Dexamethasone injectable
Injectable dexamethasone guidance for severe allergic or inflammatory reactions and for foetal lung maturation before 34 weeks.
Therapeutic action
Long-acting steroidal anti-inflammatory drug (corticosteroid).
Indications
- Symptomatic treatment of severe allergic and inflammatory reactions, when oral administration is not possible.
- Foetal lung maturation in the event of threatened premature delivery before 34 weeks of gestation.
Forms and strengths, route of administration
- 4 mg dexamethasone phosphate in 1 ml ampoule for IM or IV injection or infusion.
Dose and duration
Symptomatic treatment of severe allergic and inflammatory reactions
Dosage varies according to indication, reaction severity, and clinical response.
- Child: 0.15 to 0.6 mg/kg, maximum 16 mg, by IM or IV injection once daily.
- Adult: 0.5 to 24 mg by IM or IV injection once daily.
Foetal lung maturation
- Administer to the mother: 6 mg by IM injection every 12 hours for 2 days, total dose 24 mg.
Contra-indications, adverse effects, precautions
Duration varies according to indication. For longer treatments, change to oral route as soon as possible. In the event of treatment longer than 10 days, decrease doses gradually to avoid adrenal suppression.
In case of systemic infections, only administer if the patient is under antimicrobial treatment.
- May cause adrenal suppression, muscle atrophy, growth retardation, increased susceptibility to infections, sodium and water retention, osteoporosis, hypokalaemia, and digitalis toxicity in prolonged high-dose treatment.
- Pregnancy and breast-feeding: no contra-indication; for symptomatic treatment of severe allergic and inflammatory reactions, use the lowest effective dose.
Source
MSF Essential drugs practical guidelines (January 2026)
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