Issues When Nebulizing Dexamethasone
Dexamethasone can be extremely difficult to nebulize. The issues being observed are either extremely slow nebulization, or no nebulization at all, when using the standard medication cup.
An investigative study was done to try and understand why some brands of Dexamethasone are causing this issue and the following has been discovered.
The investigation discovered that all the brands of Dexamethasone that are showing these issues contain a chemical called polyethylene glycol 400.
Polyethylene glycol 400 is a very viscous solution widely used in a variety of pharmaceutical formulations and is deemed to be the likely reason for slow or non-existent nebulization of these specific brands of Dexamethasone.
The brands of Dexamethasone that we are aware of causing the issues are as follows: AZIUM, VET ONE Dexamethasone, VEDCO Dexamethasone and DUPHACORT
These brands of Dexamethasone either nebulize extremely slow or not at all with a standard medication cup. However. they will nebulize using a fast specification medication cup when diluted 2:1 with Saline 0.9 %.
Brands of Dexamethasone that will nebulize successfully using a standard medication cup include; Dexaject SP by Henry Schein, Dexadreson by MSD Animal Health and Dexameth by Chem-Pharm.
Note: Dexamethasone in general is 50% slower than Saline to nebulize due to its viscosity and if time is an issue for the client it can be nebulized quicker using our fast specification medication cup. It is recommended to carefully confirm the dosage of individual products (e.g. some products may state 4 mg/ml of dexamethone SP which actually is equivalent to 3 mg/ml dexamethasone. Other products may be 2 mg/ml dexamethasone).