METADEXAN Injection — Dexamethasone 4mg/mL by Beximco Pharmaceuticals

METADEXAN Injection — Dexamethasone 4mg/mL | Beximco Pharmaceuticals

Overview

METADEXAN Injection provides Dexamethasone Sodium Phosphate 4mg/mL — the standard parenteral form of this highly potent synthetic glucocorticoid. Injectable dexamethasone is used when rapid, reliable corticosteroid action is required and oral administration is not possible or fast enough — particularly in acute anaphylaxis, severe asthma, cerebral oedema, and adrenal crisis. The IV route provides the fastest onset (effect within minutes), making it first-line in emergency situations. Dexamethasone injection also plays a critical role in oncology for antiemesis and anti-tumour-oedema therapy.

Key Indications

• Anaphylaxis: Third-line agent (after epinephrine and antihistamines) for sustained anti-inflammatory effect and prevention of biphasic reaction
• Severe asthma / COPD exacerbation: Rapid systemic anti-inflammatory effect
• Cerebral oedema: Peri-tumoral, post-operative, or abscess-related — dexamethasone reduces vasogenic cerebral oedema
• Bacterial meningitis: 0.15 mg/kg IV 6-hourly for 4 days alongside antibiotics — reduces hearing loss and neurological sequelae
• Chemotherapy antiemesis: IV dexamethasone pre- and post-chemotherapy — significantly reduces nausea and vomiting
• Adrenal crisis: IV hydrocortisone preferred, but IV dexamethasone can be used in emergency
• Spinal cord compression: High-dose dexamethasone to reduce cord oedema
• COVID-19: 6mg once daily (IV if not tolerating oral) in severe cases requiring oxygen support

Dosage

Critical Diabetic Patient Warnings

• Acute severe hyperglycaemia: A single dose of IV dexamethasone 8–10mg can raise blood glucose by 8–15 mmol/L within 2–4 hours in diabetic patients — monitor BGL 2–4 hourly after administration. IV insulin correction may be required.
• Emergency setting: In acute emergencies (anaphylaxis, severe asthma), life-saving treatment takes priority — give dexamethasone and manage hyperglycaemia actively afterwards.
• Hyperglycaemia and outcomes: Steroid-induced hyperglycaemia in hospitalised patients independently worsens outcomes — wound healing, infection risk, and mortality all increase with persistent hyperglycaemia above 10 mmol/L.
• Insulin protocol: Most hospitals have a steroid-induced hyperglycaemia sliding scale protocol — ensure this is initiated when dexamethasone is prescribed in diabetic inpatients.
• Hypoglycaemia after steroid stops: When dexamethasone is stopped, BGL may fall significantly — watch for hypoglycaemia within 12–24 hours of stopping, particularly if insulin doses were increased during treatment.

Side Effects (IV/IM)

Immediate: transient perineal warmth/flushing (IM route). Hyperglycaemia within 2–4 hours (diabetics). Short-term: insomnia, mood changes, fluid retention, GI upset. With repeated courses: same as oral — Cushing's, osteoporosis, adrenal suppression.

Storage

Store at 15–25°C. Protect from light and freezing. Single use — discard unused portion.

Medical Disclaimer: IV/IM Dexamethasone causes acute hyperglycaemia in diabetic patients. Blood glucose monitoring and active management are essential during and after administration. Hospital and prescription use only.