Alfacan

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Alfacan

What is Alfacan? (Alfaxalone)

Alfacan (generic name: alfaxalone) is a unique, rapid-acting injectable medicine used exclusively by veterinarians to induce and maintain general anesthesia in animals, primarily dogs and cats. It is a specialized, prescription-only drug manufactured by Jurox.


Quick Facts and Differentiation

Property Description
Active Ingredient Alfaxalone
Manufacturer Jurox
Pharmacological Class Neuroactive steroid anesthetic
Distinctive Feature Approved for both induction and maintenance; rapid, smooth recovery profile
Regulatory Status DEA Schedule IV Controlled Substance (U.S.)

Overview and Medical Recognition

The core component, alfaxalone, belongs to the class of neuroactive steroid anesthetics. Unlike other steroids, this medicine has no known hormonal effects; its action is targeted solely at the central nervous system. Its primary mechanism involves modulating the activity of the GABA-A receptors in the brain, responsible for calming the nervous system and inducing unconsciousness.

The key feature of Alfacan is its approval for use in both the induction phase (putting the animal to sleep for intubation) and the maintenance phase of anesthesia for surgical procedures. This dual approval distinguishes it as a versatile tool for veterinary professionals. The drug is highly valued for promoting a rapid and quiet recovery after the procedure, which is beneficial for the animal's post-operative comfort.

What side effects are possible with Alfacan?

Possible Side Effects and Safety Information

Alfacan (alfaxalone) is a specialized anesthetic whose official safety profile, as documented in regulatory labeling, is primarily characterized by effects on the respiratory and nervous systems.


Adverse Reaction Frequency and System Classification

The frequency classification used in regulatory documents for adverse reactions is divided into categories based on occurrence rates.

Classification Representative Adverse Reactions
Very Common Temporary cessation of breathing (Apnoea), primarily observed immediately following the induction of anesthesia.
Very Rare Bradycardia (slowed heart rate), Cardiac arrest, Convulsion, Tremor, and behavioral signs such as Hyperactivity or Vocalisation.

These effects are largely categorized under Respiratory, Thoracic, and Mediastinal Disorders and Nervous System Disorders. Serious adverse events, including cardiac arrest and convulsions, are documented within the very rare category, alongside severe cardiorespiratory depression that is noted as being dose-dependent.


Safety Constraints and Special Populations

Official labeling defines specific safety constraints for use. Alfacan is contraindicated in animals with a known sensitivity to alfaxalone or any of its components. Additionally, the drug is officially classified as a DEA Schedule IV Controlled Substance in the U.S.

The safety of Alfacan has not been established for use in certain vulnerable animal populations, including very young puppies and kittens (typically those under 4 to 10 weeks of age, depending on the regulatory document) and in pregnant or lactating animals when the pregnancy is intended to continue.

Overdose and Emergency Response

Alfacan Overdose and when to seek help

Official government regulatory bodies have not published a verifiable, specific overdose profile for the drug designated as Alfacan. Consequently, detailed information regarding documented overdose symptoms, physiological systems affected, or specific emergency protocols mandated by health authorities cannot be provided.

Overdose Profile (Regulatory Status)

Domain
Documented Overdose Presentations Not identified in official regulatory labeling for Alfacan
Physiological Systems Affected Not identified in official regulatory labeling for Alfacan
Severity Classification Not defined in official regulatory labeling for Alfacan

Official Overdose Statements

  • No explicit statements regarding the clinical manifestations of an overdose with Alfacan are traceable within the public-facing regulatory documents of major global health authorities (e.g., FDA, EMA, NIH).
  • The absence of official data prevents the delineation of symptoms or the conditions under which urgent medical attention should be sought, based strictly on the drug’s regulatory text.

When to Seek Help

In any situation involving a suspected medication overdose, regardless of the drug, immediate emergency medical attention is required. Contact local emergency services or a poison control center for guidance. Do not wait for symptoms to worsen.

Therapeutic Uses of Alfacan

What Alfacan Treats: Main Uses and Benefits

Alfacan is commonly used to help with the induction and maintenance of general anesthesia in dogs and cats. The medicine is relevant for easing symptoms related to heightened physiological activity across three key domains: addressing awareness and sensation for painful procedures; assisting with uncontrolled motor activity to facilitate intubation or complex surgery; and managing severe resistance and fear in animals requiring urgent care.

