Precedex® Dosing for

Procedural Sedation
• Precedex should be administered only by persons skilled in management of
patients in the intensive care or operating/procedural room setting. Patients
should be continuously monitored while receiving Precedex.
• Precedex is not indicated for infusions lasting longer than 24 hours.
• Dilute vial contents in 0.9% sodium chloride solution to achieve required
concentration of 4 mcg/mL prior to administration.
• To prepare the infusion, withdraw 2 mL of Precedex and add to 48 ml of
0.9% sodium chloride injection to a total of 50 mL. Shake gently to mix well.
• Precedex should be administered using a controlled infusion device
(e.g., IV or syringe pump).
• Precedex dosing should be individualized and titrated to the desired
clinical effect.

Dosing for nonintubated procedural sedation

Loading Dose Maintenance Dose
Adult patients 1 mcg/kg over • Followed by 0.6 mcg/kg/hr
and procedures 10 minutes* • Titrate to effect with doses
Less invasive procedures 0.5 mcg/kg over from 0.2-1 mcg/kg/hr
(e.g., ophthalmic) 10 minutes may be • Rate of infusion should be
suitable adjusted to achieve targeted
level of sedation
Patients over 65 yrs 0.5 mcg/kg over • A reduction in maintenance
10 minutes dosage should be considered
Patients with impaired A dose reduction • A reduction in maintenance
hepatic or renal function should be considered dosage should be considered
Awake fiberoptic 1 mcg/kg over • Followed by 0.7 mcg/kg/hr until
intubation 10 minutes endotracheal tube is secured
*Coadministration of Precedex with anesthetics, sedatives, hypnotics and opioids can enhance the
pharmacodynamic effects of these agents. Specific studies have confirmed these effects with sevoflurane,
isoflurane, propofol, alfentanil and midazolam. A decrease in the dosage of Precedex or the concomitant
agent may be required. In patients already sedated with other anesthetics, sedatives, hypnotics or opioid
analgesics, a loading dose may not be necessary.

Please see accompanying full Prescribing Information.

HOS6468_Procedural Card_Release.indd 1 11/2/09 2:26:09 PM

 Precedex® Dosing for
Procedural Sedation
Based on 4 mcg/mL concentration
Loading Dose
• Precedex is generally initiated with a loading infusion of 1 mcg/kg
over 10 minutes. Coadministration of Precedex with anesthetics, sedatives,
hypnotics and opioids can enhance the pharmacodynamic effects of these
agents. Specific studies have confirmed these effects with sevoflurane, isoflurane,
propofol, alfentanil and midazolam. A decrease in the dosage of Precedex or the
concomitant agent may be required.
• In patients already sedated with other anesthetics, sedatives or opioid analgesics,
a loading dose may not be necessary.
Loading Infusion Total Volume
Weight (kg) Rate (mL/hr) for 10 min Infused (mL)
50 75 12.5
55 82.5 13.8
60 90 15
65 97.5 16.3
70 105 17.5
75 112.5 18.8
80 120 20
85 127.5 21.3
90 135 22.5
95 142.5 23.8
100 150 25
105 157.5 26.3
110 165 27.5
115 172.5 28.8
120 180 30
125 187.5 31.3
130 195 32.5
135 202.5 33.8
140 210 35
145 217.5 36.3
150 225 37.5
155 232.5 38.8
160 240 40
165 247.5 41.3
170 255 42.5
175 262.5 43.8
180 270 45
185 277.5 46.3

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 1 Find patient weight (row).
2 Find desired dose (top of column).
3 Find infusion rate (intersection).

