Xylazine toxicity

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  • Also known as "Tranq"
  • Analogue of clonidine and agonist at alpha 2 adrenergic receptor[1]
  • Veterinary sedative, anesthetic, analgesic, and muscle relaxant
  • Human drug of abuse, usually as drug adulterant without the knowledge of people who use these drugs
    • Not an opioid, but often combined with opioids and increases the risk of overdose and death
    • Associated with complex skin infections when injected

Clinical Features

Differential Diagnosis

Sedative/hypnotic toxicity

Symptomatic bradycardia


  • Evaluate for alternate etiologies
  • Clinical diagnosis
  • Consider collecting serum toxicology tests specifically for xylazine, if available (for public health reasons; does not affect acute management)


  • Supportive: address airway/respiratory drive/blood pressure, atropine for bradycardia
  • Consider administration of naloxone due to high likelihood that opioids are also present (does not directly affect xylazine toxicity)


  • Admit if not back to baseline

See Also

External Links