What preparations is dexamethasone available in?

Dexamethasone Available Preparations

Dexamethasone is available in both oral and intravenous formulations with equivalent dosing between routes (1:1 conversion ratio), making it a versatile corticosteroid for various clinical applications. 1

Oral Preparations

• Tablets: Available in 4 mg and 6 mg strengths with inactive ingredients including corn starch, lactose monohydrate, magnesium stearate, and specific colorants (D&C yellow 10 for 4 mg tablets, FD&C blue 1 for 6 mg tablets) 2
• Oral solution: Liquid formulation available for patients who have difficulty swallowing tablets, with bioequivalence to tablet formulations 3
• Oral dissolvable film: Innovative formulation (Dexa ODF) containing 8 mg dexamethasone, shown to be bioequivalent to tablet formulations 4

Intravenous Preparations

• Injectable solution: Contains dexamethasone sodium phosphate equivalent to dexamethasone phosphate 4 mg or dexamethasone 3.33 mg per mL 5
• Additional components: Contains benzyl alcohol 10 mg (preservative), sodium citrate dihydrate 11 mg, and sodium sulfite 1 mg (antioxidant) 5
• pH adjustment: Formulated with citric acid and/or sodium hydroxide to maintain pH between 7.0 and 8.5 5

Dosing Equivalence

• Dexamethasone has equivalent dosing when converting between IV and oral routes (1:1 ratio), unlike some other corticosteroids 1
• For example, 8 mg IV dexamethasone equals 8 mg oral dexamethasone 1
• Clinical studies confirm this equivalence, with bioavailability of oral dexamethasone in hospitalized patients being sufficient (approximately 81%) 6

Clinical Applications

• Antiemetic therapy: Used in various doses depending on the emetic risk of chemotherapy 7

  • High emetic risk: 12 mg oral/IV on day 1, followed by 8 mg on days 2-4 7, 1
  • Moderate emetic risk: 8 mg oral/IV on day 1, with optional continuation on days 2-3 7, 1
  • Low emetic risk: Single 8 mg oral/IV dose 7, 1

• Specialized formulations: Novel delivery systems such as very deformable drug carriers (Transfersomes) have been developed to increase potency and prolong effect when used topically 8

Important Considerations

• Single daily doses of corticosteroids are generally recommended for antiemetic therapy 7
• Adverse effects of single dexamethasone doses are rare but may include elevations in serum glucose levels, epigastric burning, and sleep disturbances 7
• When transitioning between oral and IV formulations, maintain the same dose due to equivalent bioavailability 1

Common Pitfalls to Avoid

• Do not confuse dexamethasone with other corticosteroids that may have different oral-to-IV conversion ratios 1
• Do not adjust the dose when converting between oral and IV formulations of dexamethasone 1
• Be aware that high-dose oral dexamethasone may have slightly lower bioavailability (approximately 63.4%) compared to standard doses 9