DEXAMETHASONE - AZIUM

Azium, Dexameth-A Vet, Dexamethasone Injection, Dexamethasone Sodium, Phosphate Injection, Dexasone, Dex-A-Vet, Voren

DESCRIPTION

Dexamethasone is a corticosteroid with potent anti-inflammatory properties.

INDICATIONS

Treatment of acute and chronic inflammatory conditions of joints.

DOSAGE AND ROUTE OF ADMINISTRATION

The manufacturer recommends use of dexamethasone orally, 10 mg/day, for anti-inflammatory effect or intravenously, 2.5-5.0 mg, to treat shock-like states.

SPECIAL PRECAUTIONS

STRICT STERILE TECHNIQUE MUST BE OBSERVED WHENEVER CORTICOSTEROIDS ARE INJECTED.

SIDE EFFECTS/TOXICITY

Even intra-articular corticosteroid use can result in systemic side effects when large doses are used, multiple joints are injected, and/or with repeated injections.

Corticosteroids have a wide variety of side effects associated with their use. Corticosteroids greatly suppress immune responses, both body-wide and in local areas where they are injected (e.g., joints). For this reason, any contamination carried in by use of improper injection techniques has a greater than normal chance of resulting in an infection. Corticosteroids may also cause low grade or inactive infections to flare up and become serious. Horses receiving corticosteroids may also be more susceptible to new infections; e.g., viral respiratory illness.

Other possible side effects include:

Intra-articular injections may cause derangements in the metabolism of joint cartilage, and possibly cause permanent damage particularly with repeated injections).

Corticosteroids can induce a diabetes-Iike state with symptoms of increased thirst, increased hunger, and increased urination. Prolonged use of corticosteroids may completely suppress the body's ability to manufacture its own normal supply of corticosteroids, an effect that may last for several months or even longer.

Corticosteroids have been implicated in causing or worsening peptic ulcers stomach or duodenum' in other species. They should be used with care in foals under stress, and their use discontinued if any symptoms of ulcers develop. Concurrent use of anti-ulcer medications may be advisable when treatment of stressed foals with corticosteroids is determined to be necessary,

DRUG INTERACTIONS

Furosemide Lasix also causes, and may worsen, steroid-related calcium and potassium losses. Corti-costeroids should not be mixed with other therapeutic agents for injection into joints.

PREGNANCY/NURSING

Corticosteroids can produce birth defects and/or induce labor in other species.

Do not use in nursing mares.

DRUG TESTING

ARCI: Dexamethasone is a Class 4 drug in the ARCI uniform classification guidelines.

Detection Time Information: A sensitive ELISA test for dexamethasone is available and dexamethasone and its metabolites may be detected in urine for at least 24 hours (Canada). Australian authorities report a 48-hour detection time for dexamethasone sodium phosphate and an 8-dav detection time for a preparation containing dexamethasone phenylpropianate. a more than 14-dav detection time for dexamethasone trimethylacetate: and more than 12 days for dexamethasone isonicotinate administered intramuscularly, and more than 14 days when administered intra-articularly. There is no recommended plasma or urinary threshold or tolerance level for dexamethasone.
Dexamethasone is a common source of medication violations.

Rules of Governing Bodies
Standardbred and Thoroughbred Racing: Standardbred and thoroughbred racing operates under a basic drug-free policy. However, individual state racing commissions may permit individual therapeutic drugs, often at certain previously established "permissible" blood levels. Check with the commission in your state

Horseman's Comments and Conclusion to this article at the bottom of this page.

Drug Name: 

Dexamethasone

  From The Pill Book (compare with human use)

Uses:

  Dexamethasone is a corticosteroid that reduces swelling and inflammation (3) and is used in a variety of disorders such as skin diseases (psoriasis, hives), allergic conditions, breathing problems, cancer, blood disorders (anemia), digestive problems, eye disorders and for arthritis/bursitis

Side Effects:

May cause dizziness, nausea, indigestion, increased appetite, weight gain, weakness or sleep disturbances. If these effects persist or worsen, contact your doctor.    Notify your doctor if you experience vomiting of blood, black or tarry stools, puffing of the face, swelling of the ankles or feet unusual weight gain, prolonged sore throat or fever, muscle weakness, breathing difficulties or mood changes.    In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include rash, itching, swelling, dizziness or trouble breathing.    If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions:

