For Animal Use Only

Alfaxan® Multidose IDX CIV

(alfaxalone) 10 mg/mL Injectable Solution
For use as an injectable sedative and anesthetic in multiple non food-producing minor species.

Federal law restricts this drug to use by or on the order of a licensed veterinarian.

In order to be legally marketed, a new animal drug intended for a minor species must be Approved, Conditionally Approved, or Indexed by the Food and Drug Administration. THIS PRODUCT IS INDEXED—MIF 900-031. EXTRA-LABEL USE IS PROHIBITED.

This product is not to be used in animals for use as food for humans or food-producing animals.

ALFAXAN MULTIDOSE IDX contains alfaxalone, a neuroactive steroid molecule with properties of a general anesthetic. Alfaxalone is chemically described as 3‑ α‑ hydroxy‑ 5‑ α‑ pregnane‑ 11, 20‑dione, and has a molecular weight of 332.5. The primary mechanism for the anesthetic action of alfaxalone is modulation of neuronal cell membrane chloride ion transport, induced by binding of alfaxalone to GABAA (gamma‑aminobutyric acid) cell surface receptors. This product contains the following preservatives: chlorocresol (0.1% w/v), benzethonium chloride (0.02% w/v) and ethanol (15% w/v).

• For sedation and anesthesia in captive reptiles, excluding any food-producing species**
• For sedation and anesthesia in captive amphibians, excluding any food-producing species**
• For sedation and anesthesia in ornamental fish, including species used in research such as the zebra fish
• For sedation and anesthesia in captive species and pet birds in the orders Psittaciformes, Passeriformes, and Columbiformes, excluding any food-producing species**
• For sedation and anesthesia in non-human primates
• For sedation and anesthesia in captive rodents
• For sedation and anesthesia in captive mustelids
• For sedation and anesthesia in captive marsupials
• For induction of anesthesia and immobilization in captive minor species ungulates, excluding any food-producing species**

Use only when there is reasonable certainty that the treated animal will not be consumed by humans or food-producing animals.

* The term “minor species” means animals other than humans that are not major species. “Major species” means cattle, horses, swine, chickens, turkeys, dogs and cats.

** As used on this label, a “food-producing minor species” is considered to be a minor species of which some members are bred, cultured, farmed, ranched, hunted, caught, trapped or otherwise harvested for the purpose of having the animals or edible products of the animals commercially distributed for consumption by humans or food-producing animals in the United States.

When administering ALFAXAN MULTIDOSE IDX by intravenous injection administer slowly to effect, titrating administration against the response of the patient. Rapid administration of ALFAXAN MULTIDOSE IDX may be associated with an increased incidence of cardiorespiratory depression or apnea. The use of preanesthetics may reduce the ALFAXAN MULTIDOSE IDX induction dose. The choice and the amount of phenothiazine, alpha₂‑ adrenoreceptor agonist, benzodiazepine or opioid will influence the response of the patient to an induction dose of ALFAXAN MULTIDOSE IDX.

When using ALFAXAN MULTIDOSE IDX, patients should be continuously monitored, and facilities for the maintenance of a patent airway, artificial ventilation, and oxygen supplementation must be immediately available.

ALFAXAN MULTIDOSE IDX contains preservatives. Use within 56 days of first puncture. Any unused ALFAXAN MULTIDOSE IDX remaining after 56 days should be discarded.

The following tables outline the dosage and administration of ALFAXAN MULTIDOSE IDX for the indicated species by major group. The doses are representative of doses published in the literature. Veterinarians are advised to consult the published literature before use of the product (see List of References at end of product insert).

No specific preanesthetic is either indicated or contraindicated with ALFAXAN MULTIDOSE IDX. The necessity for and choice of preanesthetic is left to the discretion of the veterinarian. Preanesthetic doses may be lower than the label directions for their use as a single medication. ALFAXAN MULTIDOSE IDX is compatible with benzodiazepines, opioids, alpha2‑agonists, and phenothiazines as commonly used in surgical practice.

ALFAXAN MULTIDOSE IDX is contraindicated in animals with a known sensitivity to ALFAXAN MULTIDOSE IDX or its components, or when general anesthesia and/or sedation are contraindicated. Do not use in any minor species animal that may become eligible for consumption by humans or food‑producing animals.

Animal Safety: Rapid bolus administration or anesthetic overdose may cause cardiorespiratory depression, including hypotension, apnea, hypoxia, or death. Arrhythmias may occur secondary to apnea and hypoxia. In cases of anesthetic overdose, stop ALFAXAN MULTIDOSE IDX administration and administer treatment as indicated by the patient’s clinical signs. Cardiovascular depression should be treated with plasma expanders, pressor agents, anti-arrhythmic agents or other techniques as appropriate for the treatments of the clinical signs.

Human safety: Not for human use. Keep out of the reach of children.

