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Acepromazine

Grade

Sedation/Premedication

We offer no GRADED recommendations regarding patient suitability, indication suitability or the suitability, safety or efficacy of any dosing protocol.


  • Only limited information is available regarding the use of non-reversible hypotensive, sedative premedications such as acepromazine in rabbits. Experimental use is reported in journal papers, and some current mainstream veterinary textbooks offer anecdotal dosing suggestions.

Dosing Suggestion(s)

  • 0.1-1.0 mg/kg, Once, SC/IM/Slow IV (Ref)

Subsequent Treatment

  • Additional doses have little clinical benefit and amplify the adverse effects profile. 

Additional Medications

  • Where employed, Acepromazine is generally administered at a low dose as part of balanced anaesthesia (neuroleptanalgesia/neuroleptanaesthesia) alongside additional agents such as opiates and injectable induction agents such as alfaxalone and propofol.

Patient Support

  • Patients should be managed within a suitable low-stress environment away from sounds, smells and contact with predators such as cats and dogs. 

  • Rabbits treated with Acepromazine benefit from supplementary oxygen and suitable heat to mitigate some of the effects of hypotension and hypothermia.

Suitability

  • ASA 1 & ASA2: Cautious use ONLY in normotensive, normothermic patients. Acepromazine is generally considered a poor choice of premedication in clinical settings.

  • Limited information is available regarding using non-reversible hypotensive premedications such as acepromazine in rabbits. Substantial data is available for reversible α2 adrenergic agonists, which are generally preferred.



Therapeutics

Therapeutics

About Acepromazine

  • Acepromazine possesses anti-emetic, anti-convulsant, hypothermic, hypotensive and anti-spasmodic properties and shows a marked potentiating effect on barbiturate anaesthesia.

  • Acepromazine decreases lower oesophageal sphincter pressure. Sedation and a reduction in spontaneous activity Phenothiazine with depressant effect on the CNS.

  • Phenothiazines have varying degrees of anticholinergic, antihistaminic, antispasmodic, and alpha-adrenergic blocking effects.

Multimodal Use

  • Acepromazine is generally administered at a low dose as part of balanced anaesthesia alongside additional agents such as opiates and injectable induction agents such as alfaxalone and propofol. 

  • Only limited information regarding using non-reversible hypotensive premedications such as acepromazine in rabbits is available.

Adverse Effects 

  • Common: Expected adverse effects include prolonged hypotension and hypothermia.

Reproductive Safety 

Use is not recommended in breeding animals and during pregnancy and lactation.

  • Pregnancy: Use is not recommended. 

  • Lactation: Use is not recommended. 

  • Male Fertility: Use is not recommended. 

  • Female Fertility: Use is not recommended.

  • Neonates: Use is not recommended.

Treatment Goals

  • Premedication: To reduce the dose of anaesthetic induction agents and improve the quality of rabbit anaesthesia, ensuring a minimal risk of death or other anaesthetic complications and a smooth, controllable anaesthetic recovery. 

  • Anxiolysis: Reduction in heart rate and other consequences of catecholamine release during stress and handling.

Treatment Endpoint

  • N/A: A single dose is recommended.

Efficacy

  • The risk of death and anaesthetic complications are unknown. 

  • No specific data is available regarding the outcomes of rabbits premedicated with acepromazine in clinical settings. 

  • Some evidence suggests that animals treated with acepromazine and additional agents experience anxiolysis and sedation with persistent hypotension.

Alternative Products

  • See the use of α2 adrenergic agonists (Dexmedetomidine and Medetomidine), opiates and midazolam as rabbit premedications.

Alternative Protocols  

  • See the use of α2 adrenergic agonists (Dexmedetomidine and Medetomidine), opiates and midazolam as rabbit premedications.

Clinical Review

  • The authors propose a V-GRADE 0 | Absence of evidence with proposed efficacy. This V-GRADE determination is based on two papers. The authors also used literature describing the active substance and a product SPC. No Delphi review has been performed. This is a pilot monograph.

Suitability

  • ASA 1 & 2 patients: Cautious use ONLY in normotensive, normothermic patients. Alternative reversible options with a significant supporting evidence base are preferred where available.  

  • ASA 3/4 patients: Contraindicated

Recommendations 

  • The authors cannot provide recommendations on patient suitability, indication suitability or the suitability, safety or efficacy of this dosing protocol.

Evidence

Evidence Base

Acepromazine Literature Review

  1. Cruz, F.S., Carregaro, A.B., Raiser, A.G., Zimmerman, M., Lukarsewski, R., Steffen, R.P., 2010. Total intravenous anesthesia with propofol and S(+)-ketamine in rabbits. Vet Anaesth Analg 37, 116–122. https://doi.org/10.1111/j.1467-2995.2009.00513.x

  2. Donovan, J., Brown, P., 2001. Anesthesia. Curr Protoc Immunol Chapter 1, Unit 1.4. https://doi.org/10.1002/0471142735.im0104s27

  3. Ghaffari, M.S., Moghaddassi, A.P., 2010. Effects of ketamine-diazepam and ketamine-acepromazine combinations on intraocular pressure in rabbits. Vet Anaesth Analg 37, 269–272. https://doi.org/10.1111/j.1467-2995.2010.00531.x

  4. Ghaffari, M.S., Moghaddassi, A.P., Bokaie, S., 2009. Effects of intramuscular acepromazine and diazepam on tear production in rabbits. Vet Rec 164, 147–148. https://doi.org/10.1136/vr.164.5.147

  5. Hobbs, B.A., Rolhall, T.G., Sprenkel, T.L., Anthony, K.L., 1991. Comparison of several combinations for anesthesia in rabbits. Am J Vet Res 52, 669–674.

