Dexamethasone sodium phosphate is available as a 4 mg/mL solution in 1-, 5-, and 30-mL multiple-dose vials.3744 Each mL of solution contains dexamethasone phosphate 4 mg, sodium citrate dihydrate 11 mg, sodium sulfite 1 mg, and benzyl alcohol 10 mg in water for injection; citric acid and/or sodium hydroxide may be used to adjust the pH.3744
Dexamethasone sodium phosphate also is available as a 10 mg/mL solution in 10-mL multiple-dose vials.3745 Each mL of solution contains dexamethasone phosphate 10 mg, sodium citrate dihydrate 13.5 mg, and benzyl alcohol 10 mg in water for injection; citric acid and/or sodium hydroxide may be used to adjust the pH.3745
Dexamethasone sodium phosphate also is available as a 10 mg/mL preservative-free solution in 1-mL single-dose vials.3745 Each mL of solution contains dexamethasone phosphate 10 mg with sodium citrate dihydrate 24.75 mg in water for injection; citric acid and/or sodium hydroxide may be used to adjust the pH.3745
pH
Dexamethasone sodium phosphate injections have a pH range from 7 to 8.5.3744; 3755 Dexamethasone sodium phosphate (David Bull) 0.5, 1, and 2 mg/mL in sodium chloride 0.9% for continuous subcutaneous infusion had pH values of 7.3, 7.3, and 7.5, respectively.2161
Osmolality
The osmolality of the 4-mg/mL concentration of dexamethasone sodium phosphate (Elkins-Sinn) was determined by freezing-point depression to be 356 mOsm/kg.1071 Another study reported the osmolality of a dexamethasone injection (manufacturer unspecified) to be 255 mOsm/kg.1233
Dexamethasone sodium phosphate (David Bull) 0.5, 1, and 2 mg/mL in sodium chloride 0.9% for continuous subcutaneous infusion had osmolalities of 269, 260, and 238 mOsm/kg, respectively.2161
Dexamethasone sodium phosphate 4- and 10-mg/mL may be administered by intravenous injection and by intramuscular, intra-articular, intrasynovial, intralesional, or soft-tissue injection.4; 3744; 3745
Intact vials of dexamethasone sodium phosphate should be stored at controlled room temperature and protected from light and freezing.3744; 3745 Dexamethasone sodium phosphate is heat sensitive; vials should not be autoclaved.3744; 3745
Dexamethasone sodium phosphate (Lyphomed) was diluted to a concentration of 1 mg/mL with bacteriostatic sodium chloride 0.9% and packaged in 10-mL sterile glass vials. The dilutions remained clear and colorless, and little or no loss of dexamethasone was found after 28 days of storage at 4 and 22°C.1940
Dexamethasone sodium phosphate under simulated summer conditions in paramedic vehicles was exposed to temperatures ranging from 26 to 38°C over 4 weeks. Analysis found no loss of the drug under these conditions.2562
Syringes
The stability of dexamethasone sodium phosphate (Organon Teknica) 10 mg/mL repackaged into 1- and 2.5-mL Glaspak (Becton Dickinson) and 1- and 3-mL plastic (Monoject, Sherwood) syringes was reported. Samples in the Glaspak syringes were stored at 4 and 23°C, exposed to light and both shaken and unshaken during storage. Samples in plastic syringes were stored only at 23°C. Not more than 5% loss occurred in the Glaspak syringes after 91 days at either temperature. Similarly, losses in the 3-mL plastic syringes were 7% or less after 55 days while losses in the 1-mL plastic syringes were 3% or less in 35 days; these time periods were the maximum that the plastic syringes were evaluated in this study. No contamination by the rubber components was found to leach into the drug solution.1897
Sorption
Dexamethasone sodium phosphate was shown not to exhibit sorption to polyvinyl chloride (PVC) bags and tubing, polyethylene tubing, Silastic tubing, and polypropylene syringes.536; 606
Filtration
Dexamethasone sodium phosphate (MSD) 4 mg/L in dextrose 5%, sodium chloride 0.9%, and Ringer’s injection, lactated filtered over 12 hours through a 5-µm stainless steel depth filter (Argyle Filter Connector), a 0.22-µm cellulose ester membrane filter (Ivex-2 Filter Set), and a 0.22-µm polycarbonate membrane filter (In-Sure Filter Set), showed no significant reduction due to binding to the filters.320
In another study, dexamethasone sodium phosphate (MSD) 4 mg/L in dextrose 5% and sodium chloride 0.9% did not display significant sorption to a 0.45-µm cellulose membrane filter (Abbott S-A-I-F) during an 8-hour simulated infusion.567
Central Venous Catheter
Dexamethasone sodium phosphate (American Regent) 0.5 mg/mL in dextrose 5% was found to be compatible with the ARROWg+ard Blue Plus (Arrow International) chlorhexidine-bearing triple-lumen central catheter. Essentially complete delivery of the drug was found with little or no drug loss occurring. Furthermore, chlorhexidine delivered from the catheter remained at trace amounts with no substantial increase due to the delivery of the drug through the catheter.2335
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