API: Dexamethasone Sodium Phosphate

What Is Dexamethasone Sodium Phosphate and How Does It Work?

Dexamethasone Sodium Phosphate (DSP) is a corticosteroid similar to a natural hormone produced in the adrenal gland. The drug is both an anti-inflammatory and an immunosuppressant, and as such is used to treat a number of indications across a broad spectrum of classes. This includes endocrine disorders, rheumatic disorders, collagen diseases, dermatologic diseases, allergies, ophthalmic diseases, gastrointestinal diseases, respiratory diseases, hematologic disorders, neoplastic diseases, edematous states, cerebral edema, tuberculosis, meningitis, trichinosis with myocardial or neurologic involvement, and to prevent nausea and vomiting induced by chemotherapy and post-operative stress.1

For more information, including a MSDS sheet, please see PNA’s Dexamethasone Sodium page.


Approved Indications2

Endocrine disorders: DSP is used to treat a number of endocrine disorders, such as primary and secondary adrenocortical insufficiency (possibly in conjunction with mineralocorticoids), preoperatively or in the event of trauma or illness in patients with known adrenal insufficiency, congenital adrenal hyperplasia, nonsuppurative thyroiditis, or in cases of hypercalcemia associated with cancer.

Rheumatic disorders: DSP can be used as a short-term adjunct therapy when treating post-traumatic osteoarthritis, synovitis of osteoarthritis, adult and juvenile rheumatoid arthritis, acute and subacute bursitis, epicondylitis, acute nonspecific tenosynovitis, acute gouty arthritis, psoriatic arthritis, and ankylosing spondylitis.

Collagen diseases: DSP is used for long-term management or acute treatment of systemic lupus erythematosus and acute rheumatic carditis.

Dermatological diseases: A number of dermatological diseases are treated with DSP, including pemphigus, Stevens-Johnson Syndrome, exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe psoriasis, and mycosis fungoides.

Allergies: DSP is used to control a number of severe allergic conditions, such as bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, seasonal or perennial allergic rhinitis, drug hypersensitivity reactions, and urticarial transfusion reactions.

Ophthalmic diseases: Many severe and acute conditions of the eye, such as Herpes zoster ophthalmicus, iritis, iridocyclitis, chorioretinitis, diffuse posterior uveitis and choroiditis, optic neuritis, sympathetic ophthalmia, anterior segment inflammation, allergic conjunctivitis, allergic corneal marginal ulcers, and keratitis, are treated with DSP.

Gastrointestinal diseases: DSP may help in short transitional treatment of ulcerative colitis and regional enteritis.

Respiratory diseases: DSP is used to treat symptomatic sarcoidosis, berylliosis, Loeffler’s syndrome, aspiration pneumonitis, and as an adjunct in fulminating or disseminated pulmonary tuberculosis.

Hematological disorders: DSP is also used to treat acquired (autoimmune) hemolytic anemia, idiopathic thrombocytopenic purpura in adults, secondary thrombocytopenia in adults, erythroblastopenia, and congenital (erythroid) hypoplastic anemia.

Nausea from surgical procedures and chemotherapy3: DSP is often used to stimulate appetite in cancer patients in post-operative states.

Other indications: DSP is also indicated for palliative management of certain neoplastic diseases, to treat edematous states as well as acute exacerbations of multiple sclerosis, and to treat more complicated cases of tuberculous meningitis, trichinosis with neurologic or myocardial involvement, and cerebral edema of diverse etiologies.


Side Effects and Drug Interactions

Common side effects in patients taking dexamethasone sodium include4:

  • Upset stomach or stomach irritation
  • Vomiting
  • Headache, dizziness, or insomnia
  • Restlessness or anxiety
  • Acne or increased hair growth
  • Easy bruising
  • Irregular or absent menstrual periods

Patients who suffer from any of the following serious side effects should contact their pharmacist or physician immediately.

  • Skin rash
  • Excessively high blood pressure or shortness of breath
  • Pancreatitis
  • Low potassium
  • Swelling in the face, lower legs, or ankles
  • Vision problems
  • High fever or other signs of infection
  • Muscle weakness
  • Black, bloody, or tarry stool
  • Sudden confusion

Patients who are allergic to DSP or who have systemic fungal infections should not take this medication. Since corticosteroids are implicated in many bodily processes, patients should discuss their individual cases and concurrent medications with a physician before starting this treatment. Dose and duration of treatment should be treated as a risk/benefit ratio unique to each individual case.

Note that dexamethasone should not be stopped abruptly. Dosage changes may be needed due to stress or other medical factors. Long term use of any steroid may cause a number of unwanted side effects, such as thinning of skin, easy bruising, changes in the distribution of body fat, excessive acne or facial hair, and impotence or loss of interest in sex.


Latest News and Research

DSP was developed in 1957 and is currently on the World Health Organization’s (WHO) List of Essential Medicines.5 This list, which is updated every two years, includes drugs that the WHO defines to “satisfy the health care needs of the majority of the population; they should therefore be available at all times in adequate amounts and in appropriate dosage forms, at a price the community can afford.”

Because DSP is indicated in the treatment of so many diseases and disorders, research into the optimization and delivery methods (oral versus injections) of DSP for specific conditions results in hundreds of new articles each year. Physicians should consult with experts in the specific condition treated to review the latest research regarding the use of DSP for that condition.


Buying Guide

PNA is a recommended bulk supplier of Dexamethasone Sodium Phosphate and other APIs. You can learn more about Dexamethasone Sodium Phosphate here.

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Resources

Show 5 footnotes

  1. “Dexamethasone Sodium Phosphate,” November 19, 2105, http://www.ashp.org/menu/DrugShortages/CurrentShortages/Bulletin.aspx?id=751
  2. “Dexamethasone Sodium Phosphate,” December 1, 2015, http://www.drugs.com/pro/dexamethasone-sodium-phosphate.html
  3. “Dexamethasone Sodium Phosphate,” 2015, http://chemocare.com/chemotherapy/drug-info/dexamethasone-sodium-phosphate.aspx
  4. “Dexamethasone Oral,” November 20, 2015, https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682792.html
  5. “WHO Model Lists of Essential Medicines,” August 2015, http://www.who.int/medicines/publications/essentialmedicines/en/