DEXAMETHASONE (IM/IV) 8/MG 5/AMP

Indications

Approved Uses

Indications depend on local label; generally for conditions responsive to systemic corticosteroids including severe allergic/inflammatory states, acute asthma/COPD exacerbations, cerebral edema, and adrenal insufficiency/shock adjunct where indicated; COVID-19 requiring oxygen/ventilation is guideline-supported but may be label-dependent.

Dosage & Administration

Dosing by Condition

Dosing is indication-specific and individualized; typical adult examples: cerebral edema 10 mg IV once then 4 mg IV q6h; severe allergic reaction 4-8 mg IV; antiemetic adjunct 8-20 mg IV pre-chemotherapy; COVID-19 requiring oxygen/ventilation 6 mg IV daily up to 10 days.

Initial Dose

8mg IV/IM for most acute indications

Maintenance Dose

4-8mg IV/IM every 6-12 hours depending on indication

Maximum Dose

No single universal maximum; typical regimens vary by indication-commonly up to ~24 mg/day for cerebral edema, while higher doses (e.g., up to ~40 mg/day or more) may be used short-term in life-threatening situations per specialist protocols.

Children's Dosage

Anti-inflammatory/immunosuppressive: 0.08-0.3mg/kg/day IV/IM in divided doses q6-12h. Croup: 0.6mg/kg IM/IV single dose (max 10mg). Cerebral edema: 0.5-1mg/kg IV loading dose, then 0.2-0.5mg/kg/day in divided doses

Dose Adjustment Notes

If used beyond a few days or at supraphysiologic doses, taper gradually to avoid HPA-axis suppression; use the lowest effective dose and consider stress-dose increases during major stress (surgery, severe infection) in patients with adrenal suppression.

How to Take

IV use (per SFDA route): administer by slow IV injection or dilute and give by IV infusion using aseptic technique; do NOT give intrathecally/epidurally; inspect solution/ampoule and discard if particulate/discolored; administer by trained healthcare professional.

How to Prepare

Ready-to-use solution in ampoule (SFDA: solution, 2 mL ampoule); may be given IV directly (slow IV injection) or diluted for IV infusion in compatible fluids such as 0.9% sodium chloride or 5% dextrose; inspect for particles/discoloration and discard unused portion per aseptic practice.

Side Effects

Common Side Effects

Common: hyperglycemia, fluid retention/edema, increased appetite/weight gain, insomnia, mood changes, hypertension, GI upset (nausea/dyspepsia), and injection-site pain; with longer use: acne/easy bruising can occur.

Side Effect Frequency

Common/expected with systemic corticosteroids: hyperglycemia, insomnia, increased appetite, mood changes, GI upset; with higher dose/longer duration: fluid retention/weight gain, hypertension, hypokalemia, infection risk, GI bleeding/ulceration, psychiatric effects, adrenal suppression; rare but serious: avascular necrosis, opportunistic infections.

Safety & Warnings

Warnings & Precautions

Key precautions: increased infection risk and masking of infection; avoid live vaccines at immunosuppressive doses; monitor for HPA-axis suppression and taper after prolonged use; monitor glucose (diabetes), BP/edema (HF/HTN), electrolytes (hypokalemia), GI risk (PUD/NSAIDs), bone health (osteoporosis/AVN), psychiatric effects, and ocular effects (glaucoma/cataract); use caution in patients with comorbid HTN, diabetes, PUD, osteoporosis, glaucoma, psychiatric illness, and in frail/elderly; consider excipient-related hypersensitivity if applicable to the specific ampoule.

Age Restriction

No absolute minimum age; can be used in pediatrics (including neonates) when clinically indicated, with specialist oversight and attention to formulation excipients (e.g., benzyl alcohol if present).

Special Populations

Children

Anti-inflammatory/immunosuppressive: 0.08-0.3mg/kg/day IV/IM in divided doses q6-12h. Croup: 0.6mg/kg IM/IV single dose (max 10mg). Cerebral edema: 0.5-1mg/kg IV loading dose, then 0.2-0.5mg/kg/day in divided doses

Storage & Patient Advice

Preparation Instructions

Ready-to-use solution in ampoule (SFDA: solution, 2 mL ampoule); may be given IV directly (slow IV injection) or diluted for IV infusion in compatible fluids such as 0.9% sodium chloride or 5% dextrose; inspect for particles/discoloration and discard unused portion per aseptic practice.

Missed Dose

In hospital/clinic administration: doses are given by healthcare professionals; if a scheduled dose is missed, administer as soon as feasible per prescriber and do not double-re-time subsequent doses based on clinical need.

Stopping the Medicine

Do not stop abruptly after prolonged or high-dose therapy; taper gradually based on duration/dose and clinical status.

Overdose

Acute overdose is unlikely to be immediately life-threatening; expected effects include hyperglycemia, hypertension, fluid retention, mood changes, and electrolyte disturbances; chronic excessive exposure can cause Cushingoid features and adrenal suppression-management is supportive with monitoring (glucose/electrolytes/BP) and tapering if on prolonged therapy.

Patient Counseling

Administered by a healthcare professional; do not stop abruptly if used for more than a few days (taper as directed); report signs of infection (fever/chills) and avoid exposure to chickenpox/measles; monitor blood glucose if diabetic; report significant mood changes, swelling/rapid weight gain, or GI bleeding (black/tarry stools); inform all healthcare providers you are receiving corticosteroid therapy.

Monitoring Requirements

Monitor blood glucose, blood pressure, weight/fluid status, electrolytes (esp. potassium/sodium), signs of infection; with prolonged/repeated courses monitor intraocular pressure/cataracts, bone health (osteoporosis risk), and in children growth.

Pharmacology

Mechanism of Action

Glucocorticoid receptor agonist that alters gene transcription to suppress inflammatory cytokines/mediators, reduce leukocyte trafficking, and decrease capillary permeability/edema.

Bioavailability

IV: 100%; IM: effectively ~100% (complete systemic availability, with slower absorption)

Product Information

Available Dosage Forms

For this SFDA product: solution for injection in ampoules (4 mg/mL, 2 mL); other dexamethasone dosage forms exist (tablets, oral solution, ophthalmic/otic forms) but are separate products and not implied by this specific SFDA record.

Composition per Dose

Each 2ml ampoule: 8mg dexamethasone as dexamethasone sodium phosphate (4mg/ml)

Generic Availability

Yes

OTC Alternatives

No OTC alternative for systemic corticosteroid therapy

Symptom Target

Severe allergic/inflammatory states, cerebral edema, shock

Sedating

No

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 10-07-2026