ALFAXAN MULTIDOSE IDX should be managed to prevent the risk of diversion, through such measures as restriction of access and the use of drug accountability procedures appropriate to the clinical setting. Exercise caution to avoid accidental self‑injection. Overdose is likely to cause cardiorespiratory depression (such as hypotension, bradycardia and/ or apnea). Remove the individual from the source of exposure and seek medical attention. Respiratory depression should be treated by artificial ventilation and oxygen. Avoid contact of this product with skin, eyes, and clothes. In case of contact, eyes and skin should be liberally flushed with water for 15 minutes. Consult a physician if irritation persists. In the case of accidental human ingestion, seek medical advice immediately and show the package insert or the label to the physician.

The Safety Data Sheet (SDS) contains more detailed occupational safety information. To report adverse reactions in users or to obtain a copy of the SDS for this product call 1-888-963-8471.

Note to physician: This product contains an injectable anesthetic.

Controlled substance: ALFAXAN MULTIDOSE IDX contains alfaxalone, a neurosteroid anesthetic and a class IV controlled substance.

Abuse: Alfaxalone is a central nervous system depressant that acts on GABA receptor associated chloride channels, similar to the mechanism of action of Schedule IV sedatives such as benzodiazepines (diazepam and midazolam), barbiturates (phenobarbital and methohexital) and fospropofol. In a drug discrimination behavioral test in rats, the effects of alfaxalone were recognized as similar to those of midazolam. These biochemical and behavioral data suggest that alfaxalone has an abuse potential similar to other Schedule IV sedatives.

Physical dependence: There are no data that assess the ability of alfaxalone to inducephysical dependence. However, alfaxalone has a mechanism of action similar to the benzodiazepines and can block the behavioral responses associated with precipitated benzodiazepine withdrawal. Therefore, it is likely that alfaxalone can also produce physical dependence and withdrawal signs similar to that produced by the benzodiazepines

Psychological dependence: The ability of alfaxalone to produce psychological dependence is unknown because there are no data on the rewarding properties of the drug from animal self‑administration studies or from human abuse potential studies.

Analgesia during anesthesia: ALFAXAN MULTIDOSE IDX is not an analgesic and appropriate analgesia should be provided to the patient for painful procedures.

Rapid arousal: Careful monitoring of the patient is necessary due to possibility of rapid arousal.

Apnea: Apnea may occur following IV administration of an induction dose, maintenance dose or a dose administered during transition to inhalant maintenance anesthesia of ALFAXAN MULTIDOSE IDX, especially with higher doses and rapid administration. Endotracheal intubation, oxygen supplementation and intermittent positive pressure ventilation (IPPV) should be administered to treat apnea and associated hypoxemia in the appropriate species.

Blood Pressure: ALFAXAN MULTIDOSE IDX can exacerbate the myocardial depressive and vasodilatory effects of inhalant anesthetics resulting in hypotension. Preanesthetics can potentiate the effect of ALFAXAN MULTIDOSE IDX resulting in more pronounced changes in blood pressure. Transient hypertension has also been observed with ALFAXAN MULTIDOSE IDX administration, possibly due to elevated sympathetic activity in the patient. It is prudent to monitor blood pressure whenever possible.

Body temperature: Steps should be taken to maintain the normal physiological temperature of the patient during anesthesia. Supplemental heat, appropriate for the species, should be provided to maintain acceptable core body temperature until full recovery.

Breeding animals: Alfaxalone crosses the placenta, and as with other general anesthetic agents, the administration of ALFAXAN MULTIDOSE IDX may be associated with neonatal depression.

Compromised or debilitated animals: Caution should be used in animals with cardiac, respiratory, renal or hepatic impairment, or in hypovolemic or debilitated animals and geriatric animals.

Specific adverse reactions described in the referenced literature are listed in the Dosage and Administration section of the product insert.

For a copy of the Safety Data Sheet or to report adverse reactions, call Zoetis Inc. at 1-888-963-8471. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or at www.fda.gov/reportanimalae.

Rapid administration, accidental overdose, or relative overdose due to inadequate dose sparing of ALFAXAN MULTIDOSE IDX in the presence of preanesthetics may cause cardiopulmonary depression. Respiratory arrest (apnea) may be observed. In cases of respiratory depression, stop drug administration, establish a patent airway, and initiate assisted or controlled ventilation with pure oxygen. Cardiovascular depression should be treated with plasma expanders, pressor agents, antiarrhythmic agents or other techniques as appropriate for the observed abnormality.

Store at controlled room temperature 20°C - 25°C (68° to 77°F) with excursions between 15° and 30°C (59° and 86°F). ALFAXAN MULTIDOSE IDX contains preservatives. The product can be used for 56 days after broaching the vial. Any unused ALFAXAN MULTIDOSE IDX remaining after 56 days should be discarded.

ALFAXAN MULTIDOSE IDX is supplied in 10 mL and 20 mL multiple-dose vials containing 10 mg alfaxalone per mL.

ALFAXAN is a registered trademark of Jurox Pty Ltd.
Manufactured in Australia by Jurox Pty Ltd.

Distributed by:
Zoetis Inc.
Kalamazoo, MI 49007

Revised: April 2023
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