Product Code Database
Medetomidine is a veterinary anesthetic medication with potent sedative effects and emerging illicit drug adulterant.
It is a racemic mixture of two , levomedetomidine and dexmedetomidine, the latter being the isomer with the pharmacologic effect as an alpha 2- adrenergic agonist. Effects can be reversed using atipamezole.
It was developed by Orion Pharma. It is approved for dogs in the United States, and distributed in the United States by Pfizer Animal Health and by Novartis Animal Health in Canada under the product name Domitor. Starting in 2022 medetomidine has been detected in the US in samples of illicit drugs and associated with overdoses.
The free base form of medetomidine is sold as an antifouling substance for marine paints.
Medetomidine is an α2-adrenergic receptor agonist that binds at a ratio of 1620:1 with imidazoline receptor activity. (2024). 9781119830276, Wiley Blackwell. ISBN 9781119830276
Medetomidine is metabolised in the liver via hydroxylation.
Atipamezole, an a2 adrenergic antagonist, was developed specifically as a reversal agent for medetomidine.
Medetomidine administration in sheep activates pulmonary macrophages that damage the capillary endothelium and alveolar type I cells. This in turns causes alveolar haemorrhage and oedema causing hypoxaemia.
In January 2024 drug mixtures containing medetomidine were identified in the Canadian city of Toronto, ON. In April, 2024 and May, 2024 medetomidine was found in a mixture containing fentanyl and xylazine in Philadelphia, PA and Pittsburgh, PA. Cases of overdose in Chicago from medetomidine/fentanyl mixtures have been reported In May, 2024. Massachusetts reported its first cases in August 2024.
Medetomidine does not respond to naloxone, complicating the medical response to overdoses. During summer 2024 there were "mass overdose events" linked to medetomidine adulterated drugs in Chicago and Philadelphia. Emergency room doctors in Philadelphia reported waves of overdose patients coming in with unusually low heart rates. Public health advisories were issued. Experts warned that it was not business as usual for first responders, emergency room personnel or drug users. One researcher compared experimenting with the current drug supply to "playing Russian roulette".
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