What should I do if the pharmacy is unable to fill my prescription for dexAMETHasone (Dexamethasone) Sodium Phosphate Solution?

Resolving Dexamethasone Sodium Phosphate Solution Prescription Issue

Contact your prescriber immediately to request an alternative formulation of dexamethasone that the pharmacy can fill, such as oral dexamethasone tablets or a different concentration of the solution. 1

Understanding the Issue

• The pharmacy may be unable to fill your prescription for dexamethasone sodium phosphate solution 4 mg/mL for oral rinse due to several possible reasons:
  • The specific concentration or formulation may not be readily available 1
  • The pharmacy may not stock injectable formulations for oral use 2
  • There may be confusion about the administration route (oral rinse versus injection) 1

Recommended Actions

Immediate Steps

• Call your prescriber to explain the situation and request one of these alternatives:
  • Standard oral dexamethasone tablets that can be crushed and mixed with water 3
  • A different concentration of dexamethasone solution that the pharmacy can provide 1
  • A compounded dexamethasone oral rinse formulation 4

Important Information to Share with Your Provider

• Dexamethasone sodium phosphate injection can be administered orally, but has approximately 87.4% bioavailability compared to oral dexamethasone concentrate 2
• If your provider wants to maintain the same therapeutic effect, they may need to adjust the dosage accordingly 2
• Injectable dexamethasone sodium phosphate is physically and chemically stable when diluted and can be stored for extended periods 4

Alternative Options

• Ask if a standard oral dexamethasone tablet can be prescribed instead:

  • These can be crushed and mixed with water to create a similar rinse 3
  • This is more commonly available at pharmacies 1

• Request a referral to a compounding pharmacy that can prepare the specific formulation needed 4

• If the oral rinse is for managing chemotherapy-induced oral complications:

  • Standard antiemetic regimens using oral dexamethasone tablets may be an appropriate alternative 3
  • The American Society of Clinical Oncology guidelines support various dexamethasone formulations for supportive care 3

Important Considerations

• Do not attempt to self-administer injectable medications without proper guidance 1
• Dexamethasone formulations have different potencies and bioavailabilities when administered through different routes 2
• Pharmacists play a crucial role in preventing medication errors and can often suggest appropriate alternatives 5

Remember that resolving prescription issues promptly is important to maintain your treatment plan and prevent interruption of therapy 5.