Long-acting steroidal anti-inflammatory drug (corticosteroid)
Indications
Symptomatic treatment of severe allergic and inflammatory reactions, when oral administration is not possible
Foetal lung maturation, in the event of threatened premature delivery before 34 weeks of gestation
Forms and strengths, route of administration
4 mg dexamethasone phosphatein 1 ml ampoule (4 mg/ml) for IM or IV injection or infusion
Dosage and duration
Symptomatic treatment of severe allergic and inflammatory reactions
Dosage varies according to indication, reaction severity and clinical response:
Child: 0.15 to 0.6 mg/kg (max. 16 mg) by IM or IV injection once daily
Adult: 0.5 to 24 mg by IM or IV injection once daily
Duration varies according to indication. Due to dexamethasone’s long half-life, a treatment of 1 or 2 days is usually sufficient in asthma or croup. For longer treatments, change to oral route as soon as possible. In the event of treatment longer than 10 days, decrease doses gradually to avoid adrenal suppression.
Foetal lung maturation
Administer to the mother: 6 mg by IM injection every 12 hours for 2 days (total dose: 24 mg)
Contra-indications, adverse effects, precautions
In case of systemic infections, only administer if patient is under antimicrobial treatment.
May cause (if prolonged treatment with high doses): adrenal suppression, muscle atrophy, growth retardation, increased susceptibility to infections, sodium and water retention (oedema and hypertension), osteoporosis, hypokalaemia, digitalistoxicity due to potassium loss in patients taking digitalis glycosides.
Pregnancy and breast-feeding: no contra-indication; for symptomatic treatment of severe allergic and inflammatory reactions, use the lowest effective dose.
Remarks
Foetal lung maturation:
after 34 weeks of gestation, corticosteroid treatment is not indicated;
dexamethasone may be replacedby betamethasone: 2 doses of 12 mg by IM injection at 24- hour interval (total dose:24 mg).
0.75 mg of dexamethasone has the same anti-inflammatory activity as 5 mg of prednisolone or prednisone and 20 mg of hydrocortisone.
Dexamethasone acetate,insoluble in water, is a suspension used only for local treatment: intra- articular or peri-articular injection, epidural injection (sciatica).
Storage
– Below 25 °C
The solution precipitates at 0 °C, it must not be exposed to cold temperatures.