Question#: 666

Question:

Can dexamethasone be used as a intranasal corticosteroids or do we strictly use the PO/IM/IV routes.

Answer:

As it currently stands, you are right in that the only approved administration routes for dexamethasone is the PO/IM/IV route. 

While some steroids are given intranasally (i.e. sprays for allergic rhinitis), these are different medications that have been specifically formulated for that administration. 

There are insufficient studies examining the absorption rates, concentration, and dosing; thus this route of delivery would not be accurate. 

Ultimately, IN dexamethasone for systemic use is not an approved route, and there is a plethora of evidence to support the currently approved routes.

References:

ALS PCS

https://www.uptodate.com/contents/dexamethasone-systemic-drug-information?search=dexamethasone&source=panel_search_result&selectedTitle=1~145&usage_type=panel&showDrugLabel=true&display_rank=1