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  3. Alfaxalone
Alfaxalone
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Alfaxalone

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This is a drug monograph from the BSAVA Small Animal Formulary Part B: Exotic Pets. BSAVA members should login for access to the full monograph. Non-members can join BSAVA, buy a Formulary subscription, or buy the printed edition.
  1. Álvarez ER, Solé LV and de Carellán Mateo AG (2022) Comparison of subcutaneous sedation with alfaxalone or alfaxalone-midazolam in pet guinea pigs (Cavia porcellus) of three different age groups. Journal of the American Veterinary Medical Association 260(9), 1024–1030
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  2. Arenillas M and Gomez de Segura IA (2018) Anaesthetic effects of alfaxalone administered intraperitoneally alone or combined with dexmedetomidine and fentanyl in the rat. Laboratory Animals 52(6), 588–598
    3.
  3. Bakker J, Uilenreef JJ, Pelt ER, Brok HP, Remarque EJ and Langermans JA (2013) Comparison of three different sedative-anaesthetic protocols (ketamine, ketamine-medetomidine and alphaxalone) in common marmosets (Callithrix jacchus). BMC Veterinary Research 9, 1–13
    4.
  4. Bertrand HG, Sandersen C, Murray J and Flecknell PA (2017) A combination of alfaxalone, medetomidine and midazolam for the chemical immobilization of Rhesus macaque (Macaca mulatta): preliminary results. Journal of Medical Primatology 46(6), 332–336
    5.
  5. Doerning CM, Bradley MP, Lester PA and Nowland MH (2018) Effects of subcutaneous alfaxalone alone and in combination with dexmedetomidine and buprenorphine in guinea pigs (Cavia porcellus). Veterinary Anaesthesia and Analgesia 45(5), 658–666
    6.
  6. Grint NJ, Smith HE and Senior JM (2008) Clinical evaluation of alfaxalone in cyclodextrin for the induction of anaesthesia in rabbits. Veterinary Record 163(13), 395–396
  7. Huynh M, Poumeyrol S, Pignon C, Le Teuff G and Zilberstein L (2014) Intramuscular administration of alfaxalone for sedation in rabbits. Veterinary Record 176, 255
    8.
  8. Kunze PE, Molina CV, Lima DM, Arias-Lugo MA, Pissinatti A, Moreira SB and Sanchez CR (2021) Comparison between three dosages of intramuscular alfaxalone and a ketamine–dexmedetomidine–midazolam–tramadol combination in golden-headed lion tamarins (Leontopithecus chrysomelas). Veterinary Anaesthesia and Analgesia 48(5), 697–706
    9.
  9. Lau C, Ranasinghe MG, Shiels I, Keates H, Pasloske K and Bellingham MC (2013) Plasma pharmacokinetics of alfaxalone after a single intraperitoneal or intravenous injection of Alfaxan® in rats. Journal of Veterinary Pharmacology and Therapeutics 36(5), 516–520
    10.
  10. Lennox A (2015) Introducing alfaxalone into exotic companion mammal practice. Proceedings of AEMV Conference, San Antonio, Texas.
    11.
  11. Marion BM, Ghering JM, Dixon BC et al. (2022) Comparison of alfaxalone-midazolam, tiletamine-zolazepam, and ketamine-acepromazine anesthesia during plethysmography in Cynomolgus Macaques (Macaca fascicularis) and Rhesus Macaques (Macaca mulatta). Comparative Medicine 72(4), 248–256
    12.
  12. Marsh MK, McLeod SR, Hansen A and Maloney SK (2009) Induction of anaesthesia in wild rabbits using a new alfaxalone formulation. Veterinary Record 164(4), 122–123
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  13. Miyabe‐Nishiwaki T, Miwa M, Konoike N et al. (2020) Evaluation of anaesthetic and cardiorespiratory effects after intramuscular administration of alfaxalone alone, alfaxalone-ketamine and alfaxalone-butorphanol-medetomidine in common marmosets (Callithrix jacchus). Journal of Medical Primatology 49(6), 291–299
    14.
  14. Navarrete‐Calvo R, Gómez‐Villamandos RJ, Morgaz J et al. (2014) Cardiorespiratory, anaesthetic and recovery effects of morphine combined with medetomidine and alfaxalone in rabbits. Veterinary Record 174(4), 95
    15.
