Xylazine

Xylazine is a structural analog of clonidine and an α2-adrenergic receptor agonist, sold under many trade names worldwide, most notably the Bayer brand name Rompun, as well as Anased, Sedazine and Chanazine. Xylazine is a common veterinary drug used for sedation, anesthesia, muscle relaxation, and analgesia in animals such as horses, cattle, and other mammals. In veterinary anesthesia, it is often used in combination with ketamine. Veterinarians also use xylazine as an emetic, especially in cats. Drug interactions vary with different animals. Xylazine was first investigated for human use in the 1960s in West Germany for antihypertensive effects before being discontinued and marketed as a veterinary sedative. Xylazine's mechanism of action was discovered in 1981, which led to the creation of other α2-adrenergic receptor agonists such as medetomidine and dexmedetomidine. Xylazine has become a commonly abused street drug in the United States where it is known by the street name "tranq", particularly in the territory of Puerto Rico. The drug is used as a cutting agent for heroin and fentanyl.

History Xylazine was discovered as an antihypertensive agent in 1962 by Farbenfabriken Bayer in Leverkusen, West Germany. In human trials xylazine was found to depress the central nervous system leading to the discontinuation of further research for its use in humans and it was instead marketed as a veterinary sedative, starting in the late 1960s. Xylazine proved popular and in the 1970s became one of the most common large animal sedatives. Xylazine's muscle relaxant effect inhibits the transmission of neural impulses in the central nervous system. In 1981 a study discovered that the cause sedation was due to xylazine's effect on the α2-adrenergic receptor. This led to the development of other α2-adrenergic receptor agonists such as detomidine, medetomidine, dexmedetomidine, and romifidine. In the United States, xylazine was approved by the FDA only for veterinary use as a sedative, analgesic, and muscle relaxant in dogs, cats, horses, elk, fallow deer, mule deer, sika deer, and white-tailed deer. In scientific research using animal experiments, xylazine is a component of the most common anesthetic, ketamine-xylazine (see: Rodent cocktail), to anesthetize rats, mice, hamsters, and guinea pigs. Xylazine has not previously been a controlled substance; however, due to illicit abuse, legislative restrictions have been proposed in multiple countries. Xylazine was made a class C drug in the UK on 15 January 2025.

Veterinary use

Xylazine is widely used in veterinary medicine as a sedative, muscle relaxant, and analgesic. It is frequently used in the treatment of tetanus. It is not used in human medical treatment. Xylazine is similar to drugs such as phenothiazines, tricyclic antidepressants, and clonidine. As an anesthetic, it is typically used in conjunction with ketamine. In animals, xylazine may be administered intramuscularly, intravenously, and intraosseously. Subcutaneous, oral transmusocal and intranasal have been investigated but are not standard routes for xylazine administration. As a veterinary anesthetic, xylazine is typically only administered once for the intended effect before or during surgical procedures. α2-Adrenergic receptor antagonists such as atipamezole and yohimbine may be used to reverse the effects of xylazine in animals. Xylazine is licensed for use in non-meat horses. Off-label use in cattle is common with recommended withholding periods of 1–5 days for dairy cattle and 4–10 days for meat cattle. Cattle are more sensitive to xylazine than horses with the sensitivity being greater in meat cattle breeds than dairy cattle breeds. Xylazine's use in cats and dogs is being replaced with the more selective alpha2 adrenergic receptor agonists medetomidine and dexmedetomidine and in some countries xylazine is rarely used with cats and dogs. High amounts of catecholamines in a patient will require higher doses of xylazine to be administered to provide sedation. The heightened levels required may not be practical or possible to administer and regular doses may cause excitement.

Side effects Side effects in animals include transient hypertension and hypotension. Xylazine decreases both respiration rate and minute ventilation, although the changes to PaCO2 and PaO2 are minor and innocuous. Xylazine has been demonstrated to reduce the dose of epinephrine that causes arrythmia in dogs anaesthetised with isoflurane and halothane. Xylazine administration in sheep activates pulmonary macrophages that damage the capillary endothelium and alveolar type I cells. This in turns causes alveolar haemorrhage and oedema causing hypoxaemia. Intracarotid administration can cause seizures and excitement in horses. Xylazine has been shown to cause myometrial contractions in pregnant cattle. Further evidence of xylazine's effect on pregnant animals is lacking and although other a2 adrenergic receptor agonists have been shown to not cause the same myometrial contraction the administration of a2 adrenergic receptor agonists is not recommended and for animals near-term should only be used in specific circumstances. Xylazine affects the glucose level via the activation of alpha2A andrenergic receptors on beta cells, which prevents insulin release. alpha2 adrenergic receptors have been reported to cause transient hyperglycaemia with xylazine being reported as a cause in cattle and equine. The renal threshold for glucose is not exceeded due to the hyperglycaemia with clinical doses. An alpha2 adrenergic receptor antagonist can reverse the effect. Emesis is the most common side effect in small animals; however, this can be a desired effect and xylazine is often used as an emetic in cats.

Pharmacokinetics

… excerpt ends here. Continue reading the full article.