DEXAMETHASONE injectable

Therapeutic action

• 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 phosphate in 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, digitalis toxicity 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 replaced by 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