Dexamethasone
Dexamethasone is used in veterinary medicine for inflammatory disease.
Group
Glucocorticoid
Mechanism of Action
Glucocorticoid-receptor activation suppresses inflammatory mediator expression and immune-cell activity.
Dose Rates
Dog
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammation | 0.07–0.15 mg/kg | IV, IM, PO | Every 12–24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dose expressed as dexamethasone; select a preparation labelled in dexamethasone equivalents. IV use requires a suitable soluble formulation. |
| Immunosuppression — Initial | 0.125–0.25 mg/kg | IV, IM, PO | Every 24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dose expressed as dexamethasone; select a preparation labelled in dexamethasone equivalents. IV use requires a suitable soluble formulation. |
| Pulse immunosuppression | Reference only | PO | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; 0.5 mg/kg daily for 4 consecutive days, repeated every 28 days. Cycle-dependent protocol. | |
| Low-dose suppression test | 0.01 mg/kg | IV | Once | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| Low-dose suppression test | 0.015 mg/kg | IV | Once | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Alternative laboratory protocol. |
| High-dose suppression test | 0.1 mg/kg | IV | Once | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| Alternative high-dose suppression test | Reference only | IV | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; The source also cites 1 mg/kg in dogs; confirm the laboratory protocol before using this tenfold alternative. | |
| Shock or spinal injury | Reference only | IV | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Historical 2.2–4.4 mg/kg IV regimen: efficacy is questionable and risks may be high; routine high-dose use is unsupported. | |
| Isonicotinate anti-inflammatory regimen | Reference only | IM | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dexamethasone-21-isonicotinate 0.03–0.05 mg/kg IM. Different ester basis; retained outside generic dexamethasone calculation. | |
| Addisonian crisis — Initial | 0.1–0.2 mg/kg | IV | Use soluble dexamethasone sodium phosphate with strength interpreted on the stated dexamethasone basis; dexamethasone does not cross-react with the cortisol assay. | |
| Addisonian crisis — Initial | 0.2–0.5 mg/kg | IV | Once | Alternative initial regimen using dexamethasone sodium phosphate; transition to oral glucocorticoid replacement when feasible. |
| Addisonian crisis — Maintenance | 0.05–0.1 mg/kg | IV | Every 12 h | Temporary parenteral replacement while vomiting or inappetent; transition to oral prednisone when tolerated. No mineralocorticoid activity. |
Cat
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammation | 0.07–0.15 mg/kg | IV, IM, PO | Every 12–24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dose expressed as dexamethasone; select a preparation labelled in dexamethasone equivalents. IV use requires a suitable soluble formulation. |
| Immunosuppression — Initial | 0.125–0.25 mg/kg | IV, IM, PO | Every 24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dose expressed as dexamethasone; select a preparation labelled in dexamethasone equivalents. IV use requires a suitable soluble formulation. |
| Inflammation — Initial | 0.1–0.2 mg/kg | PO | Every 24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Alternative oral regimen, mixed with food. |
| Inflammation — Maintenance | 0.05 mg/kg | PO | Every 48–72 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| Pulse immunosuppression | Reference only | PO | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; 0.5 mg/kg daily for 4 consecutive days, repeated every 28 days. Cycle-dependent protocol. | |
| Low-dose suppression test | 0.1 mg/kg | IV | Once | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| High-dose suppression test | 1 mg/kg | IV | Once | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| Shock or spinal injury | Reference only | IV | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Historical 2.2–4.4 mg/kg IV regimen: efficacy is questionable and risks may be high; routine high-dose use is unsupported. | |
| Isonicotinate anti-inflammatory regimen | Reference only | IM | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dexamethasone-21-isonicotinate 0.03–0.05 mg/kg IM. Different ester basis; retained outside generic dexamethasone calculation. |
Horse
