eiiiiF 436Dexamethasone 21-Dec-2017
lINDICATIONS AND DOSE
Physiological replacement
▶BY MOUTH, OR BY SLOW INTRAVENOUS INJECTION
▶Child: 250 – 500 micrograms/m^2 every 12 hours,
adjusted according to response
Suppression of inflammatory and allergic disorders
▶BY MOUTH
▶Child: 10 – 100 micrograms/kg daily in 1 – 2 divided
doses, adjusted according to response; up to
300 micrograms/kg daily may be required in emergency
situations
▶BY INTRAMUSCULAR INJECTION, OR BY SLOW INTRAVENOUS
INJECTION, OR BY INTRAVENOUS INFUSION
▶Child 1 month–11 years: 83 – 333 micrograms/kg daily in
1 – 2 divided doses; maximum 20 mg per day
▶Child 12–17 years:Initially 0. 4 – 20 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
Adjunctive treatment of bacterial meningitis (starting
before or with first dose of antibacterial)
▶BY SLOW INTRAVENOUS INJECTION
▶Child 3 months–17 years: 150 micrograms/kg every
6 hours (max. per dose 10 mg) for 4 days
Life-threatening cerebral oedema
▶BY INTRAVENOUS INJECTION
▶Child (body-weight up to 35 kg):Initially 16. 7 mg, then
3. 3 mg every 3 hours for 3 days, then 3. 3 mg every
6 hours for 1 day, then 1. 7 mg every 6 hours for 4 days,
then reduced in steps of 0. 8 mg daily
▶Child (body-weight 35 kg and above):Initially 20. 8 mg,
then 3. 3 mg every 2 hours for 3 days, then 3. 3 mg every
4 hours for 1 day, then 3. 3 mg every 6 hours for 4 days,
then reduced in steps of 1. 7 mg dailylUNLICENSED USE
▶With intravenous useConsult product literature; not
licensed for use in bacterial meningitis.
lINTERACTIONS→Appendix 1 : corticosteroids
lSIDE-EFFECTS
▶With intravenous useHypotension.perineal irritation (may
occur following the intravenous injection of large doses of
the phosphate ester)
▶With oral useExophthalmos.hiccups.hyperglycaemia.
hypotension.malaise.protein catabolism
lPREGNANCYDexamethasone readily crosses the placenta.
lDIRECTIONS FOR ADMINISTRATION
▶With oral useFor administrationby mouthtablets may be
dispersed in water or injection solution given by mouth.
▶With intravenous useForintravenous infusiondilute with
Glucose 5 % or Sodium Chloride 0. 9 %; give over
15 – 20 minutes.
lPRESCRIBING AND DISPENSING INFORMATION
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.
lPATIENT AND CARER ADVICEPatient counselling is advised
for dexamethasone tablet, oral solution and injection
(steroid card).
Medicines for Children leaflet: Dexamethasone for croup
http://www.medicinesforchildren.org.uk/dexamethasone-croup- 0lMEDICINAL FORMS
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)
2mgDexamethasone 2 mg soluble tablets sugar free sugar-free|
50 tabletP£ 30. 00 – £ 30. 01 DT = £ 30. 01
Dexamethasone (as Dexamethasone sodium phosphate)
4mgDexamethasone 4 mg soluble tablets sugar free sugar-free|
50 tabletP£ 60. 00 – £ 60. 01 DT = £ 60. 01
Dexamethasone (as Dexamethasone sodium phosphate)
8mgDexamethasone 8 mg soluble tablets sugar free sugar-free|
50 tabletP£ 120. 00 – £ 120. 02 DT = £ 120. 01
▶Glensoludex(Glenmark Pharmaceuticals Europe Ltd)
Dexamethasone (as Dexamethasone sodium phosphate)
2mgGlensoludex 2 mg soluble tablets sugar-free| 50 tabletP
£ 10. 00 DT = £ 30. 01
Dexamethasone (as Dexamethasone sodium phosphate)
4mgGlensoludex 4 mg soluble tablets sugar-free| 50 tabletP
£ 20. 00 DT = £ 60. 01
Dexamethasone (as Dexamethasone sodium phosphate)
8mgGlensoludex 8 mg soluble tablets sugar-free| 50 tabletP
£ 40. 00 DT = £ 120. 01
Tablet
CAUTIONARY AND ADVISORY LABELS10, 21
▶Dexamethasone (Non-proprietary)
Dexamethasone 500 microgramDexamethasone 500 microgram
tablets| 28 tabletP£ 14. 25 – £ 54. 24 DT = £ 16. 22 | 30 tabletP
£ 17. 38 – £ 64. 82
Dexamethasone 2 mgDexamethasone 2 mg tablets|
50 tabletP£ 49. 00 DT = £ 14. 25 | 100 tabletP£ 28. 50 – £ 98. 00
| 500 tabletP£ 490. 00
Dexamethasone 4 mgDexamethasone 4 mg tablets|
50 tabletP£ 85. 00 DT = £ 85. 00
▶Neofordex(Aspire Pharma Ltd)
Dexamethasone 40 mgNeofordex 40 mg tablets| 10 tabletP
£ 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 mlDexamethasone 6. 6 mg/ 2 ml solution for injection vials|
5 vialP£ 24. 00 DT = £ 24. 00
Dexamethasone 6. 6 mg/ 2 ml solution for injection ampoules|
5 ampouleP£ 11. 00 DT = £ 11. 00 | 10 ampouleP£ 22. 00
Dexamethasone 3. 3 mg/ 1 ml solution for injection ampoules|
5 ampouleP£ 12. 00 | 10 ampouleP£ 12. 00 – £ 19. 67 DT =
£ 19. 67
Dexamethasone (as Dexamethasone sodium phosphate) 3.8 mg
per 1 mlDexamethasone 3. 8 mg/ 1 ml solution for injection vials|
10 vialP£ 19. 99 – £ 20. 01 DT = £ 20. 00
Oral solution
CAUTIONARY AND ADVISORY LABELS10, 21
▶Dexamethasone (Non-proprietary)
Dexamethasone (as Dexamethasone sodium phosphate)
400 microgram per 1 mlDexamethasone 2 mg/ 5 ml oral solution
sugar free sugar-free| 150 mlP£ 42. 30 DT = £ 42. 30
Dexamethasone (as Dexamethasone sodium phosphate) 2 mg per
1mlDexamethasone 10 mg/ 5 ml oral solution sugar free sugar-free|
50 mlP£ 24. 50 – £ 24. 95 sugar-free| 150 mlP£ 101. 40 DT =
£ 94. 44
Dexamethasone (as Dexamethasone sodium phosphate) 4 mg
per 1 mlDexamethasone 20 mg/ 5 ml oral solution sugar free sugar-
free| 50 mlP£ 49. 50 DT = £ 49. 50
▶Dexsol(Rosemont Pharmaceuticals Ltd)
Dexamethasone (as Dexamethasone sodium phosphate)
400 microgram per 1 mlDexsol 2 mg/ 5 ml oral solution sugar-free|
75 mlP£ 21. 15 sugar-free| 150 mlP£ 42. 30 DT = £ 42. 30BNFC 2018 – 2019 Corticosteroid responsive conditions 439
Endocrine system6