Do not have a vaccination, other immunization (1), or any skin test while you are taking this drug unless your doctor specifically tells you that you may.  Before you take this drug, tell your doctor if you are pregnant, think that you may be pregnant or wish to become pregnant. If you become pregnant, contact your doctor. Because this drug appears in breast milk contact your doctor before breast-feeding.    This medication can cause growth suppression in infants (2).    Before you take this drug, tell your doctor your entire medical history, particularly if you have liver, kidney, intestinal, or heart disease; an underactive thyroid gland; high blood pressure; myasthenia gravis; osteoporosis (brittle bones); herpes eye infection; or a history of tuberculosis (TB), seizures, ulcers, or blood clots.    If you have a history of ulcers or take large doses of aspirin or other arthritis medication, limit your consumption of alcoholic beverages while taking this medication. It may make your stomach and intestines more susceptible to the irritating effects of alcohol, aspirin, and certain arthritis medications.    Report any injuries or signs of infection (fever, sore throat, pain during urination, and muscle aches) that occur during treatment and within 12 months after treatment with this drug. Your dose may need to be adjusted or you may need to start taking the drug again.    If you have diabetes, this drug  may increase your blood sugar level. Test your urine for sugar (glucose) frequently and contact your doctor if sugar is present; your dose of diabetes medication and your diet may need to be changed.    If your sputum (the matter you cough up during an asthma attack) thickens or changes color from clear white to yellow, green, or gray, contact your doctor; these changes may be signs of an infection. 

Interactions:

Before you take this drug, tell your doctor what prescription and nonprescription medications you are taking, especially (4) aspirin, arthritis medication, anticoagulants ("blood thinners"), diuretics ("water pills"), estrogen (5) (e.g., birth control pills), phenytoin, rifampin, phenobarbital, macrolide antibiotics (e.g., erythromycin), ketoconazole, neostigmine, pyridostigmine, ambenomium, and drugs for diabetes.    Do not start or stop any medicine without doctor or pharmacist approval. This drug may cause an allergic reaction in patients with a history of sensitivity to the following:  Glucocorticoids.  Use the Interactions Checker located on the main toolbar for additional interaction information for this drug.

Horseman's Comments

        People often have this drug in powdered form (Azium Powder) at the barn. Please be aware of the following facts:

  1. Dexamethasone interferes with the body's normal reaction to vaccination. Often horses have reaction to some vaccines in a form of swellings in the injected area. Please consult your veterinarian before you get the idea to reduce the swelling by using Dexamethasone or other anti-inflammatory drugs. 
            Reactions to vaccines are often accompanied with slightly elevated temperatures, which I consider normal and natural for the horse's body to stimulate antibodies growth. (One should rest the horse one or two days after the multi-vaccine shots, especially if fluvac is included) I believe when using anti-inflammatory drugs one will defeat the purpose of the vaccine. Often simple hot compresses did the job for the horse in reducing the swelling. (Back to 1)
  2. I would not use this drug, even in the powdered form on pregnant mares. (Back to 2)
  3. Commonly used for these purposes on horses. (Back to 3)
  4. It is essential that you always notified your veterinarian, whenever he treats your horse, about the drugs that the horse received within the last week or so (definitely within the last 48 hours). Especially in cases of emergencies, colic, surgery etc. (Back to 4)
  5. This part should be noticed, especially if you often treat the horses yourself. (Back to 5)

Noticed Side effect

        When given larger doses and/or when given in combination with other drugs, it will make your horse calmer sometimes even sleepy. It works as a downer.

Conclusion 

        I found this drug very useful and helpful in many situations. It's powdered form is handy to have at the barn, but one should always seek a veterinarian advice when using it on his horse. Horses seem to have no problem eating the powder in their feed.

        I do not find this drug abusive (if not used excessively) and I believe that it should be legalized for the use on racehorses and other performance horses. Though it may enhance the performance only slightly it will help the racehorses to bear their racing lives with much more comfort and ease. After all, athletes all over the world have access to many drugs to help them endure pains and strained bodies from hard training. We should allow drugs like these for horses. Just because the horse doesn't go visibly lame, it does not mean that he is without pain! They will run anyway!

    I have not yet come across a horse that suffered from laminitis on account of the use of this drug. I believe that most cases of laminitis associated with dexamethasone occur either by horses that are already suffering from founder "precondition" (usually in the backyards), or when this drug is administered for a lengthy period of time, which I personally do not recommend. All in all, I used azium in over a hundred horses in the course of thirty years and no laminitis, not even a slight signs of it.

All my comments are merely my opinions and beliefs gained from 40 years of professional life with horses. All drugs should be used only by the consent of a veterinarian and according to his instructions. A person who is with the horse everyday, should know him better than anyone else.