Igalmi

Q: What is Igalmi (dexmedetomidine) used for?

Igalmi (dexmedetomidine) is used in the healthcare setting to ease agitation (irritability or restlessness) in adults with [schizophrenia](https://www.goodrx.com/conditions/schizophrenia) or [bipolar disorder](https://www.goodrx.com/conditions/bipolar-disorder). It's only meant to be used short-term if someone becomes suddenly agitated. The safety and how well Igalmi (dexmedetomidine) works have only been studied within 24 hours of a single dose. Researchers don't know if this medication will continue to be safe or work well after this time. So Igalmi (dexmedetomidine) isn't a medication you take on a regular basis.

Q: How does Igalmi (dexmedetomidine) work?

Igalmi (dexmedetomidine) is an [alpha agonist](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4389556/#s5title). It [works](https://www.igalmihcp.com/mechanism-of-action) by activating alpha receptors (proteins) in the brain. When the receptors are activated, they block a chemical called norepinephrine from being released by the brain. Your brain makes norepinephrine when you're stressed. This is the chemical that makes people feel agitated. So Igalmi (dexmedetomidine) is thought to ease agitation by blocking norepinephrine.

Q: Can I take Igalmi (dexmedetomidine) at home?

No, Igalmi (dexmedetomidine) isn't a medication you can pick up at the pharmacy and give to yourself at home. You'll receive medication at a treatment center under a healthcare provider's supervision. This is because your provider needs to monitor you for side effects after taking Igalmi (dexmedetomidine).

dexmedetomidine

Used for Bipolar Disorder, Schizophrenia

Igalmi (dexmedetomidine) is a newer medication approved to treat agitation in adults with schizophrenia or bipolar disorder. It's given as a film that's dissolved under the tongue or behind the lower lip. Igalmi (dexmedetomidine) is only used short-term in a healthcare setting. This medication is given under the supervision of a healthcare provider.

Reviewed by:

Robert Chad Hakim, PharmD, BCCCP

Kristianne Hannemann, PharmD

Last reviewed on September 25, 2022

What is Igalmi (dexmedetomidine)?

What is Igalmi (dexmedetomidine) used for?

Agitation due to schizophrenia or bipolar I or II disorder

Are you looking for information on dexmedetomidine (Precedex) injection instead?

Drug facts

Common Brands	Igalmi
Drug Class	Alpha agonist
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Igalmi

Drug Class

Alpha agonist

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Pharmacist tips for Igalmi (dexmedetomidine)

The Igalmi (dexmedetomidine) films are dissolved either under the left or right side of the tongue or behind the lower lip. Don't chew or swallow the film because you might not get your full dose.
Don't eat or drink for at least 15 minutes after placing Igalmi (dexmedetomidine) under the tongue. If you place Igalmi (dexmedetomidine) behind the lower lip, don't eat or drink for at least 1 hour after taking the medication. Eating too soon might affect how well this medication works.
After receiving Igalmi (dexmedetomidine), stay lying or sitting down because it can cause low blood pressure and slow heart rate. This side effect can last even 2 hours after your dose. Let your provider know right away if you feel faint, lightheaded, extremely tired, or have trouble breathing.
If you need to get up after taking Igalmi (dexmedetomidine), do so slowly or ask a caregiver for help. You'll feel dizzy or unsteady on your feet if you suddenly getting up from a sitting or lying down position.
After the first dose, your provider might give you a second or third dose of Igalmi (dexmedetomidine) if agitation doesn't go away. You shouldn't receive more than 3 doses.
Igalmi (dexmedetomidine) can cause a rare, but serious, life-threatening irregular heart rhythm problem called QT prolongation. Let your provider know if you have any history of irregular heartbeat or heart problems. Seek medical attention if you notice changes in vision, lightheadedness, feeling like your chest is pounding, or weakness.
Drowsiness is a common side effect of Igalmi (dexmedetomidine). Don't drive or perform any activities that require you to be alert for at least 8 hours after taking this medication. If you need to go anywhere, make sure a caregiver is with you so they can help make sure you're safe.

Common questions about Igalmi

Igalmi is used in the healthcare setting to ease agitation (irritability or restlessness) in adults with schizophrenia or bipolar disorder. It's only meant to be used short-term if someone becomes suddenly agitated. The safety and how well Igalmi works have only been studied within 24 hours of a single dose. Researchers don't know if this medication will continue to be safe or work well after this time. So Igalmi isn't a medication you take on a regular basis.

Igalmi is an alpha agonist. It works by activating alpha receptors (proteins) in the brain. When the receptors are activated, they block a chemical called norepinephrine from being released by the brain. Your brain makes norepinephrine when you're stressed. This is the chemical that makes people feel agitated. So Igalmi is thought to ease agitation by blocking norepinephrine.

The typical dose is 60 to 120 mcg dissolved under the tongue or behind the lower lip, depending on your age, how severe your agitation is, and if you have liver problems. If needed, up to two more doses of 60 to 90 mcg can be given at least 2 hours apart if agitation continues after the first dose.

No, Igalmi isn't a medication you can pick up at the pharmacy and give to yourself at home. You'll receive medication at a treatment center under a healthcare provider's supervision. This is because your provider needs to monitor you for side effects after taking Igalmi.

The most common side effect is extreme sleepiness and tiredness. Other common side effects include feeling of "pins and needles," numbness in the mouth, and dizziness. Less common side effects include low blood pressure, dry mouth, nausea, low heart rate, and stomach pain. Your provider will monitor you for side effects after you take your dose.