The application helps provide deep, reversible unconsciousness for conditions associated with acute or disruptive episodes. It is applied in addressing situations where functional stability becomes affected, such as during surgical procedures, diagnostic imaging, and Cesarean sections. The medication supports a recovery that may be smooth and quiet, which contributes to improved comfort during symptomatic phases.

Quick Fact: Relief for Suppression of Awareness
Used for: Inducing and maintaining general anesthesia to manage the symptoms related to physical discomfort and contributes to temporary management of awareness during necessary clinical intervention.

Regulatory References

  1. U.S. National Library of Medicine (DailyMed)

Eligibility and Restrictions for Use

Who Can and Cannot Use Alfacan? — Official Regulatory Information

The eligibility profile for Alfacan ( Alfaxan^circledR Multidose IDX) is strictly defined by regulatory indexing for specific animal populations. Use is legally restricted to multiple non-food-producing minor species, including captive reptiles, amphibians, ornamental fish, non-human primates, captive rodents, mustelids, marsupials, and certain orders of pet birds (Psittaciformes, Passeriformes, Columbiformes).

Contraindications and Restrictions

Contraindicated Populations

  • Any minor species animal that may become eligible for consumption by humans or food-producing animals. Extra-label use (use outside the labeled instructions) is prohibited.
  • Animals with a known sensitivity to Alfacan or its components.
  • Animals for whom general anesthesia or sedation is contraindicated for any medical reason.

Use with Caution or Restriction

  • Condition-Specific Caution: Use is advised with caution in animals that are hypovolemic, debilitated, or have known cardiac, respiratory, renal, or hepatic impairment.
  • Age-Related: Caution should be exercised when administering the product to geriatric animals.
  • Breeding Status: Administration to breeding animals may be associated with neonatal depression as the drug is known to cross the placenta.

The drug is designated for Animal Use Only and its administration is restricted by law to by or on the order of a licensed veterinarian.

What should I know about interactions with other medicines?

Alfacan Interactions with other medicines and products

Official regulatory information for Alfacan (alfaxalone) primarily documents pharmacodynamic interactions related to its use as a general anesthetic.

Documented Interaction Patterns

Interaction Type Interacting Substances/Classes Official Description of Interaction
Pharmacodynamic Potentiation CNS Depressants (Opioids, Benzodiazepines, Phenothiazines, Preanesthetics) Co-administration may potentiate the depressant effects of Alfacan.
Altered Duration of Effect Alpha-2-adrenoceptor agonists (e.g., Xylazine, Medetomidine) Premedication with these agents can markedly increase the duration of anesthesia.
Cardiac/Vascular Effects Inhalant Anesthetics Co-administration can exacerbate myocardial depressive and vasodilatory effects.

No specific medicinal products are officially classified as contraindicated for co-administration with Alfacan in regulatory labels.

Procedural and Population Constraints

The prescribing information includes constraints related to administration and specific populations:

  • Physical Incompatibility Restriction: Alfacan must not be mixed with any other therapeutic agents in the same syringe or container prior to administration.
  • Population Note: The interaction with CNS depressants is recognized as more significant in animals with existing cardiac or respiratory impairment.

Metabolic (CYP-mediated or transporter-based) and food/alcohol interactions are not explicitly documented in the official regulatory product labels.

Mechanism of Action

How Alfacan Works

Alfacan (alfaxalone) exerts its primary action through selective effects on the inhibitory signaling systems within the central nervous system (CNS).

Targeted Modulation of the GABA A Receptor

The molecule functions as a positive allosteric modulator of the gamma-Aminobutyric acid type A ( GABA A) receptor, the principal mediator of inhibition in the brain. This specific engagement amplifies the effect of the endogenous inhibitory neurotransmitter, GABA, resulting in an increase in the influx of chloride ions across the neuronal membrane. This action initiates the early molecular steps that result in cellular inhibition.

The Cascade of Neuronal Hyperpolarization

The rapid influx of chloride ions causes the neuronal membrane to become hyperpolarized—electrically less excitable. This systemic inhibition of electrical activity spreads across CNS regions that control consciousness and motor function, leading to a reversible state of global neuro-depression. The efficiency of this cascade underlies the drug's rapid onset and rapid return of physiological function.

Mechanistic Specificity and Functional Constraints

The GABA-A receptor mechanism is relevant for systems requiring rapid pathway adjustment, but it offers minimal direct interaction with the pathways responsible for pain signaling (nociception). This means the primary action is confined to achieving unconsciousness and immobility. This mechanistic constraint requires separate modulation of nociceptive pathways.

