[1] It is a racemic mixture of two stereoisomers, levomedetomidine and dexmedetomidine, the latter being the isomer with the pharmacologic effect as an alpha 2- adrenergic agonist.

[citation needed] In veterinary anesthesia, medetomidine is used as both a surgical and analgesic in combinations with opioids (butorphanol, buprenorphine etc.)

It is sometimes used in combination with butorphanol and ketamine (given IM) to produce general anaesthesia for short periods in healthy, but fractious felines, that will not allow an intravenous induction agent to be given providing a good degree of muscle relaxation.

It is thought that this family of drugs has a degree of analgesic action, though this is, in comparison to the sedative effect, minor.

[6] Often the dosage of induction agents (e.g. propofol) may be drastically reduced, as may the volumes of anesthetic gases (i.e. halothane, isoflurane, sevoflurane) used to maintain general anesthesia.

The Center for Forensic Science Research and Education (CFSRE) first identified a synthetic opioid blend containing fentanyl and medetomidine sold in Maryland in July, 2023.

During summer 2024 there were "mass overdose events" linked to medetomidine adulterated drugs in Chicago and Philadelphia.

Emergency room doctors in Philadelphia reported waves of overdose patients coming in with unusually low heart rates.

Experts warned that it was not business as usual for first responders, emergency room personnel or drug users.

Such a mixture wouldn't be used for recreational use and would instead likely produce dysphoria with heavy sedative effects that may render a person immobile or unable to defend themselves.