Maintenance Dose
1
2
WEIGHT DOSE (mcg/kg/hr)
(kg) 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1
50 2.5 3.8 5 6.3 7.5 8.8 10 11.3 12.5
55 2.8 4.1 5.5 6.9 8.3 9.6 11 12.4 13.8
60 3 4.5 6 7.5 9 10.5 12 13.5 15
65 3.3 4.9 6.5 8.1 9.8 11.4 13 14.6 16.3
70 3.5 5.3 7 8.8 10.5 12.3 14 15.8 17.5
75 3.8 5.6 7.5 9.4 11.3 13.1 15 16.9 18.8
80 4 6 8 10 12 14 16 18 20
85 4.3 6.4 8.5 10.6 12.8 14.9 17 19.1 21.3
90 4.5 6.8 9 11.3 13.5 15.8 18 20.3 22.5
95 4.8 7.1 9.5 11.9 14.3 16.6 19 21.4 23.8
100 5 7.5 10 12.5 15 17.5 20 22.5 25
105 5.3 7.9 10.5 13.1 15.8 18.4 21 23.6 26.3
110 5.5 8.3 11 13.8 16.5 19.3 22 24.8 27.5
115 5.8 8.6 11.5 14.4 17.3 20.1 23 25.9 28.8
120 6 9 12 15 18 21 24 27 30
125 6.3 9.4 12.5 15.6 18.8 21.9 25 28.1 31.3
130 6.5 9.8 13 16.3 19.5 22.8 26 29.3 32.5
135 6.8 10.1 13.5 16.9 20.3 23.6 27 30.4 33.8
140 7 10.5 14 17.5 21 24.5 28 31.5 35
145 7.3 10.9 14.5 18.1 21.8 25.4 29 32.6 36.3
150 7.5 11.3 15 18.8 22.5 26.3 30 33.8 37.5
155 7.8 11.6 15.5 19.4 23.3 27.1 31 34.9 38.8
160 8 12 16 20 24 28 32 36 40
165 8.3 12.4 16.5 20.6 24.8 28.9 33 37.1 41.3
170 8.5 12.8 17 21.3 25.5 29.8 34 38.3 42.5
175 8.8 13.1 17.5 21.9 26.3 30.6 35 39.4 43.8
180 9 13.5 18 22.5 27 31.5 36 40.5 45
185 9.3 13.9 18.5 23.1 27.8 32.4 37 41.6 46.3

3 INFUSION RATE (mL/hr) The rate of the maintenance infusion should

be adjusted from 0.2 to 1 mcg/kg/hr to achieve the desired effect.

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 Important dosing and safety information
• Moderate decreases in heart rate and blood pressure should be expected.
If medical intervention is required, treatment may include:
1. Decreasing or stopping Precedex® infusion
2. Increasing the rate of intravenous fluid administration
3. Elevation of lower extremities
4. Use of pressor agents such as atropine, ephedrine or glycopyrrolate
• Clinically significant episodes of bradycardia and sinus arrest have been reported
with Precedex administration in young, healthy volunteers with high vagal tone
or with different routes of administration including rapid intravenous or bolus
administration.
• Hypotension and bradycardia may necessitate intervention and may be
more pronounced in patients with hypovolemia, diabetes mellitus or chronic
hypertension as well as in the elderly. Use with caution in patients with advanced
heart block or severe ventricular dysfunction.
• Use with caution when coadministering Precedex with other vasodilators or
negative chronotropic agents due to additive pharmacodynamic effects.
• Transient hypertension has been observed primarily during the administration
of the loading dose. Treatment has generally not been necessary, although a
reduction in loading dose infusion rate may be desirable.
• Coadministration of Precedex with anesthetics, sedatives, hypnotics and opioids
can enhance the pharmacodynamic effects of these agents. Specific studies have
confirmed these effects with sevoflurane, isoflurane, propofol, alfentanil and
midazolam. A decrease in the dosage of Precedex or the concomitant agent may
be required. In patients already sedated with other anesthetics, sedatives or
opioid analgesics, a loading dose may not be necessary.
• Patients sedated with Precedex can be aroused and become alert when stimulated
while sedated. However, this alone should not be considered as lack of efficacy in
the absence of other clinical signs and symptoms of patient discomfort.

Please see accompanying full Prescribing Information.

Advancing Wellness™

www.precedex.com For more information on Advancing WellnessTM,

contact your Hospira representative
Hospira, Inc. 275 North Field Drive, Lake Forest, IL 60045 at 1-877-9HOSPIRA (1-877-946-7747)
P09-2019/R1-Nov., 09. Printed in the USA. or visit www.hospira.com.

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