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Dexamethasone

By: Dr. Dawn Ruben

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Overview

  • The immune and inflammation systems of pets and people constitute essential safeguards against infections and disease.
  • However, in some situations, inflammation is dangerous and can lead to severe damage in tissues and organs.
  • Similarly, the immune system, often for no apparent reason, can attack the body, causing great damage or even death. The resulting medical conditions are called autoimmune diseases.
  • There are a number of drugs available to control inflammation and suppress the immune system. Among the most prominent of these are steroid hormones resembling cortisone.
  • Dexamethasone is a potent glucocorticoid, a hormone that is related to cortisone (which is normally produced by the adrenal gland).
  • The effects of glucocorticoids, such as dexamethasone, can be observed in every organ system and these drugs should only be used when necessary.
  • An important effect of dexamethasone is the suppression of the immune system, when given at specific doses.
  • Dexamethasone also reduces inflammation throughout the body, though the effects on the nervous system are limited.
  • Dexamethasone is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.

    Brand Names and Other Names

  • This drug is registered for use in animals and humans.
  • Human formulations: Dexamethasone is supplied by numerous drug companies with a variety of trade names and various generic preparations
  • Veterinary formulations: Azium® (Schering), Pet-Derm® (Pfizer), Dexameth-a-Vet® (Anthony), Dex-a-Vet® (Anthony) and various generic preparations

    Uses of Dexamethasone

  • Since dexamethasone exhibits effects on nearly every body system, the uses of this drug are wide and varied.
  • Dexamethasone often is used in the treatment of shock related to infection or the release of endotoxins (toxic chemicals produced by some bacteria).
  • Dexamethasone is used to help diagnose and treat diseases of the adrenal glands.
  • It may be part of a treatment plan for various cancers, respiratory diseases, liver disorders, gastrointestinal diseases, skin disorders and nervous system abnormalities.
  • Dexamethasone is also used to suppress the immune system in autoimmune diseases such as immune mediated hemolytic anemia.

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, dexamethasone can cause side effects in some animals.
  • Dexamethasone should not be used in animals with known hypersensitivity or allergy to the drug.
  • Dexamethasone may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with dexamethasone. Such drugs include furosemide, insulin, phenobarbital, certain vaccines and non-steroidal anti-inflammatories.
  • Common side effects include increased thirst and appetite, panting, vomiting, restlessness and diarrhea.
  • Elevations in liver enzymes are commonly observed. These liver changes are often mild – and of little consequence – but in other cases, liver injury can constitute a more serious problem.
  • Dexamethasone should be avoided in infections caused by fungi (molds and yeasts) and as a general rule should not be given to treat infectious disease (except in cases of shock).
  • Dexamethasone should not be administered to pregnant animals, since it can induce labor.
  • Extreme care must be taken when stopping dexamethasone therapy. If an animal has received dexamethasone for an extended period of time, slow weaning of the drug is critical to avoid serious complications caused by insufficiency of the adrenal glands.
  • Some animals develop stomach or intestinal ulcers or experience bloody diarrhea related to dexamethasone use.
  • Long-term treatment with dexamethasone may result in loss of hair, weakening of the muscles, liver impairment and behavioral changes.

    How Dexamethasone Is Supplied

  • Dexamethasone is available in 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg and 6 mg tablets.
  • It is also available in 2 mg/ml, 4 mg/ml, 8 mg/ml, 10 mg/ml, 16 mg/ml, 20 mg/ml and 24 mg/ml injectable forms.
  • Dexamethasone is also available as a 0.5mg/5ml liquid preparation.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • The dose of dexamethasone varies depending on the reason for prescribing and the dose will be determined based on the disorder, severity of the condition, and the duration of therapy.
  • Anti-inflammatory doses range from 0.1 to 0.3 mg per pound (0.2 to 0.5 mg/kg) up to twice daily.
  • Immunosuppressive doses range from 1 to 3 mg per pound (2 to 6 mg/kg) up to three times daily.
  • Doses for various disease range between 0.1 to 3 mg per pound (0.2 to 6 mg/kg).
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.




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