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  • BDD Moderators: Keif’ Richards

Precedex (Dexmedetomidine) -- highly selective Intravenous alpha-2 adrenergic agonist for sedation, analgesia,

Them Witches

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Apr 21, 2025
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30 days ago is admitted into hospital and immediately went to ICU for a total of 3 days. The cause was Urine Retention (inability to empty the bladder) is a major risk factor for, and a symptom of, severe urosepsis, a life-threatening infection originating in the urinary tract. It causes urine to back up, creating a breeding ground for bacteria. Emergency care, including Foley catheterization and antibiotics, is required if symptoms like fever, confusion, and low output occur. There was no need to share the details from this post but what the fuck... why not I am not embarrassed. This is what happens when I do not drink the correct amount of water each day and which was basically no water leading up to this event, just drinking very dark roast and lots of it. I found out that once severe urosepsis starts, I blacked out and do not remember anything. some scary events happened before I finally made it to the hospital.

ICU immediately started Precedex (Dexmedetomidine) 24/7 constant infusions 400 mcg / 100 mL (3rd highest strength || 3 of 4) which lasted 3 days. Precedex a sedative agent commonly used in intensive care settings for sedation of initially intubated and mechanically ventilated patients, as well as for non-intubated patients prior to and/or during surgical and other procedures. It is important to consult a healthcare professional, such as a doctor or pharmacist, for specific dosage and administration instructions based on individual patient needs and clinical guidelines.

Precedex is an intravenous alpha-2 adrenergic agonist used for sedation of, typically, mechanically ventilated patients in the ICU and non-intubated patients before or during procedures. It provides sedation and analgesia without respiratory depression, commonly causing hypotension, bradycardia, and dry mouth. (Dexmedetomidine) is 8 times stronger than Duraclon IV (Clonidine HCl IV).

Precedex is 100% a badass amazing drug but is only prescribed in the ICU. It would be an amazing solution for post-op acute pain and it works very well with opioids and benzos. ICU added Diluadid IV 8mg every 4 hrs because my kidneys were being tested so my normal Roxi 30mg : 4hrs was reduced to 20mg : 4hrs and my Ativan was stopped. I am a new fan of Precedex, it is euphoric, has clean pleasurable sedative effects, and very good pain relief.
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Have you ever had any other a2 agonists (clonidine, tizanidine, lofexidine, xylazine, guanfacine)? If so how do they compare to the dexmedetomidine?
 
Tizanidine is fantastic for sedation and pain. So this substance u write about is probably something very useful too.
 
Have you ever had any other a2 agonists (clonidine, tizanidine, lofexidine, xylazine, guanfacine)? If so how do they compare to the dexmedetomidine?
(1) I currently have a Rx daily Clonidine 0.9mg (PO 0.3mg tablets) // without pause total Rx 25 years -- started at 0.1mg : 12hrs >> 0.2mg : 12hrs >> past year 0.3mg : 3 times daily - PCA, PRN for BP/Pu (ex. 0.3mg morning & 0.6mg evening) // I have received Duraclon IV (Clonidine HCl IV) on many hospital occasions and it hits completely different than PO tablets.
NOTE : Clonidine has never failed me once regarding my high dosage tolerance, it always reduces blood pressure in pulse, and the synergistic effects. Clonidine is 40 times stronger than Xylazine mg per mg

(2) Moved back to 2qty scheduled 2 narcotics // Rx Discontinued Zanaflex (Tizanidine) 4mg tablets : 4hrs // I did not find it as effective as Clonidine for analgesia and as a sedative.
Currently, I still have a Cyclobenzaprine Rx muscle relaxer.
NOTE : If I had a choice for a muscle relaxer, I would choose Zanaflex (Tizanidine) .

(3) Having a Clonidine 0.9mg Rx and Cyclobenzaprine Rx, I have no desire to try Xylazine.

(4) I have not tried Lofexidine. Though it has a safer profile than Clonidine, Lofexidine has less sedative qualities, less analgesia, and has lower hypotension qualities. I have no desire to trade off Clonidine for Lofexidine because I need the lower hypotension qualities, I need more analgesia qualities, and I need as much sedative qualities as possible.

(5) I have not tried Guanfacine, but it is 15-20 times more selective for 𝛼2𝐴 than other subtypes making it more suitable for daytime use and ADHD treatment. Whereas Clonidine is less selective but has higher affinity for imidazoline receptors or influencing the blood pressure/pulse lowering effects and a much higher sedative effects.

(6) Precedex (Dexmedetomidine) is the "end boss" of alpha-2 and is 8 times stronger than Duraclon IV (Clonidine HCl IV). The only place it can be prescribed is ICU in-patient because patients have to constantly monitored. It is very strong. I was on the pre-mixed infusion bags 400mcg/100mL. The closest thing I can related it to is Propofol but has arousablity. The ICU treated me as PCA with Diluadid 8mg IV every 4hrs. I slept 2 hours the entire 3 days in ICU which took them off-guard. Especially giving the Precedex constant infusion, Diluadid 8mg IV :4hrs, (then PO meds) Oxycodone HCl IR 30mg :4hrs, Methadone HCl 10mg IR :6hrs, Clonidine 0.3mg IR :8hrs, Ativan 1mg :12hrs, Lunesta 3mg :24hrs, Cyclobenzaprine 10-20mg :bedtime, Vistaril PAM 100mg :bedtime, Zoloft 100mg, Busbar 15mg :12hrs, and Gabapentin 100mg :12hrs.
NOTE : Precedex is amazing with IV or PO opioids, and benzos.

Precedex makes Versed seem like candy cigarettes. Inapsine (Droperidol) 2.5-5mg IV with a high dose of Versed doesn't hold a candle to Precedex. I love some Inapsine (Droperidol) too. Precedex can also be programmed to deliver high infusion rates. The ICU tries to follow a 3 day rule with Precedex being the day 1-2 maintain high dosage and the 3rd day dial it back to avoid dependence.

I have a extremely high tolerance to opioids, alpha-2, sedatives, hypnotics, barbiturates, anti-histamines, Antipsychotics, and a without the opioid tolerance my benzo tolerance would be very high.
 
Tizanidine is fantastic for sedation and pain. So this substance u write about is probably something very useful too.
useful in the ICU. It is too useful that treating out-patient will never happen. It takes "all things bad appear gone" and Precedex with Diluadid, Oxycodone, Methadone, and Ativan a stay in the hospital closely resembles a extended vacation to where ever that maybe located.
 
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