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammation | 0.04–0.15 mg/kg | IV, IM | Every 24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| Inflammation | 5–20 mg/animal | IV, IM | Every 24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Alternative fixed-dose product regimen; do not combine with the weight-based alternative. |
| Equine asthma | 0.05–0.1 mg/kg | IV, IM | Every 24 h | Up to 3 days; Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| Equine asthma | 0.165 mg/kg | PO | Every 24 h | Up to 3 days; Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Short oral course. Longer courses require a separate taper. |
| Equine asthma taper | Reference only | PO | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; 0.165 mg/kg daily for 7 days, then half that dose daily for another 7 days. | |
| Isonicotinate anti-inflammatory regimen | Reference only | IM | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dexamethasone-21-isonicotinate 0.01–0.04 mg/kg IM; do not calculate with dexamethasone-base strengths. | |
| Dexamethasone suppression test | 0.04 mg/kg | IM | Once | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Use the sampling times specified by the laboratory protocol. |
| Equine asthma | 0.05 mg/kg | PO | Every 24 h | Up to 7 days; Studied during continuing antigen exposure; environmental control remains important. |
| Sodium-phosphate asthma taper | Reference only | IM | Dexamethasone sodium phosphate regimen: 0.1 mg/kg daily for four days, 0.075 mg/kg daily for four days, then 0.05 mg/kg daily for four days, with environmental control. Interpret the product strength on its explicitly stated active basis. |
Cattle
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammation | 0.04–0.15 mg/kg | IV, IM | Every 24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan |
| Inflammation | 5–20 mg/animal | IV, IM | Every 24 h | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Alternative fixed-dose product regimen; do not combine with the weight-based alternative. |
| Isonicotinate anti-inflammatory regimen | Reference only | IM | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Dexamethasone-21-isonicotinate 0.01–0.04 mg/kg IM; do not calculate with dexamethasone-base strengths. | |
| Ketosis | 0.01–0.04 mg/kg | IV, IM | Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan | |
| Insect bite or sting adjunct | Reference only | IV | The additional source prints 2 mg/kg IV or IM every 4 hours, far above its other glucocorticoid regimens; the dose is unresolved. Epinephrine is the immediate treatment if anaphylaxis develops. | |
| Ketosis | 5–20 mg | IV, IM |
Sheep
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Induction of parturition | 0.15 mg/kg | IM | Every 24 h | Up to 5 days; Do not use in: Concurrent NSAID treatment without a specific risk-assessed plan; Use for 1–5 days during the final week of gestation. |
Mouse
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory therapy | 0.6 mg/kg | IM |
Rat
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory therapy | 0.6 mg/kg | IM |
Gerbil
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory therapy | 0.6 mg/kg | IM |
Hamster
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory therapy | 0.6 mg/kg | IM |
Guinea Pig
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory therapy | 0.6 mg/kg | IM |
Chinchilla
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory therapy | 0.6 mg/kg | IM |
Pig
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Glucocorticoid therapy | 1–10 mg | IV, IM |
Reptile
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Adjunctive septic shock therapy | 0.1–0.25 mg/kg | IV, IM | Dexamethasone sodium phosphate regimen; adjunctive treatment only. |
Llama
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anaphylaxis adjunct | Reference only | IV | The additional source reports 2 mg/kg IV as adjunctive therapy; its unusually high amount is inconsistent with the other supplied glucocorticoid regimens and is retained as an unresolved reference. |
Indications
- Inflammatory disease
- Immune-mediated disease
- Adrenal suppression testing
- Equine asthma
- Bovine ketosis
- Induction of parturition
Contraindications
- Use cautiously with infection, ulcers, diabetes, renal disease, pregnancy or impaired wound healing.
- Dexamethasone isonicotinate suspension must not be given IV.
- Do not apply ophthalmic corticosteroids to an ulcerated cornea or an uncontrolled ocular infection.
Interactions
- NSAIDs increase gastrointestinal injury.
