Parenteral Manual


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Alternate Name(s): 
Original Date: 
August 2005
Revised Date: 
December 2019
  • Anti-inflammatory      
  • Immunosuppressant         
  • Antileukemic                                                         
  • Antiemetic for chemotherapy-induced nausea and vomiting
Reconstitution and Stability: 
  • Available as 4 mg/mL solution
  • Protect from light and freezing
  • Diluted solutions stable 24 hours at room temperature

- Solutions Compatible: D5W, 0.9% NaCl

- Additives/Above Cassette Compatible: furosemide, granisetron, hydromorphone

- Y-site Compatible: morphine, KCl (up to 40 mmol/L), TPN (amino acids/dextrose), ondansetron, meropenem

- Incompatible: daunorubicin, vancomycin, diphenhydramine, ciprofloxacin



(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)


Usual dilution: undiluted

IV Direct

YES: Dose <10 mg only (Doses greater than or equal to 10 mg must be given  IV intermittent)
Usual dilution: 1 mg/mL
- 0.4 mg/mL for dose less than 1 mg

Infusion time: 3-5 minutes

IV Intermittent Infusion

Usual dilution: 1 mg/mL

- 0.4 mg/mL for dose less than 1 mg
Infusion time: 10-30 minutes

IV Continuous Infusion NO

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

- Cerebral edema:            

  • Initial: 1-2 mg/kg/dose IM/IV as a single dose
  • Maintenance:  1-1.5 mg/kg/day IM/IV ÷ Q 4-6 hours × 5 days, then taper (Maximum: 16 mg/day)         

- Anti-Emetic:                  

  • 8 mg/m2/dose IV Q6H (Maximum: 20 mg/dose) 

- Anti-inflammatory:   0.08-0.3 mg/kg/day ÷ Q 6-12 hours

- Meningitis: 0.15 mg/kg/dose IV Q 6 hours × 4 days

- Airway edema or extubation:               

  • 0.5-2 mg/kg/day IM/IV ÷ Q 6 hours: begin 24 hours prior to extubation and continue for 4-6 doses after extubation

- Croup:  0.6 mg/kg/dose x 1

- COVID-19 Infection: 0.15 mg/kg/day (max:6mg) IV/PO q24h x 10 days

- Cerebral edema:           

  • Initial: 10 mg IV
  • Maintenance: 4 mg IV/IM Q 6 hours

- Anti-inflammatory:       

  • 0.75-9 mg/day IM/IV ÷ Q 6-12 hours

- Anti-emetic:                  

  • 8-20 mg given before chemotherapy, additional lower doses may be given over next 24-72 hours

- COVID-19 Infection: 6mg IV/PO q24h x 10 days 

Potential hazards of parenteral administration: 
  • Increased blood pressure with large doses
  • Perineal irritation with high doses (slow infusion may reduce likelihood)
  • Growth suppression in children, cushing?s syndrome, edema, hypokalemia
  • May mask signs of infection
  • Hypertension, edema                                                                                      
  • Psychosis, insomnia
  • Osteoporosis, muscle weakness
  • Withdrawal of therapy should be gradual to avoid the symptoms of adrenal insufficiency (after >10-14 days of continuous therapy)
  • Contraindicated in systemic fungal infections, mycobacterium infections
  • Delay live virus vaccinations for 1 month after ending a >2 week course of high dose corticosteriods (0.3 mg/kg/day of dexamethasone)

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