab Number 3

Tab Number 4

Tab Number 5

Procedural Sedation
Procedural Sedation Initiation¹
  • For adult patients: a loading infusion of 1 mcg/kg over 10 minutes. For less invasive procedures such as ophthalmic surgery, a loading infusion of 0.5 mcg/kg given over 10 minutes may be suitable
  • For awake fiberoptic intubation in adult patients: a loading infusion of 1 mcg/kg over 10 minutes
  • For patients over 65 years of age: a loading infusion of 0.5 mcg/kg over 10 minutes
  • For adult patients with impaired hepatic function: consider a dose reduction
 Maintenance¹
  • For adult patients: the maintenance infusion is generally initiated at 0.6 mcg/kg/hour and titrated to achieve desired clinical effect with doses ranging from 0.2 to 1 mcg/kg/hour. Adjust the rate of the maintenance infusion to achieve the targeted level of sedation
  • For awake fiberoptic intubation in adult patients: a maintenance infusion of 0.7 mcg/kg/hour is recommended until the endotracheal tube is secured
  • For patients over 65 years of age: consider a dose reduction
  • For adult patients with impaired hepatic function: consider a dose reduction
Procedural Sedation Initiation¹
  • 1 month to less than 2 years: a loading infusion of 1.5 mcg/kg over 10 minutes
  • 2 years to less than 18 years: a loading infusion of 2 mcg/kg over 10 minutes
  • Consider a reduction in dosage if clinically indicated
 Maintenance¹
  • 1 month to less than 18 years: the maintenance infusion is generally initiated at 1.5 mcg/kg/hour and titrated to achieve desired clinical effect with dosage ranging from 0.5 to 1.5 mcg/kg/hour
  • As clinically warranted, titrate the maintenance dose to individual patient clinical response
ICU=intensive care unit.ReferencePRECEDEX [prescribing information]. Lake Forest, IL: Hospira Inc., December 2022.Dosing and Administration Review Hanging Instructions for PRECEDEX
Hanging Instructions
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INDICATIONS AND USAGEIntensive Care Unit Sedation
 
  • PRECEDEX is indicated for sedation of initially intubated and mechanically ventilated adult patients during treatment in an intensive care setting. PRECEDEX should be administered by continuous infusion not to exceed 24 hours.
  • PRECEDEX has been continuously infused in mechanically ventilated adult patients prior to extubation, during extubation, and post-extubation. It is not necessary to discontinue PRECEDEX prior to extubation.
Procedural Sedation
 
  • PRECEDEX is indicated for sedation of non-intubated adult patients prior to and/or during surgical and other procedures.
  • PRECEDEX is indicated for sedation of non-intubated pediatric patients aged 1 month to less than 18 years prior to and during non-invasive procedures.
Please see full Prescribing Information.
Important Safety Information Monitoring: Continuously monitor patients while receiving PRECEDEX. Bradycardia and Sinus Arrest: Clinically significant episodes of bradycardia and sinus arrest have occurred in young healthy volunteers with high vagal tone or with different routes of administration, e.g., rapid intravenous or bolus administration. Hypotension and Bradycardia: Reports of hypotension and bradycardia have been associated with PRECEDEX infusion. Some of these cases have resulted in fatalities. May necessitate medical intervention. May be more pronounced in patients with hypovolemia, diabetes mellitus, or chronic hypertension and in the elderly. Use with caution in patients with advanced heart block or severe ventricular dysfunction. Co-administration with other Vasodilators or Negative Chronotropic Agents: Use with caution due to additive pharmacodynamic effects. Transient Hypertension: Observed primarily during the loading dose. Consider reduction in loading infusion rate. Arousability: Patients can become aroused/alert with stimulation; this alone should not be considered lack of efficacy. Tolerance and Tachyphylaxis: Prolonged exposure to dexmedetomidine beyond 24 hours may be associated with tolerance and tachyphylaxis and a dose-related increase in adverse events. Withdrawal Intensive Care Unit Sedation: With administration up to 7 days, regardless of dose, 12 (5%) PRECEDEX adult subjects experienced at least 1 event related to withdrawal within the first 24 hours after discontinuing study drug and 7 (3%) PRECEDEX adult subjects experienced at least 1 event 24 to 48 hours after the end of study drug. The most common events were nausea, vomiting, and agitation. In adult subjects, tachycardia and hypertension requiring intervention in the 48 hours following study drug discontinuation occurred at frequencies of <5%. If tachycardia and/or hypertension occurs after discontinuation of PRECEDEX, supportive therapy is indicated. Procedural Sedation: In adult subjects, withdrawal symptoms were not seen after discontinuation of short-term infusions of PRECEDEX (<6 hours). In pediatric patients, mild transient withdrawal symptoms of emergence delirium or agitation were seen after discontinuation of short-term infusions. Specific Populations Dosage reductions should be considered for adult patients with hepatic impairment and for geriatric patients. Adverse Reactions The most common adverse reactions: (Incidence greater than 2%) in adults are hypotension, bradycardia, and dry mouth. (Incidence greater than 5%) in pediatrics aged 1 month to less than 17 years are bradypnea, bradycardia, hypertension, and hypotension. Adverse reactions associated with infusions greater than 24 hours in duration include acute respiratory distress syndrome, respiratory failure, and agitation. Drug Interactions Co-administration 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. No pharmacokinetic interactions between Precedex and isoflurane, propofol, alfentanil, and midazolam have been demonstrated. However, due to possible pharmacodynamic interactions, when co-administered with Precedex, a reduction in dosage of Precedex or the concomitant anesthetic, sedative, hypnotic, or opioid may be required. IndicationsIntensive Care Unit Sedation
  • PRECEDEX is indicated for sedation of initially intubated and mechanically ventilated adult patients during treatment in an intensive care setting. PRECEDEX should be administered by continuous infusion not to exceed 24 hours.
  • PRECEDEX has been continuously infused in mechanically ventilated adult patients prior to extubation, during extubation, and post-extubation. It is not necessary to discontinue PRECEDEX prior to extubation.
Procedural Sedation
  • PRECEDEX is indicated for sedation of non-intubated adult patients prior to and/or during surgical and other procedures.
  • PRECEDEX is indicated for sedation of non-intubated pediatric patients aged 1 month to less than 18 years prior to and during non-invasive procedures.
Please see full Prescribing Information.