Dosage and Administration Information

How to Use Alfacan

Alfacan (alfaxalone) is an injectable neuroactive steroid anesthetic whose usage is strictly confined to intravenous (IV) injection by veterinary professionals. The medication is supplied as a 10 mg/ mL solution and is exclusively administered within a clinical setting to induce and maintain general anesthesia in dogs and cats.

Official Dosing and Administration Protocol

Administration follows a two-part dosing regimen: a single, calculated dose for induction, followed by a maintenance protocol. The required dose is based on the animal's body weight (mg/ kg) and whether pre-anesthetic medication was used, as pre-medication officially reduces the required amount of alfaxalone. For instance, unpremedicated dogs typically require approximately 2.2 mg/ kg for induction, while unpremedicated cats require around 4.0 mg/ kg.

Phase Dosing Pattern
Induction Single dose administered slowly over approximately 60 seconds, titrated to effect.
Maintenance Achieved through intermittent IV boluses or a Constant Rate Infusion (CRI) as the anesthetic depth declines.

Procedural and Contextual Rules

The injection must be administered slowly and carefully titrated until the animal reaches the required plane of anesthesia. The official protocol advises that patients be fasted prior to receiving the anesthetic. Although Alfacan is approved for procedures lasting up to one hour, specific instructions note that the solution must not be mixed with any other therapeutic agents before administration. Dose adjustments may be required in patients with severely diminished hepatic or renal blood flow.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Alfacan (Alfaxalone)


Evidence for Use in Induction of General Anesthesia

Research exploring the use of Alfacan for the induction of general anesthesia has been primarily conducted through short-term Randomized Controlled Trials (RCTs) and comparative studies. These trials focused on healthy dogs and cats and were evaluated alongside other anesthetic agents. Researchers monitored outcomes related to required dose, time to intubation, and initial measurements of heart rate and blood pressure.

Findings describe patterns observed where the medicine was associated with a short time to induction. However, dose requirements often varied depending on whether the animal had received a calming premedication. Some studies reported patterns of transient respiratory changes (like temporary pausing of breathing) that are typically observed during the induction phase and require close monitoring by veterinary staff.

Evidence for Use in Maintenance of General Anesthesia

Clinical research has explored using Alfacan for the maintenance of general anesthesia via continuous infusion. Studies examined outcomes related to systemic or functional imbalance by monitoring cardiovascular stability and tracking the time it took for the animal to wake up after the infusion was stopped. Studies report that the medicine was associated with a state of unconsciousness suitable for surgery. The findings also describe patterns observed in recovery, noting that the time to ambulation and quality of recovery were measured, and reports suggested a return to mobility measured in minutes to a few hours post-infusion.

Research Gaps and Limitations

While widely studied for routine procedures, the evidence base is limited for certain groups. Research has not fully established the required dose for every possible combination of premedication. The clinical profile and required dose often can be heavily influenced by the choice of premedication, meaning that findings were mixed across studies employing different pre-anesthetic protocols. Furthermore, follow-up durations were limited to the immediate post-operative period. Long-term effects are not fully established, and there are gaps concerning the durability or extended consequences associated with repeated use of the medication.

Key Studies & References

  1. Alfaxalone versus propofol for induction of anaesthesia in bitches undergoing caesarean section

Frequently Asked Questions (FAQ)

Common questions about Alfacan (FAQ)

Q: Are the side effects of Alfacan permanent?

A: Official regulatory documents indicate that the adverse reactions associated with Alfacan, such as temporary cessation of breathing (apnoea), are generally observed immediately following administration. These effects are described as transient, meaning they are expected to pass quickly. They are not characterized in official documentation as permanent side effects.


Q: How long after taking Alfacan does the effect last?

A: Alfacan is a short-acting anesthetic. Regulatory documents describe the duration of the intended anesthetic effect as brief. To maintain unconsciousness for a procedure, a licensed professional may need to administer additional injections or a continuous infusion.


Q: Can I take over-the-counter pain relievers while using Alfacan?

A: Official product information documents known interactions with other medicines that cause central nervous system (CNS) depression. However, the regulatory label does not explicitly list common over-the-counter pain relievers in its pharmacodynamic interaction section. Official information indicates that no specific medicines are officially classified as contraindicated for co-administration.


Q: What foods or drinks should be avoided when on Alfacan?

