From the Guidelines
Decadron (dexamethasone) can be taken orally (PO) with the same dosage as intravenous (IV) administration, as they have equivalent bioavailability, meaning 4 mg IV equals 4 mg PO, as supported by the most recent guidelines 1. When considering the administration of dexamethasone, it is essential to note that the oral form is a suitable alternative to IV administration in many clinical situations. The dosage remains the same, regardless of the route of administration, due to their equivalent bioavailability.
- Oral dexamethasone is available in various strengths, including tablets (0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, and 6 mg) and an oral solution (0.5 mg/5 mL or 1 mg/mL) 1.
- The specific dosage and duration of dexamethasone depend on the condition being treated, ranging from short courses for acute conditions to longer regimens for chronic issues.
- Dexamethasone should be taken with food to minimize gastrointestinal irritation, and patients should not abruptly stop taking it after prolonged use, as this can lead to adrenal insufficiency 1.
- The medication works by suppressing inflammation and immune responses through inhibition of inflammatory mediators and has a long half-life of 36-54 hours, allowing for once-daily dosing in most cases.
- According to the most recent guidelines, patients treated with low-emetic-risk antineoplastic therapy should be offered a 5-HT receptor antagonist or dexamethasone, with the dexamethasone dose adjusted based on the specific treatment regimen and emetic risk category 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Dexamethasone sodium phosphate injection, USP 4 mg/mL is for intravenous, intramuscular, intra-articular, intralesional and soft tissue injection. The FDA drug label does not answer the question.
From the Research
Dexamethasone Administration
- The administration of dexamethasone can be done through various routes, including intravenous (IV) and oral (PO) 2.
- A study on the use of a single premedication dose of dexamethasone 20 mg IV before docetaxel administration found that hypersensitivity reactions and fluid retention reactions occurred in 7.8% and 12.2% of patients, respectively 2.
Oral Dexamethasone
- There is limited information available on the specific use of oral dexamethasone (PO) in the provided studies.
- However, a study on the steroid-induced mental disorders in oncology patients found that dexamethasone was the most commonly prescribed steroid, but it does not specify the route of administration 3.
Comparison of Routes of Administration
- A study on the preemptive analgesic effects of dexamethasone alone or combined with non-steroidal anti-inflammatory drugs (NSAIDs) in third molar surgeries used a dose of 8 mg of dexamethasone 1 hour before the surgical procedure, but it does not compare the effectiveness of different routes of administration 4.
- Another study on the modeling of combined immunosuppressive and anti-inflammatory effects of dexamethasone and naproxen in rats does not provide information on the route of administration 5.
- A study on once-daily single-inhaler triple versus dual therapy in patients with COPD does not mention dexamethasone or its route of administration 6.