Before using any combinations consult the contraindications and warnings that appear on the other products' data sheets.
Contraindications
1.Do not use in conjunction with sympathomimetic amines or with intravenous potentiated sulphonamides.
2.Do not administer simultaneously with ketamine in the same syringe (see sections interaction and administration).
3.Do not use the butorphanol combination in horses suffering from colic.
4.Do not use in seriously ill animals with heart failure or impaired liver or kidney function.
5.Do not use in case of hypersensitivity to the active substance or to any of the excipients.
6.Do not administer to horses in the last month of pregnancy.
Precautions
The product should not be used in horses with pre-existing AV blocks, with severe coronary insufficiency, respiratory disease or chronic renal failure.
Careful consideration should be given prior to administration to animals in shock and to animals with liver or kidney disease.
Intravenous administration should be slow.
It is recommended that feed should be withheld for at least 12 hours prior to anaesthesia.
The horse should not be given water or feed before the drug effect has passed.
Routine safety measures should be employed to protect practitioners and handlers.
Adverse reactions
Adverse reactions are very rare.
All alpha-2 adrenoceptor agonists, including detomidine, may cause decreased heart rate, changes in the conductivity of cardiac muscle (as evidenced by partial atrioventricular and sinoatrial blocks), changes in the respiratory rate, incoordination/ataxia and sweating.
A diuretic effect is usually observed within 45 to 60 minutes after treatment.
The potential for isolated cases of hypersensitivity exists, including paradoxical response (excitation).
Partial, transient penis prolapse may occur in male horses. In rare cases, horses may show signs of mild colic following administration of alpha-2 adrenoceptor agonists because substances of this class inhibit intestinal motility.
Occasional reports of urticaria have been received. Mild adverse reactions have reportedly resolved without treatment. Severe reactions should be treated symptomatically.
The frequency of adverse reactions is defined using the following convention:
- very common (more than 1 in 10 animals displaying adverse reaction(s) during the course of one treatment)
- common (more than 1 but less than 10 animals in 100 animals)
- uncommon (more than 1 but less than 10 animals in 1,000 animals )
- rare (more than 1 but less than 10 animals in 10,000 animals)
- very rare (less than 1 animal in 10,000 animals, including isolated reports)
Use during pregnancy, lactation
Not to be used in mares in the last month of pregnancy.
Interactions
Domosedan should not be mixed with other products.
Use with care with other sedatives and anaesthetics because of an additive/synergistic effect.
Where appropriate the product may be used in conjunction with local anaesthetic agents.
Induction of anaesthesia with detomidine and ketamine has been used prior to maintenance with halothane. Because of the nature of the induction agents, the effects of halothane may be delayed and special care must be taken to avoid over-dosage.
When detomidine is used as a premedication prior to general anaesthesia, the product may delay onset of induction.
Use in conjunction with sympathomimetic amines and intravenous potentiated sulphonamides is contra-indicated.
Overdose
Overdose may cause cardiac arrhythmia, hypotension, delayed recovery, and deep depression of the central nervous system and the respiratory system’. If recovery is delayed, it should be ensured that the animal can recover in a quiet and warm place. An oxygen supplement may be indicated in circulatory and respiratory depression. In cases of overdose, or should the effects become life-threatening, an alpha2 antagonist (atipamezole) is recommended (5-10 times the dose of detomidine in µg/kg).
AV blocks may be prevented by IV administration of atropine at 0.005 - 0.02 mg/kg. Atropine raises the heart rate but may cause arrhythmias and should be used with caution.
Operator warnings
Routine safety measures should be employed to protect practitioners and handlers.
In the case of accidental oral intake or self-injection, seek medical advice immediately and show the package leaflet to the doctor but DO NOT DRIVE as sedation and changes in blood pressure may occur.
Avoid skin, eye or mucosal contact.
Immediately after exposure, wash the exposed skin with large amounts of fresh water.
Remove contaminated clothes that are in direct contact with skin.
In the case of accidental contact of the product with eyes, rinse with large amounts of fresh water. If symptoms occur, seek the advice of a doctor.
If pregnant women handle the product, special caution should be observed not to self inject as uterine contractions and decreased foetal blood pressure may occur after accidental systemic exposure.
Advice to doctors: Detomidine hydrochloride is an alpha2-adrenoreceptor agonist. Symptoms after absorption may involve clinical effects including dose-dependent sedation, respiratory depression, bradycardia, hypotension, a dry mouth, and hyperglycaemia. Ventricular arrhythmias have also been reported. Respiratory and haemodynamic symptoms should be treated symptomatically.
Withdrawal Period
Horses (meat and offal): 1 day