Dexam 5 mg/ml Injection

Dexam 5 mg/ml injection by Medimet Pharmaceuticals Ltd. is an injectable corticosteroid medicine containing Dexamethasone Sodium Phosphate. In Bangladesh, it is mainly used in hospitals or clinics to treat severe inflammation, serious allergic reactions, asthma/COPD exacerbations, certain autoimmune conditions, cerebral oedema, and other conditions where a fast steroid effect is needed.

Dexamethasone Sodium Phosphate works by reducing inflammation and suppressing overactive immune responses. A key caution is that it can increase infection risk and may worsen uncontrolled diabetes, high blood pressure, or stomach ulcer problems, so it should be used only when clinically appropriate.

• Severe allergic reactions and angioedema as an adjunct to standard emergency treatment.
• Acute exacerbations of asthma or chronic obstructive pulmonary disease when a systemic corticosteroid is needed.
• Inflammatory and autoimmune disorders such as rheumatic, dermatologic, allergic, respiratory, eye, blood, gastrointestinal, and renal conditions when corticosteroid therapy is indicated.
• Cerebral oedema associated with brain tumours or neurosurgical conditions, when prescribed by a specialist.
• Certain endocrine disorders, including adrenal insufficiency, as part of appropriate corticosteroid replacement or emergency management.
• Supportive treatment in selected cancers and chemotherapy-related nausea/vomiting regimens when prescribed.
• Use when oral corticosteroid therapy is not possible or a rapid injectable effect is required.

Dexamethasone Sodium Phosphate injection may be given by intravenous, intramuscular, or sometimes local injection routes depending on the condition and the product instructions. Adult dosing varies widely by diagnosis, severity, route, and response. It should be administered by a trained healthcare professional, using the lowest effective dose for the shortest suitable time. If treatment is continued for more than a short course, the doctor may reduce the dose gradually rather than stopping suddenly.

• Increased appetite, indigestion, nausea, or stomach discomfort.
• Difficulty sleeping, mood changes, anxiety, or irritability.
• Raised blood glucose, fluid retention, swelling, or increased blood pressure.
• Increased risk of infections or masking of infection symptoms such as fever.
• Injection-site pain, irritation, or local tissue changes.
• With repeated or high-dose use: weight gain, Cushingoid appearance, muscle weakness, osteoporosis, skin thinning, easy bruising, cataract or glaucoma, and adrenal suppression.
• Serious but less common effects include severe allergic reaction, gastrointestinal bleeding or perforation, severe psychiatric symptoms, pancreatitis, serious infection, and electrolyte disturbances.

Use caution in people with current or recent infections, tuberculosis, diabetes, hypertension, heart failure, kidney or liver disease, peptic ulcer disease, osteoporosis, glaucoma, cataract, epilepsy, myasthenia gravis, thyroid disorders, or a history of severe mood or psychiatric illness. Avoid abrupt withdrawal after prolonged use because adrenal suppression may occur. Use under a registered doctor's or pharmacist's guidance, and inform healthcare providers about all current medicines and vaccines before receiving this injection.

• NSAIDs such as ibuprofen, diclofenac, or naproxen may increase the risk of stomach ulcer or bleeding.
• Anticoagulants such as warfarin may have altered effect; monitoring may be needed.
• Antidiabetic medicines and insulin may need adjustment because dexamethasone can raise blood glucose.
• Live vaccines should generally be avoided during immunosuppressive corticosteroid therapy; vaccine response may be reduced.
• Enzyme inducers such as rifampicin, phenytoin, carbamazepine, and phenobarbital may reduce dexamethasone effect.
• CYP3A4 inhibitors such as ketoconazole, itraconazole, clarithromycin, ritonavir, or cobicistat may increase corticosteroid exposure and side effects.
• Diuretics that lower potassium, amphotericin B, or high-dose beta-agonists may increase the risk of low potassium; digoxin toxicity risk may rise if potassium is low.
• Cyclosporine may increase exposure to either medicine and may increase seizure risk.

• Known hypersensitivity to dexamethasone, other corticosteroids, or any component of the injection.
• Systemic fungal infection unless specifically directed by a specialist for a life-threatening situation.
• Administration of live or live-attenuated vaccines during immunosuppressive doses of corticosteroids.
• Local injection into an area with untreated local infection, when applicable.

Dexamethasone crosses the placenta. During pregnancy, it should be used only when the expected benefit justifies potential risks, especially with repeated or prolonged courses. Newborns exposed to substantial corticosteroid doses may need observation for adrenal suppression. Dexamethasone can pass into breast milk; short medically necessary use is often compatible with breastfeeding, but high-dose or prolonged therapy may affect the infant or milk production. Pregnant or breastfeeding patients should follow the prescribing doctor's advice.

Store as directed on the product label, usually at controlled room temperature, protected from light, and do not freeze. Keep out of the reach of children. Do not use if the solution is discoloured, cloudy, contains particles, or the ampoule/vial is damaged. Use only before the expiry date and discard any unused portion according to healthcare facility procedures.