- Do not mix alkaline dexamethasone solutions with acidifying solutions.
Adverse effects
- Polyuria, polydipsia and polyphagia
- Adrenal suppression, hyperglycemia and hepatopathy
- Gastrointestinal ulceration and secondary infection
- Delayed healing; possible equine laminitis
Toxicity
Excess or prolonged exposure causes iatrogenic hyperadrenocorticism and adrenal suppression; abrupt withdrawal after prolonged treatment can cause adrenal insufficiency.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Dexamethasone 0.25 mg | Tablet | 0.25 mg / tablet | PO |
| Dexamethasone 0.5 mg | Tablet | 0.5 mg / tablet | PO |
| Dexamethasone 0.75 mg | Tablet | 0.75 mg / tablet | PO |
| Dexamethasone 1 mg | Tablet | 1 mg / tablet | PO |
| Dexamethasone 1.5 mg | Tablet | 1.5 mg / tablet | PO |
| Dexamethasone 2 mg | Tablet | 2 mg / tablet | PO |
| Dexamethasone 4 mg | Tablet | 4 mg / tablet | PO |
| Dexamethasone 6 mg | Tablet | 6 mg / tablet | PO |
| Dexamethasone polyethylene-glycol solution 2 mg/mL Give IV slowly; soluble sodium phosphate is preferred for IV use. | Injection | 2 mg / mL | IV, IM |
| Dexamethasone oral solution 0.1 mg/mL | Oral Liquid | 0.1 mg / mL | PO |
| Dexamethasone oral solution 1 mg/mL | Oral Liquid | 1 mg / mL | PO |
| Dexamethasone powder 10 mg/15 g | Powder | 10 mg / 15 g | PO |
| Dexamethasone sodium phosphate 4 mg/mL The source describes this presentation as equivalent to 3 mg/mL dexamethasone base. Salt-labelled product is not auto-linked to the base regimen. | Injection | 4 mg / mL | IV, IM |
| Dexamethasone isonicotinate suspension 1 mg/mL Depot ester; never IV. | Injection | 1 mg / mL | IM |
| Glucortin-20 2 mg/mL Interchemie werken De Adelaar B.V. Contains dexamethasone 2 mg/mL as sodium phosphate, explicitly expressed as dexamethasone equivalents. | Injection | 2 mg / mL | IV, IM |
| Dexamethasone sodium phosphate ophthalmic solution 0.1% Ophthalmic solution only; not an injectable preparation. Confirm the label’s salt-equivalent basis before interchange. | Other | 1 mg / mL | TOPICAL |
| Dexamethasone phosphate ophthalmic ointment 0.05% Ophthalmic ointment; not interchangeable with systemic formulations. | Other | 0.5 mg / g | TOPICAL |
Monitoring and Administration
Sodium phosphate is the preferred water-soluble IV form. Polyethylene-glycol solutions require slow injection because rapid injection can cause hemolysis, hypotension or collapse.
Monitor clinical response, glucose, infection and CBC during prolonged treatment; taper when indicated.
For canine/feline low-dose suppression testing, obtain baseline, 4-hour and 8-hour cortisol samples.
Equine suppression sampling differs between source protocols (17 and 19 hours versus 24 hours); use one validated laboratory protocol.
Protect from light. Sodium phosphate diluted in saline or 5% dextrose has a reported 24-hour use period. Formulation-specific stability must not be transferred to unrelated mixtures.
0.05 mg/kg (example: 25 mg per cow) during the final 1–2 weeks of gestation. The source does not explicitly specify the route for this regimen and cites an ambiguous PGF2-alpha combination amount; route and combination must be resolved before calculation.
For canine low-dose dexamethasone suppression testing, collect baseline, four-hour and eight-hour cortisol samples; feline testing uses a different dose. Use the laboratory’s species-specific interpretation. Dexamethasone has a long biological effect, so alternate-day administration may still suppress adrenal function.