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Dexmedetomidine (Precedex)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Dexmedetomidine

What it is

Dexmedetomidine is a sedative that activates alpha-2 adrenergic receptors in the brain, producing a calm, sleep-like state from which people can still be woken, with little effect on breathing. It is used for sedation in intensive care and during procedures, and as a film under the tongue for agitation in schizophrenia and bipolar disorder. It is sold as Precedex and Igalmi.

How genes come into it

Dexmedetomidine is cleared mainly by UGT enzymes and CYP2A6. Most gene studies on it looked at ADRA2A, the gene for the receptor it acts on, for how sedated people became and how much they needed, and at CYP2A6 for its clearance. The findings come from single or a few studies, and there is no CPIC or DPWG guideline.

What research found

Every published finding on gene variants and Dexmedetomidine. Upload your DNA file to see which of these rows apply to you.

Rated evidence (5 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

PRKCB rs9922316: Level 3. Other. 1.

ADRA2A rs1800544: Level 3. Other. 1.

ADRA2A rs1800035: Level 3. Efficacy: Pain, Postoperative. 1.

ADRA2A rs201376588: Level 3. Efficacy: Pain, Postoperative. 1.

Metabolism (5 findings)

Studies of how quickly the body processes this medication.

CYP2A6 rs28399433: Allele C is associated with decreased clearance of dexmedetomidine in women as compared to allele A.

CYP1A2 rs762551: Genotypes AC + CC is associated with increased clearance of dexmedetomidine in people with sedation as compared to genotype AA.

CACNB2 rs560765906: Allele T is associated with decreased clearance of dexmedetomidine in children with Pain, Postoperative as compared to allele A.

CYP2A6 CYP2A6*1, CYP2A6*4, CYP2A6*9: CYP2A6 *1/*4 + *1/*4 + *9/*9 are not associated with clearance of dexmedetomidine in ICU patients as compared to CYP2A6 *1/*1.

Response (5 findings)

Studies of how well it worked in people carrying a variant.

ADRA2A rs1800035: Genotypes CG + GG are associated with decreased response to dexmedetomidine in women with Pain, Postoperative as compared to genotype CC.

ADRA2A rs201376588: Genotypes CT + TT are associated with decreased response to dexmedetomidine in women with Pain, Postoperative as compared to genotype CC.

ADRA2A rs775887911: Genotypes CT + TT are associated with decreased response to dexmedetomidine in women with Pain, Postoperative as compared to genotype CC.

ADRB2 rs1042713: Genotype AA is associated with increased response to dexmedetomidine in people with surgery as compared to genotypes AG + GG.

Dosing (8 findings)

Studies of how much of the drug people needed or tolerated.

ADRA2A rs1800544: Genotype GG is associated with decreased dose of dexmedetomidine in people with surgery as compared to genotypes CC + CG.

CYP2D6 rs16947: Genotype GG is associated with increased dose of dexmedetomidine in people with surgery as compared to genotypes AA + AG.

KCNMA1 rs16934182: Genotypes AA + AG is associated with decreased dose of dexmedetomidine in people with surgery as compared to genotype GG.

ADRA2A rs1800544: Allele C is not associated with dose of dexmedetomidine in men as compared to allele G.

Side effects (3 findings)

Studies of side effects in people carrying a variant.

rs141294036: Genotype CC is associated with increased response to dexmedetomidine in people with surgery as compared to genotypes CT + TT.

KCNMA1 rs16934182: Genotypes AA + AG is associated with increased response to dexmedetomidine in people with surgery as compared to genotype GG.

WBP2NL rs5758550: Genotypes AG + GG is associated with increased response to dexmedetomidine in people with surgery as compared to genotype AA.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

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Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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