Tiletamine
Tiletamine is a dissociative anaesthetic arylcyclohexylamine used almost exclusively in veterinary medicine, combined with the benzodiazepine zolazepam as the product Telazol/Zoletil. It is a potent, longer-acting NMDA antagonist related to ketamine, not approved for human use.
01 Overview
Tiletamine was developed in the 1960s as a more potent, longer-lasting ketamine analogue. On its own it causes marked muscle rigidity and seizures, so it is formulated 1:1 with zolazepam to smooth induction and recovery. This combination is a mainstay of veterinary anaesthesia in cats, dogs and exotic species.
Human data are limited to case reports of accidental exposure, veterinary-worker misuse and diversion. The effects resemble ketamine but are more prolonged and with a rougher recovery, and toxicology in humans is poorly characterised.
02 Mechanism
Non-competitive NMDA receptor antagonist producing dissociative anaesthesia; more potent and longer-acting than ketamine.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Veterinary (with zolazepam) | 2–10 mg/kg | IM | Species-dependent veterinary anaesthesia; not a human dose. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Dissociative anaesthesiaProduces immobility and analgesia in animals; ketamine-like dissociation reported in human exposure. | surgical plane | Clinical | |
| AnalgesiaNMDA blockade contributes to somatic analgesia during anaesthesia. | n/a | Preclinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Muscle rigidity and seizuresUsed alone it causes rigidity and convulsions, the reason it is co-formulated with zolazepam. | Severe | Common without benzodiazepine | Preclinical | |
| Prolonged rough recoveryEmergence delirium and prolonged sedation, worse than ketamine in humans exposed. | Moderate | Common | Observational |