  6. Jeske, J., Stochla, K., 1966. [Effect of acetylpromazine on blood sugar as well as on hypoglycemia and hyperglycemia in rabbits]. Acta Pol Pharm 23, 285–287.

  7. Lefebvre, H.P., Jaeg, J.P., Rico, A.G., Toutain, P.L., Braun, J.P., 1992. Variations of plasma creatine kinase in rabbits following repetitive blood sampling effects of pretreatment with acepromazine, carazolol and dantrolene. Eur J Clin Chem Clin Biochem 30, 425–428.

  8. Lipman, N.S., Marini, R.P., Erdman, S.E., 1990. A comparison of ketamine/xylazine and ketamine/xylazine/acepromazine anesthesia in the rabbit. Lab Anim Sci 40, 395–398.

  9. Ludders, J.W., Thomas, C.B., Sharp, P., Sedgwick, C.J., 1987. An anesthetic technique for repeated collection of blood from New Zealand White rabbits. Laboratory animal science (USA).

  10. Mazzaferro, V., Makowka, L., Enrichens, F., Kahn, D., Ferla, G., Banner, B., Olivero, G., Selby, R.R., Stevenson, W.C., Todo, S., 1989. A modified technique of orthotopic transplant of the kidney in rabbits. J Invest Surg 2, 293–303. https://doi.org/10.3109/08941938909057435

  11. McCormick, M.J., Ashworth, M.A., 1971. Acepromazine and methoxyflurane anesthesia of immature New Zealand white rabbits. Lab Anim Sci 21, 220–223.

  12. Moore, L.R., Chang, S.F., Greenstein, E.T., 1987. Urethane-acepromazine: a novel method of administering parenteral anesthesia in the rabbit. Methods Find Exp Clin Pharmacol 9, 711–715.

  13. Najman, I.E., Ferreira, J.Z., Abimussi, C.J.X., Floriano, B.P., Meneghetti, T.M., Oliva, V.N.L.S., do Nascimento, P., 2015. Ultrasound-assisted periconal ocular blockade in rabbits. Vet Anaesth Analg 42, 433–441. https://doi.org/10.1111/vaa.12237

  14. Raillard, M., Detotto, C., Grepper, S., Beslac, O., Fujioka-Kobayashi, M., Schaller, B., Saulacic, N., 2019. Anaesthetic and Perioperative Management of 14 Male New Zealand White Rabbits for Calvarial Bone Surgery. Animals (Basel) 9, 896. https://doi.org/10.3390/ani9110896

  15. Vachon, P., 1999. Self-mutilation in rabbits following intramuscular ketamine-xylazine-acepromazine injections. Can Vet J 40, 581–582.

Premedication

  1. Cruz, F.S., Carregaro, A.B., Raiser, A.G., Zimmerman, M., Lukarsewski, R., Steffen, R.P., 2010. Total intravenous anesthesia with propofol and S(+)-ketamine in rabbits. Vet Anaesth Analg 37, 116–122. https://doi.org/10.1111/j.1467-2995.2009.00513.x

  2. McCormick, M.J., Ashworth, M.A., 1971. Acepromazine and methoxyflurane anesthesia of immature New Zealand white rabbits. Lab Anim Sci 21, 220–223.

KAX Anaesthesia

  1. Donovan, J., Brown, P., 2001. Anesthesia. Curr Protoc Immunol Chapter 1, Unit 1.4. https://doi.org/10.1002/0471142735.im0104s27

  2. Ghaffari, M.S., Moghaddassi, A.P., 2010. Effects of ketamine-diazepam and ketamine-acepromazine combinations on intraocular pressure in rabbits. Vet Anaesth Analg 37, 269–272. https://doi.org/10.1111/j.1467-2995.2010.00531.x

  3. Hobbs, B.A., Rolhall, T.G., Sprenkel, T.L., Anthony, K.L., 1991. Comparison of several combinations for anesthesia in rabbits. Am J Vet Res 52, 669–674.

  4. Lipman, N.S., Marini, R.P., Erdman, S.E., 1990. A comparison of ketamine/xylazine and ketamine/xylazine/acepromazine anesthesia in the rabbit. Lab Anim Sci 40, 395–398.

  5. Ludders, J.W., Thomas, C.B., Sharp, P., Sedgwick, C.J., 1987. An anesthetic technique for repeated collection of blood from New Zealand White rabbits. Laboratory animal science (USA).

  6. Mazzaferro, V., Makowka, L., Enrichens, F., Kahn, D., Ferla, G., Banner, B., Olivero, G., Selby, R.R., Stevenson, W.C., Todo, S., 1989. A modified technique of orthotopic transplant of the kidney in rabbits. J Invest Surg 2, 293–303. https://doi.org/10.3109/08941938909057435

  7. Najman, I.E., Ferreira, J.Z., Abimussi, C.J.X., Floriano, B.P., Meneghetti, T.M., Oliva, V.N.L.S., do Nascimento, P., 2015. Ultrasound-assisted periconal ocular blockade in rabbits. Vet Anaesth Analg 42, 433–441. https://doi.org/10.1111/vaa.12237

  8. Raillard, M., Detotto, C., Grepper, S., Beslac, O., Fujioka-Kobayashi, M., Schaller, B., Saulacic, N., 2019. Anaesthetic and Perioperative Management of 14 Male New Zealand White Rabbits for Calvarial Bone Surgery. Animals (Basel) 9, 896. https://doi.org/10.3390/ani9110896

Expert Opinion

  1. 1317822 Extrapolation of pharmacological properties in man and veterinary species. Some material employed in collating the data displayed here was taken from veterinary product datasheets or extrapolated from pharmacology texts.



Monograph Details

Monograph Details

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