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Dexmedetomidine Sublingual and Buccal

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Why is this medication prescribed?

Dexmedetomidine is used to treat agitation episodes in patients with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of severe mania, and other abnormal moods) or schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions). Alpha2 receptor agonists are the group of drugs that includes dexmedetomidine. It functions by altering the brain’s natural chemical components’ activities.

How should this medicine be used?

Dexmedetomidine is applied as a sublingual film to the lower gums (behind the lower lip) or beneath the tongue. Usually, a healthcare provider supervises the single dose that is taken as needed. You might get up to two more doses if, following your initial dose, you’re still agitated; these doses would need to be administered at least two hours apart.

Decxmedetomidine sublingual film should be taken by placing it under your tongue after removing it from the foil packet with clean, dry hands. Another option is to apply the film on the lower gum, which is located behind the lower lip. The movie will stay put. Shut your mouth and wait for the film to fully disintegrate before removing it. Sublingual film should not be chewed or swallowed. The film may take approximately 6 to 8 minutes to dissolve beneath your tongue, or approximately 18 minutes to disintegrate on the lower gum.

After placing the film under your tongue, wait at least 15 minutes before consuming any food or liquids. After the film is applied to your lower gum (below your lower lip), wait at least an hour before eating or drinking anything.

Request a copy of the patient’s manufacturer’s information from your pharmacist or physician.

Other uses for this medicine

  • Procedural Sedation: Sublingual or buccal dexmedetomidine may be explored for procedural sedation, particularly in settings where intravenous access is difficult or not preferable.
  • Pain Management: Some studies suggest potential applications of dexmedetomidine for pain management, although more research is needed in this area.
  • Anxiety Management: Dexmedetomidine’s sedative properties may also be beneficial for managing anxiety in certain clinical scenarios.

What special precautions should I follow?

Special precautions should be observed when taking dexmedetomidine. Here are some key considerations:

  • If you have an allergy to any of the ingredients in dexmedetomidine sublingual film, other drugs, or dexmedetomidine itself, let your doctor and pharmacist know. Get an ingredient list from your pharmacist.
  • Inform your physician and pharmacist about any additional prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal remedies you now take or intend to use. Your doctor might need to carefully monitor you for any negative effects or adjust the dosages of your medications.
  • Inform your physician if you currently have or have ever had diabetes, a prolonged QT interval (a rare cardiac condition that can result in a slow or irregular heartbeat, fainting, or sudden death), fainting episodes, low potassium or magnesium levels in the blood, a slow or irregular heartbeat, high or low blood pressure, or liver or heart disease.
  • Inform your physician if you intend to get pregnant, are nursing a baby, or are currently pregnant. When taking dexmedetomidine and you become pregnant, contact your doctor.
  • Inform the physician or dentist that you take dexmedetomidine if you need surgery, including dental surgery.
  • It is important to note that dexmedetomidine may cause drowsiness. After taking dexmedetomidine sublingual film, wait at least eight hours before operating a vehicle or using any machinery.
  • You should be aware that when you stand up too rapidly from a laying position, dexmedetomidine might produce lightheadedness, dizziness, and fainting. Get out of bed gradually, putting your feet on the floor for a few minutes before getting up, to prevent this issue.

Always follow your healthcare provider’s instructions and guidance regarding the use of dexmedetomidine, and report any adverse reactions or concerns promptly.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Dexmedetomidine sublingual or buccal formulations. However, if you have concerns or questions about your diet while taking this medication, it’s best to consult your healthcare provider or a registered dietitian.

What should I do if I forget a dose?

  • If you miss a dose of Dexmedetomidine, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
  • Do not take a double dose to make up for a missed one.
  • If you’re unsure about what to do, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Dexmedetomidine is generally well-tolerated, but like any medication, it can cause side effects in some individuals. Common side effects of Dexmedetomidine include:

  • Excessive sleepiness or tiredness
  • Dizziness
  • Dry mouth
  • Mouth numbness
  • Numbness and tingling of the arms, hands, legs, or feet
  • Nausea
  • Stomach pain
  • Heartburn

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • Fast or irregular heartbeat
  • Fainting
  • Dizziness or lightheadedness
  • Blurred vision

It’s important to note that this list is not exhaustive, and other side effects may occur. If you experience any persistent or severe side effects while taking Dexmedetomidine, or if you have any concerns about your medication, contact your healthcare provider promptly. They can provide guidance and may adjust your treatment plan if necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal:

  • Storage:
    • Store Dexmedetomidine sublingual and buccal formulations according to the instructions provided by the manufacturer.
    • Typically, it should be stored at room temperature away from light and moisture.
    • Keep it out of reach of children and pets.
    • Do not store Dexmedetomidine in the bathroom or near the kitchen sink, where it might be exposed to moisture.
  • Disposal:
    • Dispose of any unused or expired Dexmedetomidine sublingual and buccal formulations properly.
    • Follow any specific disposal instructions provided by your healthcare provider or pharmacist.
    • Do not flush Dexmedetomidine down the toilet unless instructed to do so by your healthcare provider or pharmacist.
    • Consider using a drug take-back program in your community for safe disposal.

In case of emergency/overdose

  • In case of emergency or suspected overdose of Dexmedetomidine sublingual or buccal formulations, seek immediate medical attention by calling your local emergency services or going to the nearest emergency room.
  • Symptoms of Dexmedetomidine overdose may include severe drowsiness, difficulty breathing, slowed heart rate, low blood pressure, or even loss of consciousness.
  • It’s crucial to provide medical professionals with as much information as possible, including the amount of Dexmedetomidine taken and when it was ingested.

What other information should I know?

  • Inform your healthcare provider about any allergies you have, medications you are currently taking (including over-the-counter drugs, vitamins, and herbal supplements), and any medical conditions you have, especially if you have a history of heart problems, low blood pressure, or kidney disease.
  • Dexmedetomidine may interact with other medications, so it’s essential to discuss potential drug interactions with your healthcare provider.
  • Follow the dosage instructions provided by your healthcare provider or pharmacist carefully. Do not exceed the recommended dose unless instructed to do so by your healthcare provider.
  • Do not drive or operate heavy machinery while under the influence of Dexmedetomidine, as it may cause drowsiness and impair your ability to perform these tasks safely.
  • Avoid alcohol consumption while taking Dexmedetomidine, as it can increase the risk of side effects.
  • If you have any questions or concerns about Dexmedetomidine sublingual or buccal formulations, do not hesitate to consult your healthcare provider or pharmacist for clarification.

By following these guidelines and staying informed about Dexmedetomidine, you can use it safely and effectively as prescribed by your healthcare provider.

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