Dexamethasone dosing for patients with spinal cord injury
During this time when methylprednisolone may be in short supply, a possible protocol has come from the American Society of Health-Systems Pharmacists for use of dexamethasone in patients with spinal cord injury. Remember, however, that this protocol has not been evaluated in clinical trials. Some literature has recommended doses ranging from 20-40 mg daily or 100 mg once.
You can read the AHSP position at:
http://www.ashp.org/shortage/methylprednisolone.cfm
A specific timeline for the drug delivery was not offered. If, however, it is to follow the same time guidelines as those for methylprednisolone, then the timeline may be as follows:
"Continuous infusion may not need to be administered as long as with methylprednisolone due to dexamethasone’s longer biologic half-life. Studies in the literature used dexamethasone for 12–24 hours."
Note: In the methylprednisolone guidelines, it is recommended that the practitioner catch up if there is a pause in delivery (e.g. while in MRI). There are as yet no available guidelines concerning "catching up" when using dexamethasone.