Active Ingredient: Dexamethasone
For this indication, competent medicine agencies globally authorize below treatments:
Oral
0.5 - 9 mg
From 0.25 To 4.5 mg 2 time(s) per day every day
The dosage should be titrated to the individual response and the nature of the disease. In order to minimise side effects, the lowest effective possible dosage should be used.
The initial dosage varies from 0.5–9mg a day depending on the disease being treated. In more severe diseases, doses higher than 9mg may be required. The initial dosage should be maintained or adjusted until the patient’s response is satisfactory. Both the dose in the evening, which is useful in alleviating morning stiffness, and the divided dosage regimen are associated with greater suppression of the hypothalamo-pituitary-adrenal axis. If satisfactory clinical response does not occur after a reasonable period of time, discontinue treatment with dexamethasone and transfer the patient to another therapy.
If the initial response is favourable, the maintenance dosage should be determined by lowering the dose gradually to the lowest dose required to maintain an adequate clinical response. Chronic dosage should preferably not exceed 1.5mg dexamethasone daily.
Patients should be monitored for signs that may require dosage adjustment. These may be changes in clinical status resulting from remissions or exacerbations of the disease, individual drug responsiveness and the effect of stress (e.g. surgery, infection, trauma). During stress it may be necessary to increase dosage temporarily.
If the drug is to be stopped after more than a few days of treatment, it should be withdrawn gradually.
The following equivalents facilitate changing to dexamethasone from other glucocorticoids:
Milligram for milligram, dexamethasone is approximately equivalent to betamethasone, 4 to 6 times more potent than methylprednisolone and triamcinolone, 6 to 8 times more potent than prednisone and prednisolone, 25 to 30 times more potent than hydrocortisone, and about 35 times more potent than cortisone.
Acute, self-limiting allergic disorders or acute exacerbations of chronic allergic disorders.
First day: Dexamethasone sodium phosphate injection 4mg or 8mg (1ml or 2ml) intramuscularly.
Second day: 1mg (2.5ml) Dexamethasone Oral Solution twice a day.
Third day: 1mg (2.5ml) Dexamethasone Oral Solution twice a day.
Fourth day: 500micrograms (1.25ml) Dexamethasone Oral Solution twice a day.
Fifth day: 500micrograms (1.25ml) Dexamethasone Oral Solution twice a day.
Sixth day: 500micrograms (1.25ml) Dexamethasone Oral Solution.
Seventh day: 500micrograms (1.25ml) Dexamethasone Oral Solution.
Eighth day: Re-assessment.
If a dose of less than 5ml is required, an oral dosing device should be employed.
This schedule is designed to ensure adequate therapy during acute episodes whilst minimising the risk of overdosage in chronic cases.
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