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The tolerability of Precedex was studied in one study in which healthy adult subjects were administered doses at and above the dose of 0.2 to 0.7 mcg/kg/hr. The maximum blood concentration achieved in this study was approximately 13 times the upper boundary of the therapeutic range. The most notable effects observed in two subjects who achieved the highest doses were first degree atrioventricular block and second-degree heart block. No hemodynamic compromise was noted with the atrioventricular block and the heart block resolved spontaneously within one minute.
The signs and symptoms of dexmedetomidine overdose are exaggerated pharmacology, especially cardiovascular effects. A patient who received a loading bolus dose of undiluted dexmedetomidine (19.4 mcg/kg), had cardiac arrest from which he was successfully resuscitated. A 20-month-old child received 60 mcg/kg/h (1 mcg/kg/min) for 36 minutes and experienced bradycardia, hypertension and hypoglycemia.
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