Drenex Dosage/Direction for Use

Individualized dexamethasone dose based on the condition being treated and the response of the patient.
Initial Oral Adult Dose: Varies from 0.75 mg (750 mcg) to 9 mg a day depending on the type and severity of the disease being treated.
Initial Oral Pediatric Dose: Varies from 0.02 to 0.3 mg/kg body weight per day (0.6 to 9 mg/m² body surface area/day) depending on the type and severity of the disease being treated given in three or four divided doses.
Maintain and/or adjust initial dosage until a satisfactory response is noted. Discontinue dexamethasone and shift the patient to other appropriate therapy if clinical response is unsatisfactory.
Signs that may require dosage adjustment include changes in clinical status resulting from remissions or exacerbations of the disease, individual drug responsiveness, and stress which may be attributed to surgery, infection, or trauma. In times of stress (e.g., surgery, infection, or trauma) temporarily increasing corticosteroid dose in patients with adrenal insufficiency may be necessary.
Upon obtaining a satisfactory response, decrease dose in small increments until the lowest level that maintains an adequate clinical response is reached.
Gradually withdraw dexamethasone when stopping treatment after long-term therapy (more than 3 weeks) since significant adrenal suppression is expected to occur in patients receiving corticosteroids for more than 3 weeks.
Treatment of Acute Exacerbations of Multiple Sclerosis: Usual Recommended Oral Dexamethasone Dose: 30 mg daily for a week, then 4 to 12 mg every other day for 1 month.
Treatment of Acute, Self-Limited Allergic Disorders or Acute Exacerbations of Chronic Disorders: Day 1: 4-8 mg dexamethasone sodium phosphate injection given IM.
Days 2 & 3: 3 mg oral dexamethasone in two divided doses.
Day 4: 1.5 mg oral dexamethasone in two divided doses.
Days 5 & 6: 0.75 mg (750 mcg) oral dexamethasone once daily.
Then the drug is discontinued.
Treatment of Cerebral Edema: Dexamethasone sodium phosphate injection is generally administered initially until symptoms of cerebral edema subside.
When possible, oral dexamethasone 1-3 mg three times daily should replace parenteral dexamethasone.
Treatment of Chemotherapy-Induced Nausea and Vomiting: See table.

Click on icon to see table/diagram/image

Dexamethasone Suppression Tests: A. Test For Cushing's Syndrome: 1 mg Dexamethasone orally at 11 PM, then blood is extracted for plasma cortisol determination at 8 AM the following morning or 0.5 (500 mcg) Dexamethasone orally every 6 hours for 48 hours, then to determine urine free cortisol and 17-hydroxycorticosteroid excretion.
This test provides greater accuracy.
B. Test for distinguishing Cushing's Syndrome due to pituitary Adrenocorticotropic Hormone (ACTH) excess from Cushing's syndrome due to other causes: 2 mg Dexamethasone orally every 6 hours for 48 hours, then 24-hour urine free cortisol and 17-hydroxycorticosteroid excretion.