thoughtscape NP Psychiatry · Patient education
Dexmedetomidine
Igalmi film / Separate hospital IV formulations
A guide for adults receiving dexmedetomidine.
Follow the directions from your treating healthcare team.
Formulations: Igalmi is a dissolving film placed under the tongue or behind the lower lip. Hospital IV formulations are not interchangeable with the film.
What it is used for
Igalmi treats acute agitation associated with schizophrenia or bipolar I or II disorder in adults under a healthcare provider’s supervision. IV dexmedetomidine is used for sedation in monitored medical settings and has a different regimen.
How it works
It activates alpha-2 receptors, reducing norepinephrine signaling and arousal. This can reduce agitation while also lowering blood pressure and pulse.
What to expect over time
The purpose is short-term relief of acute agitation. Staff reassess symptoms, blood pressure, pulse, and alertness. It does not replace ongoing treatment for schizophrenia or bipolar disorder.
Taking your medication
- Use the film only under the prescribed clinical supervision. Let it dissolve; do not chew or swallow it.
- Do not eat or drink for at least 15 minutes after under-the-tongue use or one hour after use behind the lower lip.
- Remain in the monitored setting as instructed. Additional doses are a clinical decision.
- Do not drive or perform hazardous activities for at least eight hours, and longer if still impaired.
When to get help
Emergency symptoms. Tell staff immediately about fainting, chest pain, breathing trouble, or inability to stay awake. Call 911 if these occur after leaving care.
Prompt medical advice. Report persistent severe dizziness, weakness, or palpitations. Do not take additional medication to manage these symptoms without instructions.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Sleepiness or dizziness
- Low blood pressure or slow pulse
- Dry mouth or numbness/tingling in the mouth with film
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
The clinical team monitors vital signs and alertness. Stay seated or lying down when directed and ask for help before standing.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Tell staff about low blood pressure, fainting, slow pulse, heart block, dehydration, liver disease, and all recently taken medicines or substances. Discuss pregnancy and breastfeeding with the treating team.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Other sedatives and medications that lower blood pressure or heart rate can intensify effects. Medicines that prolong QT need review. Tell staff about alcohol, opioids, sleeping pills, and blood-pressure medicines.
Everyday tips
Tell staff if you need help standing or walking.
Arrange transportation and follow the discharge instructions.
Your questions answered
Can I keep it for unsupervised use?
This guide describes administration under healthcare supervision. Follow the prescribing instructions; do not use a hospital sedative preparation at home.
Is sleepiness the same as recovery?
No. The team also evaluates the cause of agitation and the plan for ongoing treatment and safety.
Storage and safety
The prescribed formulation should be stored and handled according to its label and the treating facility’s instructions. Keep films secure from children; do not share them.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.