  15. Parkinson L and Mans C (2017) Anesthetic and postanesthetic effects of alfaxalone–butorphanol compared with dexmedetomidine–ketamine in chinchillas (Chinchilla lanigera). Journal of the American Association for Laboratory Animal Science 56(3), 290–295
    16.
  16. Tutunaru AC, Sonea A, Drion P, Serteyn D and Sandersen C (2013) Anaesthetic induction with alfaxalone may produce hypoxemia in rabbits premedicated with fentanyl/droperidol. Veterinary Anaesthesia and Analgesia 40(6), 567–659
    17.
  17. Vaughan KL, Toepfer K and Mattison JA (2024) Physiological effects of alfaxalone anesthesia on rhesus monkeys during intravenous glucose tolerance testing. Plos One 19(7), e0308007
    18.
  18. Conner CM, Hoppes SM, Stevens BJ and Simon BT (2022) Intranasal butorphanol and midazolam administered prior to intramuscular alfaxalone provides safe and effective sedation in Quaker parrots (Myiopsitta monachus). American Journal of Veterinary Research, 83(12)
  19. Escalante GC, Balko JA and Chinnadurai SK (2018) Comparison of the sedative effects of alfaxalone and butorphanol-midazolam administered intramuscularly in budgerigars (Melopsittacus undulatus). Journal of Avian Medicine and Surgery 32(4), 279–285
    20.
  20. Greunz EM, Limón D and Bertelsen MF (2021) Alfaxalone sedation in black-cheeked lovebirds (Agapornis nigrigenis) for non-invasive procedures. Journal of Avian Medicine and Surgery 35(2), 161–166
    21.
  21. Kılıç, N. (2021). Clinical evaluation of Alfaxalone in cyclodextrin as an intravenous anesthetic in the common buzzards (Buteo buteo). Iranian Journal of Veterinary Surgery 16(1), 24–28
    22.
  22. Lierz M and Korbel R (2012) Anaesthesia and analgesia in birds. Journal of Exotic Pet Medicine 21(1), 44–58
    23.
  23. Perrin KL, Nielsen JB, Thomsen AF and Bertelsen MF (2017) Alfaxalone anesthesia in the Bengalese finch (Lonchura domestica). Journal of Zoo and Wildlife Medicine 48(4), 1146–1153
    24.
  24. Whitehead MC, Hoppes SM, Musser JM, Perkins JL and Lepiz ML (2019) The use of alfaxalone in quaker parrots (Myiopsitta monachus). Journal of Avian Medicine and Surgery, 33(4), 340–348
  25. Bertelsen MF and Sauer CD (2011) Alfaxalone anaesthesia in the green iguana (Iguana iguana). Veterinary Anaesthesia and Analgesia 38(5), 461–466
    26.
  26. Chen K, Keating S, Strahl-Heldreth D and Clark-Price S (2020) Effects of intracoelomic alfaxalone–dexmedetomidine on righting reflex in common garter snakes (Thamnophis sirtalis): preliminary data. Veterinary Anaesthesia and Analgesia, 47(6), 793–796
    27.
  27. Gaudio E, voltan L and De Benedictis GM (2018) Alfaxalone anaesthesia in Lemur catta following dexmedetomidine-butorphanol-midazolam sedation. Veterinary Anaesthesia and Analgesia 45(30), 351–356
    28.
  28. Gil AG, Silván G, Villa A and Illera JC (2012) Heart and respiratory rates and adrenal response to propofol or alfaxalone in rabbits. Veterinary Record 170 (17), 444
    29.
  29. Giral M, García-Olmo DC, Gómez-Juárez M and Gómez de Segura IA (2014) Anaesthetic effects in the ferret of alfaxalone alone and in combination with medetomidine or tramadol: a pilot study. Laboratory Animals 48(4), 313–320
    30.
  30. Hansen LL and Bertelsen MF (2013) Assessment of the effects of intramuscular administration of alfaxalone with and without medetomidine in Horsfield tortoises (Agrionemys horsfieldii). Veterinary Anaesthesia and Analgesia 40(6), 68–75
    31.
  31. Hawkins S, Doss G and Mans C (2020) Evaluation of subcutaneous alfaxalone-midazolam and ketamine-midazolam sedation protocols in African pygmy hedgehogs (Atelerix albiventris). Journal of the American Veterinary Medical Association 257, 820–825
    32.
