Drug Action
Dexamethasone has very high glucocorticoid activity and insignificant mineralocorticoid activity.
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Drug reference
Dexamethasone has very high glucocorticoid activity and insignificant mineralocorticoid activity.
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Suppression of inflammatory and allergic disorders ▶BY MOUTH ▶Adult: 0.5–10 mg daily Mild croup ▶BY MOUTH ▶Child: 150 micrograms/kg for 1 dose Severe croup (or mild croup that might cause complications) ▶INITIALLY BY MOUTH ▶Child: Initially 150 micrograms/kg for 1 dose, to be given before transfer to hospital, then (by mouth or by intravenous injection) 150 micrograms/kg, then (by mouth or by intravenous injection) 150 micrograms/kg after 12 hours if required Congenital adrenal hyperplasia (under expert supervision) ▶BY MOUTH ▶Adult: Consult specialist for advice on dosing ▶BY INTRAMUSCULAR INJECTION, OR BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: Consult specialist for advice on dosing Overnight dexamethasone suppression test ▶BY MOUTH ▶Adult: 1 mg for 1 dose, to be given at night Adjunctive treatment of bacterial meningitis (starting before or with first dose of antibacterial) ▶BY INTRAVENOUS INJECTION ▶Adult: 8.3 mg every 6 hours for 4 days Symptom control of anorexia in palliative care ▶Adult: 2–4 mg daily Dysphagia due to obstruction by tumour in palliative care ▶Adult: 8 mg daily Dyspnoea due to bronchospasm or partial obstruction in palliative care ▶Adult: 4–8 mg daily Adjunct in the treatment of nausea and vomiting in palliative care ▶BY MOUTH ▶Adult: 8–16 mg daily Headaches due to raised intracranial pressure in palliative care ▶Adult: 16 mg daily for 4–5 days, then reduced to 4–6 mg daily, reduce dose if possible. To be given before 6pm to reduce the risk of insomnia Pain due to nerve compression in palliative care ▶Adult: 8 mg daily Cerebral oedema associated with malignancy ▶BY MOUTH ▶Adult: 0.5–10 mg daily Cerebral oedema ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: Initially 8–16 mg for 1 dose, then (by intramuscular injection or by intravenous injection) 5 mg every 6 hours until adequate response achieved then taper-off gradually, use the 3.8 mg/mL injection preparation for this dose Cerebral oedema associated with malignancy ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: Initially 8.3 mg for 1 dose, then (by intramuscular injection) 3.3 mg every 6 hours as required for 2–4 days, subsequently, reduce dose gradually and stop over 5–7 days, use the 3.3 mg/mL injection preparation for this dose l UNLICENSED USE ▶With intravenous use Consult product literature; not licensed for use in bacterial meningitis.
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Dexamethasone 3.8 mg/mL Injection has replaced dexamethasone 4 mg/mL Injection. All dosage recommendations for intravenous, intramuscular, intrarticular use or local infiltration; are given in units of dexamethasone base. Palliative care For further information on the use of dexamethasone in palliative care, see www.medicinescomplete.com/#/content/palliative/systemic- corticosteroids.
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→Appendix 1: corticosteroids
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▶With oral use Hiccups. hyperglycaemia. myocardial rupture (following recent myocardial infarction). protein catabolism ▶With parenteral use Perineal irritation (may occur following the intravenous injection of large doses of the phosphate ester)
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Dexamethasone readily crosses the placenta.
