Centers for Disease Control and Prevention (CDC) recently notified public health professionals, clinicians, laboratorians, and people at risk for overdose about the presence of medetomidine in the illegal drug supply, particularly in substances sold as fentanyl. Medetomidine is also colloquially called rhino tranq, mede, or dex. Its use can lead to overdose and a serious withdrawal syndrome.
About medetomidine
Medetomidine is approved for veterinary use but not for use in humans. A related drug, dexmedetomidine (Precedex), is approved for certain medical uses in humans. Testing shows the medetomidine in the illegal drug supply is likely produced illegally, rather than diverted from hospitals or veterinary clinics.
Medetomidine use can cause extreme sedation, bradycardia (slow heart rate), and hypotension (low blood pressure). People who use it regularly and then stop can experience severe withdrawal symptoms, such as very high blood pressure, anxiety, nausea, vomiting, and confusion. Overdose and withdrawal can be serious enough to require emergency department care and sometimes intensive care admission.
Recommendations
Many overdoses involving medetomidine also involve fentanyl. If someone experiences a suspected overdose and is not breathing normally, you should still administer naloxone (Narcan) to reverse the possible opioid overdose. Medetomidine is not an opioid, so naloxone will not reverse its effects.
Clinicians, first responders, and other organizations should watch for possible cases of medetomidine overdose and withdrawal. While there is no reporting requirement, we encourage you to report possible cases of medetomidine overdose or withdrawal to Call (253) 649-1412, press 0 (M-F, 8 a.m.-4:30 p.m.). Or call the 24 hour Reporting Line: (253) 649-1413 and leave a message with the patient\'s first name, last name, date of birth..
For concerns about poisoning or overdose, clinicians can contact the Washington Poison Center at (800) 222‑1222. Clinicians can also consult with a medical toxicologist or addiction medicine specialist.
To learn more, please review the recent CDC Health Advisory.