Xylazine | The JHI

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Xylazine

Found in:  

Cocaine, Fentanyl, also sold as pure substance

Type/Reason added:  

Veterinary Tranquilizer

Relative Potency:  

n/a

Overview

The Effects

Treatment Options

Supportive Care:

Airway management, oxygenation, fluid resuscitation for hypotension, and cardiac monitoring. There is no specific opioid reversal agent effective against xylazine because it is not an opioid.

Antidote:

No reversal reagent for xylazine, and no effective withdrawal treatment. Treating acute toxicity due to xylazine alone primarily focuses on supporting respiratory depression and blood
pressure (27–29).

However, naloxone may be administered to treat any concomitant opioid toxidrome as it is commonly reported to be coadministered primarily with opioids such as fentanyl (27,28).

Pharmacokinetics and Dynamics

Metabolism:

Xylazine is metabolized by cytochrome P450 enzymes in the liver and excreted through the kidney. (28)

Xylazine was also shown to have a very high volume of distribution, with values ranging between 1.9 and 2.5. Distribution half-life and elimination half-life yielding values between 1.21 and 5.97 min and 23.11 and 49.51 min respectively. (27)

Drug-Drug Interactions:

Xylazine’s depressant effects are dangerously amplified when combined with opioids, benzodiazepines, alcohol, or other CNS depressants. These combinations significantly heighten the risk of respiratory failure, unconsciousness, and death.