Active Ingredient: Dexamethasone
For this indication, competent medicine agencies globally authorize below treatments:
Intravenous
3.4 - 41.5 mg
From 0.34 To 4.15 mg 10 time(s) per day every day
Initially 8.3 mg (2.2 mL) dexamethasone solution for injection intravenously followed by 3.3 mg (0.9 mL) intramuscularly every 6 hours until symptoms of cerebral oedema subside. Response is usually noted within 12 to 24 hours: dosage may be reduced after 2 to 4 days and gradually discontinued over a period of 5 to 7 days.
High doses of dexamethasone solution for injection are recommended for initiating short-term intensive therapy for acute life-threatening cerebral oedema. Following the high loading dose schedule of the first day of therapy, the dose is scaled down over the 7 to 10 day period of intensive therapy and subsequently reduced to zero over the next 7 to 10 days. When maintenance therapy is required, this should be changed to oral dexamethasone as soon as possible.
Suggested high dose schedule in cerebral oedema is listed in the chart below:
| Adults | |
|---|---|
| Initial Dose | 41.5 mg (10.9 ml), I.V. |
| 1st day | 6.6 (1.7 ml) mg, I.V. every 2 hours |
| 2nd day | 6.6 (1.7 ml) mg, I.V. every 2 hours |
| 3rd day | (1.7 ml) mg, I.V. every 2 hours |
| 4th day | 3.3 mg (0.9 ml), I.V. every 2 hours |
| 5th to 8th day | 3.3 mg (0.9 ml), I.V. every 4 hours |
| Thereafter | decrease by daily reduction of 3.3 mg (0.9 ml) |
| Children (35 kg and over) | |
| Initial Dose | 20.8 mg (5.5 ml), I.V. |
| 1st day | 3.3 mg (0.9 ml), I.V. every 2 hours |
| 2nd day | 3.3 mg (0.9 ml), I.V. every 2 hours |
| 3rd day | 3.3 mg (0.9 ml), I.V. every 2 hours |
| 4th day | 3.3 mg (0.9 ml), I.V. every 4 hours |
| 5th to 8th day | 3.3 mg (0.9 ml), I.V. every 6 hours |
| Thereafter | decrease by daily reduction of 1.7 mg (0.4 ml) |
| Children (below 35 kg) | |
| Initial Dose | 16.6 mg (4.4 ml), I.V. |
| 1st day | 3.3 mg (0.9 ml), I.V. every 3 hours |
| 2nd day | 3.3 mg (0.9 ml), I.V. every 3 hours |
| 3rd day | 3.3 mg (0.9 ml), I.V. every 3 hours |
| 4th day | 3.3 mg (0.9 ml), I.V. every 6 hours |
| 5th to 8th day | 1.7 mg (0.4 ml), I.V. every 6 hours |
| Thereafter | decrease by daily reduction of 0.83 mg (0.2 ml) |
For palliative management of patients with recurrent or inoperable brain tumours: Maintenance therapy should be individualized with dexamethasone solution for injection or dexamethasone tablets. A dosage of 1.7 mg (0.4 ml) 2 or 3 times a day may be effective.
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