  32. James LE, Williams CJ, Bertelsen MF and Wang T (2018) Anaesthetic induction with alfaxalone in the ball python (Python regius): dose response and effect of injection site. Veterinary Anaesthesia and Analgesia 45(3), 329–337
    33.
  33. Jones KL (2012) Therapeutic review: alfaxalone. Journal of Exotic Pet Medicine 4, 347–353
    34.
  34. Kischinovsky M, Duse A, Wang T and Bertelsen MF (2013) Intramuscular administration of alfaxalone in red-earded sliders (Trachemys scripta elegans) – effects of dose and body temperature. Veterinary Anaesthesia and Analgesia 40, 13–20
    35.
  35. Kleinschmidt LM, Hanley CS, Sahrmann JM and Padilla LR (2018) Randomized controlled trial comparing the effects of alfaxalone and ketamine hydrochloride tn the Haitian Giant Galliwasp (Celestus Warreni). Journal of Zoo and Wildlife Medicine 49(2), 283–290
    36.
  36. Knotek Z (2014) Alfaxalone as an induction agent for anaesthesia in terrapins and tortoises. Veterinary Record 175(13), 327
    37.
  37. Knotek Z (2017) Induction to inhalation anaesthesia in agamid lizards with alfaxalone. Veterinarni Medicina 62(1), 41–43
    38.
  38. Knotek Z, Hrda A, Kley N and Knotkova Z (2011) Alfaxalone anesthesia in veiled chameleon (Chamaeleo calyptratus). Proceedings of the Association of Reptilian and Amphibian Veterinarians, pp. 179–181
    39.
  39. Knotek Z, Hrda A, Knotkova Z, Barazorda Romero S and Habich A (2013) Alfaxalone anaesthesia in the green iguana (Iguana iguana). Acta Veterinaria Brno 82, 109–114
    40.
  40. Morici M, Di Giuseppe M, Spadola F et al. (2018) Intravenous alfaxalone anaesthesia in Leopard Geckos (Eublepharis macularius). Journal of Exotic Pet Medicine 27(3), 11–14
    41.
  41. Morici M, Lubian E, Costa GL and Spadola F (2021). Difference between cranial and caudal intravenous alfaxalone administration in Yellow-Bellied Sliders (Trachemys scripta scripta). Acta Veterinaria Eurasia 47(2), 88–93
    42.
  42. Perrin KL and Bertelsen MF (2017). Intravenous alfaxalone and propofol anesthesia in the bearded dragon (Pogona vitticeps). Journal of Herpetological Medicine and Surgery 27(3–4), 123–126
    43.
  43. Rockwell K, Boykin K, Padlo J et al. (2021) Evaluating the efficacy of alfaxalone in corn snakes (Pantherophis guttatus). Veterinary Anaesthesia and Analgesia 48(3), 364–371
    44.
  44. Rockwell K, Boykin K, Padlo J, Ford C, Aschebrock S and Mitchell M (2021) Evaluating the efficacy of alfaxalone in corn snakes (Pantherophis guttatus). Veterinary Anaesthesia and Analgesia 48(3), 364–371
    45.
  45. Scheelings TF, Baker RT, Hammersley G, Hollis K, Elton I and Holz P (2011) A preliminary investigation into the chemical restraint with alfaxalone of selected Australian squamate species. Journal of Herpetological Medicine and Surgery 21, 63–67
    46.
  46. Scheelings TS (2013) Use of intravenous and intramuscular alfaxalone in Macquarie river turtles (Emydura macquarii). Proceedings of the Association of Reptilian and Amphibian Veterinarians, pp. 71
    47.
  47. Strahl-Heldreth DE, Clark-Price SC, Keating SC et al. (2019) Effect of intracoelomic administration of alfaxalone on the righting reflex and tactile stimulus response of common garter snakes (Thamnophis sirtalis). American Journal of Veterinary Research 80(2), 144–151
    48.
  48. Adami C, Spadavecchia C, Angeli G and d'Ovidio D (2015) Alfaxalone anesthesia by immersion in oriental fire‐bellied toads (Bombina orientalis). Veterinary Anaesthesia and Analgesia 42(5), 547–551
  49. [if !supportLists]Adami C, d’Ovidio D and Casoni D (2016) Alfaxalone–butorphanol versus alfaxalone–morphine combination for immersion anaesthesia in oriental fire-bellied toads (Bombina orientalis). Laboratory Animals 50(3), 204–211
    50.
