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Yohimbine (Yobine®, Antagonil®)

By: Dr. Nicholas Dodman

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Overview

  • In veterinary medicine, it is sometimes necessary to administer a drug to reverse the effects of another drug.
  • Yohimbine is such a drug. It may be used safely to reverse the effects drugs, such as xylazine and detomidine.
  • Yohimbine is a centrally-acting alpha-2 receptor antagonist.
  • Yohimbine is the principal indole alkaloid derived from the bark of the Yohimbe tree. It is also found in the Rauwolfia root and is structurally and functionally similar to reserpine.
  • Yohimbine is administered almost exclusively by injection in domestic animals. The oral route of administration is employed in humans when yohimbine is indicated for the treatment of impotence.
  • In the United States, yohimbine is a prescription drug and can only be administered by a veterinarian.

    Brand Names and Other Names

  • Veterinary formulations: Yobine® (Lloyd) and Antagonil® (Wildlife Labs)
  • Human formulations: Aphrodyne® (Star), Dayto Himbine® (Dayton), Yocon® (Palisades) and Yohimex® (Kramer)

    Uses of Yohimbine

  • Yohimbine is used for reversal of alpha-2 agonists, like xylazine and detomidine.
  • It may also be helpful in reversing amitraz toxicity.
  • Yohimbine is partially effective in reversing the CNS depressant effects of a number of centrally-acting drugs (e.g. pentobarbital, ketamine, benzodiazepines).

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, yohimbine may cause unacceptable side effects in some animals.
  • Yohimbine should not be used in animals with known hypersensitivity or allergy to the drug.
  • Yohimbine should be used with caution in animals with known kidney disease or seizure disorders.
  • Yohimbine may interact with other medications. Consult your veterinarian to determine if other drugs your pet is receiving could interact with yohimbine. Such drugs include phenylephrine, phenylpropanolamine, and tricyclic antidepressants.

    How Yohimbine is Supplied

  • Yohimbine is available in an injectable form in a 2 mg/mL or 5 mg/mL concentration. It is also available in 5.4 mg tablets for human use.

    Dosing Information

    Yohimbine is usually administered in a hospital setting.
  • For reversal of xylazine, yohimbine is dosed at 0.05 – 0.1 mg per pound (0.1 to 0.2 mg/kg) slowly by intravenous route.
  • For amitraz toxicity, yohimbine is dosed at 0.05 mg per pound (0.1 mg/kg) intravenous.
  • For anti-emesis, yohimbine is dosed at 0.12 to 0.25 mg per pound (0.25 to 0.5 mg/kg) subcutaneous or intramuscular, up to every 12 hours.
  • The duration of administration depends on the condition being treated, response to the medication, and the development of any adverse effects.



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