General: In vitro studies indicate that clinically relevant cytochrome P-450-mediated drug interactions are unlikely.
Anesthetics/Sedatives/Hypnotics/Opioids: Co-administration of Precedex is likely to lead to an enhancement of effects with anesthetics, sedatives, hypnotics, and opioids. Specific studies have confirmed these effects with sevoflurane, isoflurane, propofol, alfentanil and midazolam. No pharmacokinetic interactions between dexmedetomidine and isoflurane, propofol, alfentanil and midazolam were demonstrated. However, due to pharmacodynamic effects, when co-administered with Precedex, a dosage reduction with these agents may be required.
Neuromuscular Blockers: No clinically significant increases in the magnitude of neuromuscular blokade and no pharmacokinetic interactions were observed with Precedex and rocuronium administration.
Compatibility: Precedex been shown to be compatible when administered with the following IV fluids and drugs: Lactated Ringer's, dextrose 5% in water, 0.9% sodium chloride in water, 20% mannitol, thiopental sodium, etomiate, vecuronium bromide, pancuronium bromide, succinylcholine, atracurium besylate, mivacurium chloride, glycopyrrolate bromide, phenylephrine HCl, atropine sulphate, midazolam, morphine sulphate, fentanyl citrate, and a plasma substitute.
Compatibility studies have shown potential for adsorption of dexmedetomidine HCl to some types of natural rubber. Although dexmedetomidine HCl is dosed to effect, it is advisable to use components with synthetic or coated natural rubber gaskets.
Incompatibilities: Compatibility of dexmedetomidine hydrochloride with co-administration of blood, serum or plasma has not been established. Precedex must not be mixed with other medicinal products or diluents except those mentioned previously.