  50. Cermakova E, Oliveri M, Ceplecha V and Knotek Z (2020) Anesthesia with intramuscular administration of alfaxalone in Spanish ribbed newt (Pleurodeles waltl). Journal of Exotic Pet Medicine 33, 23–26
  51. Lang DM, Freeman EJ, Griffioen JA et al. (2024) Comparison of subcutaneous alfaxalone and subcutaneous alfaxalone–dexmedetomidine for sedation in the houston toad (Anaxyrus houstonensis). Journal of Zoo and Wildlife Medicine 55(1), 102–110
    52.
  52. McMillan MW and Leece EA (2011) Immersion and branchial/transcutaneous irrigation anaesthesia with alfaxalone in a Mexican axolotl. Veterinary Anaesthesia and Analgesia 38 (6), 619–623
    53.
  53. Posner LP, Bailey KM, Richardson EY, Motsinger-Reif AA and Harms CA (2013) Alfaxalone anesthesia in bullfrogs (Lithobates catesbeiana) by injection or immersion. Journal of Zoo Wildlife and Medicine 44(4), 965–971
    54.
  54. Sladakovic I, Johnson RS and Vogelnest L (2014) Evaluation of intramuscular alfaxalone in three Australian frog species (Litoria caerulea, Litoria aurea, Litoria booroolongensis). Journal of Herpetological Medicine and Surgery 24(1), 36–42
    55.
  55. Spitznagel K, Sadar MJ, Willis EL and Brandão J (2023) Intramuscular alfaxalone effective dose (ED) determination and cardiopulmonary effects of ED99 in Sonoran Desert Toads (Incilius alvarius). Journal of Herpetological Medicine and Surgery 33 (4), 251–256
    56.
  56. Williams CJ, Alstrup AK, Bertelsen MF, Jensen HM, Leite CA and Wang T (2018) Cardiovascular effects of alfaxalone and propofol in the bullfrog (Lithobates catesbeianus). Journal of Zoo and Wildlife Medicine 49 (1), 92–98
    57.
  57. Yaw TJ, Mans C, Martinelli L and Sladky KK (2020) Comparison of subcutaneous administration of alfaxalone–midazolam–dexmedetomidine with ketamine–midazolam–dexmedetomidine for chemical restraint in juvenile blue poison dart frogs (Dendrobates tinctorius azureus). Journal of Zoo and Wildlife Medicine 50(4), 868–873
  58. Yaw TJ, Mans C, Martinelli L and Sladky K K (2020) Evaluation of subcutaneous alfaxalone for sedation in juvenile blue Poison Dart frogs (Dendrobates tinctorius azureus). Journal of Herpetological Medicine and Surgery 30(4), 248–253
    59.
  59. Yaw T J, Mans C, Martinelli L and Sladky KK (2020) Comparison of subcutaneous administration of alfaxalone–midazolam–dexmedetomidine with ketamine–midazolam–dexmedetomidine for chemical restraint in juvenile blue Poison Dart frogs (Dendrobates tinctorius azureus). Journal of Zoo and Wildlife Medicine 50(4), 868–873
    60.
  60. Bailey KM, Minter LJ, Lewbart GA, Harms CA, Griffith EH and Posner LP (2014) Alfaxalone as an intramuscular injectable anesthetic in koi carp (Cyprinus carpio). Journal of Zoo and Wildlife Medicine 45(4), 852–8
    61.
  61. Bauquier SH, Greenwood J and Whittem T (2013) Evaluation of the sedative and anaesthetic effects of five different concentrations of alfaxalone in goldfish (Carassius auratus). Aquaculture 396, 119–123
    62.
  62. Bugman AM, Langer PT, Hadzima E, Rivas AE and Mitchell MA (2016) Evaluation of the anesthetic efficacy of alfaxalone in oscar fish (Astronotus ocellatus). American Journal of Veterinary Research 77(3), 239–244
    63.
  63. Minter LJ, Bailey KM, Harms CA, Lewbart GA and Posner LP (2014) The efficacy of alfaxalone for immersion anesthesia in koi carp (Cyprinus carpio). Veterinary Anaesthesia and Analgesia 41(4), 398–405
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