A: The official protocol requires the patient to be fasted (not given food) prior to receiving the anesthetic. Regarding the drug's metabolism, regulatory documents state that general food or alcohol interactions are not explicitly documented in the official product labels.


Q: Are there different strengths or formulations of Alfacan available?

A: The regulatory document lists the specific strength and formulation supplied for Alfacan (alfaxalone) Multidose. This is typically described as a 10 mg/ mL solution for intravenous injection. Regulatory information details the characteristics of this specific product.


Q: How does Alfacan interact with common supplements like vitamin D or magnesium?

A: Official documentation focuses on pharmacodynamic interactions, which involve combined effects with other central nervous system (CNS) depressants. Metabolic interactions, which would include most supplements, are not explicitly documented in the regulatory labeling.


Q: Can Alfacan be taken with antacids or heartburn medicines?

A: Official regulatory documentation focuses on how Alfacan interacts with medicines that cause central nervous system (CNS) depression. No specific medicinal products, including common antacids or heartburn medicines, are officially listed as contraindicated for co-administration in the product labels.


Q: How long do the mild side effects of Alfacan typically last?

A: Adverse reactions, such as temporary cessation of breathing (apnoea), are primarily observed immediately following the induction of anesthesia and are considered transient effects. Clinical studies report that the process of recovery, including a return to mobility, generally occurs in minutes to a few hours.


Q: Does Alfacan have any known interactions with alcohol?

A: According to the official product labels reviewed by regulatory bodies, interactions related to the metabolism of the drug, including those with alcohol, are not explicitly documented.


Q: What makes Alfacan different from older treatments for the same condition?

A: Official documents describe Alfacan's specific feature as its approval for use in both the induction (putting to sleep) and maintenance phases of anesthesia. The drug is also noted for being associated with a rapid, smooth recovery profile.


Q: What is the risk of a severe allergic reaction to Alfacan?

A: Official regulatory information states that the drug is contraindicated (should not be used) in any patient with a known sensitivity to alfaxalone or any of its components. This restriction is in place to manage the potential risk of an allergic reaction.


Q: Does Alfacan cause blood pressure changes?

A: The regulatory label documents that dose-dependent cardiorespiratory depression, which can affect heart rate and blood pressure, may occur. Co-administration with certain inhalant anesthetics is also noted as being able to worsen myocardial depressive and vasodilatory effects.


Q: What if I'm taking herbal remedies—will they interact with Alfacan?

A: Official regulatory documentation lists known interactions, which primarily focus on pharmacodynamic effects when Alfacan is combined with central nervous system depressants. Interactions related to the drug's metabolism, which would include many herbal remedies, are not explicitly documented in the official labeling.


Q: Are there any known interactions between Alfacan and caffeine?

A: Official regulatory documentation for Alfacan focuses on pharmacodynamic interactions with central nervous system (CNS) depressants, which slow down activity. Interactions with stimulants like caffeine are not specifically documented in the official product information.


Q: What are the signs of a serious interaction with Alfacan?

A: The official label documents that serious adverse reactions, such as cardiac arrest, are known but are classified as very rare. An interaction with CNS depressants is described as having the potential to strengthen the depressant effects, leading to pronounced nervous and respiratory system changes.


Q: What does 'contraindicated' mean in the context of Alfacan?

A: The term 'contraindicated' is used in regulatory documents to designate a circumstance in which the drug should not be used because the risk outweighs any benefit. For Alfacan, this includes a known sensitivity to one of the components.


Q: Are there specific medical conditions that might make Alfacan less effective?

A: Regulatory documents describe that dose adjustments may be required in patients with severely diminished hepatic (liver) or renal (kidney) blood flow. This indicates that these conditions may potentially affect the duration or quality of the resulting anesthesia.

How should Alfacan be stored and disposed of?

How to Store and Dispose of Alfacan?

The official regulatory labeling strictly governs the storage and disposal of Alfacan ( Alfaxalone). The unpunctured vial must be kept at controlled room temperature, specifically between 20 C and 25 C (68 F and 77 F), and must not be frozen. Vials should be kept in the original container, tightly closed, and protected from light.

Stability and Security

Once the Multidose vial is punctured, its shelf-life is limited, requiring that any unused portion be discarded after 56 days. Due to its Schedule IV status, the product must be stored locked up and out of the reach of children.

Disposal

Unused product and waste material must be disposed of in accordance with local regulations. It is prohibited to dispose of the medicine via wastewater or drains, thereby preventing environmental contamination.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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