Acepromazine

What is acepromazine?

Acepromazine maleate (brand names and alternative names: acetylpromazine, ACE, ACP, PromAce®) is a sedative/tranquilizer used as a pre-anesthetic and for chemical restraint in dogs and cats.  

Its use in small exotics as a pre-anesthetic or tranquilizer is “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is acepromazine given?

Acepromazine is administered as an injection in the muscle, under the skin, or in the vein, usually within the hospital setting. It can also be given as a tablet by mouth. It should be given 45 minutes to an hour before a procedure or event.

The tranquilization effects of acepromazine can be overridden, and it cannot always be counted upon when used as a restraining agent in pets.

What if I miss giving my pet the acepromazine?

Typically, this medication is not given on a schedule. Your veterinarian will provide you with information specific to your pet with regards to missed doses.

Are there any potential side effects?

The most common and important side effect of acepromazine use is low blood pressure, and in severe cases, it can cause cardiovascular collapse. In cats, it can also decrease tear production. Occasionally, aggressiveness and hyperactivity can occur, and when given in the muscle, this medication can cause temporary pain at the injection site. This drug may also cause the urine to become mildly discolored pinkish to red-brown, but is not concerning and will resolve.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Acepromazine should not be used in pets that have been exposed to organophosphates, strychnine, or procaine, or in pets with significant heart disease, low blood pressure, severe dehydration, tetanus, or shock. It should be used with caution in pets with liver disease, heart disease, clotting problems, or low platelets, as well as in debilitated, pregnant, or young animals.

Some breeds of dogs (e.g., collies, sheepdogs, and collie- or sheepdog-cross breeds) are more sensitive than others to medications, such as acepromazine. This is typically due to a specific genetic mutation (MDR1 or ABCB1-1delta) that makes them less able to tolerate high doses of these medications. Lower doses of acepromazine should be used in dogs with MDR1 mutations, as well as giant breeds, greyhounds, and Boxers from UK-bred lines. If given at normal doses, the effect may be stronger and last longer in these breeds.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when used with acepromazine: acetaminophen, antacids, antidiarrheal mixtures, emetics (e.g. apomorphine), cisapride, central nervous system depressants, dopamine, emetics, fluoxetine, hypotensive agents, metoclopramide, metronidazole, NSAIDs, opiates, organophosphate agents, phenobarbital, phenytoin, procaine, propranolol, quinidine, or sucralfate.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Your veterinarian may regularly monitor your pet's heart rate, heart rhythm, and blood pressure while your pet is taking this medication. Body temperature should also be checked, especially if the environmental temperature is warmer or colder than average room temperature.

How do I store acepromazine?

Acepromazine should be stored in a dark place protected from light. Tablets should be stored at room temperature in a tight container.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.