Decadron 4 mg/ml Injection – Box of 25 Ampoules (1 ml each)

Description

Decadron injection (dexamethasone sodium phosphate) is a potent corticosteroid used to reduce inflammation, suppress immune responses, and manage allergic and certain endocrine conditions. Each ampoule contains 1 ml of solution delivering 4 mg dexamethasone. It is used under medical supervision, often in hospitals or clinics.

Ingredients

• Active ingredient: Dexamethasone sodium phosphate, equivalent to 4 mg dexamethasone per 1 ml ampoule.

• Excipients / inactive ingredients: (may include buffer, stabilizers, water for injection)

Drug Class

Corticosteroid / Glucocorticoid

Dosage Form

Sterile injection (aqueous solution) — 1 ml ampoule delivering 4 mg dexamethasone.

Uses (Indications)

Decadron injection may be used in:

• Management of severe allergic reactions and anaphylaxis

• Control of inflammation and edema (e.g., cerebral edema, spinal cord compression)

• Acute exacerbations of asthma or COPD

• Autoimmune, rheumatic, dermatological conditions

• As adjunct therapy in certain endocrine or hematologic disorders

• As part of chemotherapy regimens for antiemetic or adjunctive steroid effects

• To suppress immune responses, e.g. in transplant protocols

(References: MedlinePlus, Drugs.com) 

Dosage

• Adults: Typical injectable doses vary widely depending on the condition. Doses of 0.5 to 24 mg (IM or IV) daily have been used in clinical practice. 

• For intrajoint or local injection: e.g. 2–4 mg for large joints, 0.8–1 mg for small joints. 

• Children: Dose based on body weight (e.g. 0.15 to 0.6 mg/kg daily IV or IM) in some guidelines. 

• The specific regimen (frequency, tapering schedule) must be determined by a physician.

In Case of Overdose

• Symptoms: adrenal suppression, hyperglycemia, fluid retention, hypertension, electrolyte imbalance, immune suppression, Cushingoid features

• Management: supportive care, gradual tapering of corticosteroids, monitoring of metabolic and endocrine parameters

Missed Dose

• In clinical/injection settings, “missed dose” is not usually applicable as doses are given under supervision.

• Always follow medical direction; do not self-administer or double dose.

How to Use / Administration

• Administer via intravenous (IV) or intramuscular (IM) injection using aseptic technique.

• For IV, infusion or slow administration is preferred to avoid sudden hemodynamic changes.

• In joint or tissue injection (if indicated), local administration is done under sterile conditions.

• Physician must calculate dose, adjust for patient’s condition, and monitor.

When Not to Use (Contraindications)

• Known hypersensitivity to dexamethasone or corticosteroids

• Systemic fungal infections

• Untreated infections (unless treated)

• Active tuberculosis (unless under treatment)

• Peptic ulcer disease (active)

• Uncontrolled viral, bacterial, fungal, or parasitic infections

• Use with caution (or avoid) in patients with uncontrolled diabetes, hypertension, glaucoma, osteoporosis, mental health disorders, severe renal or hepatic disease

• In pregnancy or lactation, use only if benefit outweighs risks (pregnancy category C) 

Side Effects

Common / less serious:

• Increased appetite, weight gain

• Insomnia, restlessness

• Mood changes (irritability, euphoria, depression)

• Abdominal discomfort, dyspepsia

• Hypertension, fluid retention

• Elevated blood sugar levels

• Acne, skin thinning, bruising

Serious / less common:

• Adrenal suppression

• Increased susceptibility to infections

• Peptic ulcers or GI bleeding

• Osteoporosis, bone density loss

• Cataracts, glaucoma

• Muscle weakness, myopathy

• Psychiatric effects (psychosis, depression)

• Electrolyte imbalance (hypokalemia)

• Delayed wound healing

• Allergic reactions (rare) 

Precautions & Warnings

• Monitor blood pressure, blood glucose, electrolytes, signs of infection

• Taper dose when discontinuing long-term therapy to avoid adrenal insufficiency

• Avoid abrupt withdrawal, especially after prolonged use

• Use lowest effective dose for the shortest duration

• Be cautious in patients with comorbidities (diabetes, hypertension, peptic ulcer, osteoporosis, mental illness)

• Avoid live vaccines during therapy, as immune response may be suppressed 

• Monitor ocular health (for glaucoma, cataracts)

• Inform surgical/dental teams of steroid therapy before procedures

Drug Interactions

Potential interactions include:

• NSAIDs (e.g. ibuprofen) – increased risk of GI bleeding

• Anticoagulants (warfarin) – may alter anticoagulant effect

• Diuretics (esp. potassium-loss diuretics) – risk of hypokalemia

• Insulin / oral hypoglycemics – may require dose adjustment due to hyperglycemic effect

• Cyclosporine, tacrolimus – increased risk of immunosuppression

• Vaccines (live attenuated) – may have reduced efficacy or increased risk

• Certain antifungals, anticonvulsants, rifampin, others – may affect metabolism of dexamethasone via CYP - affecting levels 

Storage / Disposal

• Store at controlled room temperature (usually up to 25–30 °C), protect from light

• Do not freeze

• Use before expiration date

• Dispose unused or expired ampoules as per medical waste guidelines

Control Drug Status

• Dexamethasone is not typically classified as a narcotic or controlled drug, but it is a prescription medicine requiring medical oversight.

Quick Tips

• Always use under physician supervision; do not self-administer

• Monitor for side effects regularly (blood sugar, BP, signs of infection)

• Use the minimal effective dose and taper off gradually

• Avoid concomitant use of NSAIDs unless necessary

• Inform healthcare providers (surgeons, dentists) about your steroid therapy

• Keep vaccination schedule and live vaccines under supervision during therapy