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▶With oral use in children For administration by mouth tablets may be dispersed in water or injection solution given by mouth. ▶With intravenous use in children For intravenous infusion dilute with Glucose 5% or Sodium Chloride 0.9%; give over 15–20 minutes. ▶With intravenous use in adults For intravenous infusion (Dexamethasone, Hospira) give continuously or intermittently or via drip tubing in Glucose 5% or Sodium Chloride 0.9%.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: capsule, oral suspension, oral solution Soluble tablet ▶Dexamethasone (Non-proprietary) Dexamethasone (as Dexamethasone sodium phosphate) 2 mg Dexamethasone 2mg soluble tablets sugar-free | 50 tablet P £30.01 DT = £30.01 Dexamethasone (as Dexamethasone sodium phosphate) 4 mg Dexamethasone 4mg soluble tablets sugar-free | 50 tablet P £60.01 DT = £60.01 Dexamethasone (as Dexamethasone sodium phosphate) 8 mg Dexamethasone 8mg soluble tablets sugar-free | 50 tablet P £120.01 DT = £120.01 ▶Glensoludex (Glenmark Pharmaceuticals Europe Ltd) Dexamethasone (as Dexamethasone sodium phosphate) 2 mg Glensoludex 2mg soluble tablets sugar-free | 50 tablet P £10.00 DT = £30.01 Dexamethasone (as Dexamethasone sodium phosphate) 4 mg Glensoludex 4mg soluble tablets sugar-free | 50 tablet P £20.00 DT = £60.01 Dexamethasone (as Dexamethasone sodium phosphate) 8 mg Glensoludex 8mg soluble tablets sugar-free | 50 tablet P £40.00 DT = £120.01 Tablet CAUTIONARY AND ADVISORY LABELS 10, 21 ▶Dexamethasone (Non-proprietary) Dexamethasone 500 microgram Dexamethasone 500microgram tablets | 28 tablet P £54.24 DT = £6.40 | 30 tablet P £6.86– £64.82 Dexamethasone 2 mg Dexamethasone 2mg tablets | 50 tablet P £49.00 DT = £6.84 | 100 tablet P £17.98–£98.00 Dexamethasone 4 mg Dexamethasone 4mg tablets | 50 tablet P £85.00 DT = £83.01 | 100 tablet P £166.02– £169.40 ▶Neofordex (Aspire Pharma Ltd) Dexamethasone 40 mg Neofordex 40mg tablets | 10 tablet P £200.00 DT = £200.00 Solution for injection CAUTIONARY AND ADVISORY LABELS 10 ▶Dexamethasone (Non-proprietary) Dexamethasone (as Dexamethasone sodium phosphate) 3.3 mg per 1 ml Dexamethasone (base) 6.6mg/2ml solution for injection ampoules | 10 ampoule P £22.00 DT = £22.00 Dexamethasone (base) 6.6mg/2ml solution for injection vials | 5 vial P £24.00 DT = £24.00 Dexamethasone (base) 3.3mg/1ml solution for injection ampoules | 5 ampoule P £12.00 | 10 ampoule P £15.00–£23.66 DT = £23.66 Dexamethasone (as Dexamethasone sodium phosphate) 3.8 mg per 1 ml Dexamethasone (base) 3.8mg/1ml solution for injection vials | 10 vial P £19.99 DT = £20.00 (Hospital only) | 10 vial P £19.99–£20.00 DT = £20.00 Oral solution CAUTIONARY AND ADVISORY LABELS 10, 21 ▶Dexamethasone (Non-proprietary) Dexamethasone (as Dexamethasone sodium phosphate) 400 microgram per 1 ml Dexamethasone 2mg/5ml oral solution sugar-free | 150 ml P £42.30 DT = £42.30 Dexamethasone (as Dexamethasone sodium phosphate) 2 mg per 1 ml Dexamethasone 10mg/5ml oral solution sugar-free | 50 ml P £24.50–£24.95 sugar-free | 150 ml P £101.40 DT = £94.44 Dexamethasone (as Dexamethasone sodium phosphate) 4 mg per 1 ml Dexamethasone 20mg/5ml oral solution sugar-free | 50 ml P £49.50 DT = £49.50 ▶Dexsol (Rosemont Pharmaceuticals Ltd) Dexamethasone (as Dexamethasone sodium phosphate) 400 microgram per 1 ml Dexsol 2mg/5ml oral solution sugar-free | 75 ml P £21.15 sugar-free | 150 ml P £42.30 DT = £42.30 ▶Martapan (Martindale Pharmaceuticals Ltd) Dexamethasone (as Dexamethasone sodium phosphate) 400 microgram per 1 ml Martapan 2mg/5ml oral solution sugar- free | 150 ml P £35.96 DT = £42.30 eiiii F 709
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Medicines for Children leaflet: Dexamethasone for croup www.medicinesforchildren.org.uk/dexamethasone-croup-0
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0.5–10 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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150 micrograms/kg for 1 dose
First-line fragment. Read the complete Indications and Dose section above.
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Initially 150 micrograms/kg for 1 dose, to be
First-line fragment. Read the complete Indications and Dose section above.
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Consult specialist for advice on dosing
First-line fragment. Read the complete Indications and Dose section above.
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Consult specialist for advice on dosing
First-line fragment. Read the complete Indications and Dose section above.
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1 mg for 1 dose, to be given at night
First-line fragment. Read the complete Indications and Dose section above.
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8.3 mg every 6 hours for 4 days
First-line fragment. Read the complete Indications and Dose section above.
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2–4 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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8 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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4–8 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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8–16 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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16 mg daily for 4–5 days, then reduced to
First-line fragment. Read the complete Indications and Dose section above.
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8 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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0.5–10 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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Initially 8–16 mg for 1 dose, then (by
First-line fragment. Read the complete Indications and Dose section above.
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Initially 8.3 mg for 1 dose, then (by
First-line fragment. Read the complete Indications and Dose section above.
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