RAPIDEXON

2 mg/ml, solution for injection

Target species 
Horses, cattle, pigs, cats and dogs. 

Composition 
Each millilitre contains: 
Active substance: 
Dexamethasone (as Dexamethasone Sodium Phosphate) 2.0 mg 
Excipient: 
Benzyl alcohol (E1519) 15.0 mg 

Pharmaceutical form 
Solution for injection. 
A clear colourless solution practically free from particles. 

Indications for use 
In horses, cattle, pigs, dogs and cats: 
Dexamethasone may be used for the treatment of inflammatory or allergic conditions. 

In cattle: 
Treatment of primary ketosis (acetonaemia). 
Induction of parturition 

In horses: 
Treatment of arthritis, bursitis or tenosynovitis. 

Contraindications 
Except in emergency situations, do not use in animals suffering from diabetes mellitus, renal insufficiency, cardiac insufficiency hyperadrenocorticism, or osteoporosis. 
Do not use in viral infections during the viraemic stage or in cases of systemic mycotic infections. 
Do not use in animals suffering from gastrointestinal or corneal ulcers, or demodicosis. 
Do not administer intra-articularly where there is evidence of fractures, bacterial joint infections and aseptic bone necrosis. 
Do not use in known cases of hypersensitivity to the active substance, to corticosteroids and to any other ingredient of the product. 

Amounts to be administered and administration route 
For intravenous, intramuscular, intra-articular intrabursal or local administration in horses.For intramuscular injection in cattle, pigs, dogs and cats. 

For the treatment of inflammatory or allergic conditions the following average doses are advised. However the actual dose used should be determined by the severity of the signs and the length of time for which they have been present.

Doses may be repeated once at 24-48 hour intervals if required. Injection sites should be alternated. 

For the treatment of primary ketosis in cattle (acetonaemia) 
0.02 to 0.04 mg/kg body weight corresponding to 5-10 ml per cow given by intramuscular injection is advocated dependent on the size of the cow and the duration of the signs. Care should be taken not to overdose Channel Island breeds. Larger doses will be required if the signs have been present for some time or if relapsed animals are being treated. In most early cases a single dose will effect a cure but the dose may be repeated at 48 hour intervals if necessary. 

For the induction of parturition  
0.04 mg/kg body weight corresponding to 10 ml per cow as a single intramuscular injection after day 270 of pregnancy. 
Parturition will normally occur within 48-72 hours. If calving does not occur within these periods the dose may be repeated. 

For the treatment of arthritis, bursitis or tenosynovitis by single intra-articular, intrabursal or local injection in the horse 
Dosage 1-5 ml 
These quantities are not specific and are quoted purely as a guide. Injections into joint spaces or bursae should be preceded by the removal of an equivalent volume of synovial fluid. Strict asepsis is essential. 
To measure small volumes of less than 1 ml a suitably graduated syringe should be used to ensure accurate administration of the correct dose. 

Special precautions to be taken by the person administering the veterinary medicinal product to animals 
In case of accidental self-injection, seek medical advice immediately and show the package leaflet to the physician. People with known hypersensitivity to the active substance or any of the excipients should avoid contact with the veterinary medicinal product. Pregnant women should not handle this veterinary medicinal product. 

Special precautions for use in animals 
If the veterinary medicinal product is used for induction of parturition in cattle, then a high incidence of retained placentae may be experienced and possible subsequent metritis and/or subfertility. Response to long-term therapy should be monitored at regular intervals by a veterinary surgeon. Use of corticosteroids in horses has been reported to induce laminitis. Therefore horses treated with such preparations should be monitored frequently during the treatment period. Because of the pharmacological properties of the active ingredient, special care should be taken when the product is used in animals with a weakened immune system. Except in cases of acetonaemia and induction of the parturition, corticoid administration is to induce an improvement in clinical signs rather than a cure. The underlying disease should be further investigated. When treating groups of animals, use a draw-off needle to avoid excessive broaching of the stopper. Following intra-articular administration, use of the joint should be minimized for one month and surgery on the joint should not be performed within eight weeks of use of this route of administration. Only the 25 ml vial should be used to treat cats, dogs and small piglets to prevent excessive puncturing of the closure. 

Adverse reactions (frequency and seriousness) 
Corticosteroids are known to exert a wide range of side-effects. Whilst single high doses are generally well tolerated, they may induce severe adverse reactions with long term use and when esters possessing a long duration of action are administered. Dosage in medium to long term use should therefore generally be kept to the minimum necessary to control clinical signs. Steroids themselves, during treatment, may cause iatrogenic hyperadrenocorticism (Cushings disease) involving significant alteration of fat, carbohydrate, protein and mineral metabolism, e.g. redistribution of body fat, increase in body weight, muscle weakness and wastage and osteoporosis may result. During therapy effective doses suppress the hypothalamo-pituitreal adrenal axis. Following cessation of treatment, signs of adrenal insufficiency extending to adrenocortical atrophy can arise and this may render the animal unable to deal adequately with stressful situations. Consideration should therefore be given to means of minimising problems of adrenal insufficiency following the withdrawal of treatment (for further information see standard texts). Systemically administered corticosteroids may cause polyuria, polydipsia and polyphagia, particularly during the early stages of therapy. Some corticosteroids may cause sodium and water retention and hypokalaemia in long term use. Systemic corticosteroids have caused deposition of calcium in the skin (calcinosis cutis). Corticosteroid use may delay wound healing and the immunosuppressant actions may weaken resistance to or exacerbate existing infections. In the presence of bacterial infection, concurrent antibacterial therapy is usually required. In the presence of viral infections, corticosteroids may worsen or hasten the progress of the disease. Gastrointestinal ulceration has been reported in animals treated with corticosteroids and g.i.t. ulceration may be exacerbated by steroids in patients given non-steroidal anti-inflammatory drugs and in animals with spinal cord trauma. Corticosteroid use may cause enlargement of the liver (hepatomegaly) with increased serum hepatic enzymes and may increase the risk of acute pancreatitis. Other possible adverse reactions associated with corticosteroid use include changes in blood biochemical and haematological parameters. Transient hyperglycaemia can occur. 

Use during pregnancy or lactation
Do not administer the product in pregnant females, except where the intention is to induce parturition. Administration in early pregnancy is known to have caused foetal abnormalities in laboratory animals. Administration in late pregnancy is likely to cause abortion or early parturition in ruminants and may have a similar effect in other species. Use of the veterinary medicinal product in lactating cows may cause a reduction in milk yield. 

Interactions with other veterinary medicinal products and other forms of interaction 
Concurrent use with non-steroidal anti-inflammatory drugs may exacerbate gastrointestinal tract ulceration. Because corticosteroids can reduce the immunoresponse to vaccination, dexamethasone should not be used in combination with vaccines or within two weeks after vaccination. Administration of dexamethasone may induce hypokalaemia and hence increase the risk of toxicity from cardiac glycosides. The risk of hypokalaemia may be increased if dexamethasone is administered together with potassium depleting diuretics. Concurrent use with anticholinestaerase may lead to increased muscle weakness in patients with myasthenia gravis. Glucocorticoids antagonise the effects of insulin. Concurrent use with phenobarbital, phenytoin and rifampicin can reduce the effects of dexamethason. 

Overdose (symptoms, emergency procedures, antidotes) if necessary 
An overdose can induce drowsiness and lethargy in horses. 

Withdrawal periods 
Cattle:    meat and offal: 7 days  -  milk: 72 hours 
Pig:        meat and offal: 2 days 
Horse:    meat and offal: 11 days

Safety Data Sheet: Rapidexon 2012 MSDS