Stability of Injectable Dexamethasone in Chlorhexidine Wipes & Pads

Sandra N. Koch, DVM, MS, DACVD, University of Minnesota

ArticleLast Updated March 20232 min read
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In the Literature 

Bancroft S, Heinrich N, McGilliard M. Stability of dexamethasone sodium phosphate over a 28 day period when added to commercial veterinary wipe and pad products. Vet Dermatol. 2022;33(6):498-502. doi:10.1111/vde.13108 

The Research … 

Topical antimicrobials and corticosteroids are important for management of allergies and secondary infections in dogs.1-3 Currently, there are no commercially available wipes that contain antimicrobials and dexamethasone; however, in-clinic compounding of corticosteroids into antimicrobial wipes may facilitate use and improve compliance. Evaluating compounded products for stability is important to verify effectiveness of active ingredients.4 

This study investigated the stability of injectable 4 mg/mL dexamethasone sodium phosphate (DEX) added to 3 commercial veterinary chlorhexidine wipes or pads. The amount of DEX added was based on each product’s base liquid volume (reported by the manufacturer) and the minimum amount of DEX required to cover all wipes or pads in the container. The container was then manually shaken, resulting in a 0.04% DEX solution per wipe. Containers were stored at room temperature under 77°F (25°C) and 60% relative humidity. DEX concentration in 3 wipes or pads per container (one from the top, middle, and bottom) was measured via liquid chromatography on days 0, 14, and 28.  

DEX concentration in wipes that contained chlorhexidine with either ketoconazole or tromethamine/EDTA remained stable from day 0 to day 28. DEX concentration in pads that contained chlorhexidine with climbazole and phytosphingosine declined significantly between day 0 and day 14. The pads were thicker and more absorbent than the wipes, possibly preventing DEX from being adequately mixed in the solution. 

Future studies with a larger number of samples are needed to evaluate potential influence on the effectiveness of antimicrobial ingredients, as well as clinical efficacy and safety of compounded DEX wipes in dogs with allergies and secondary infections. 

… The Takeaways

Key pearls to put into practice: 

  • Addition of injectable DEX to wipes that contain chlorhexidine with ketoconazole or tromethamine/EDTA may be considered for use up to 28 days in dogs with allergies and secondary infections if topical corticosteroids are needed and pet owner compliance with multiple topical therapies is a concern.  

  • Results from this study cannot be extrapolated to other wipes or pads. In addition, the manufacturer of the pads that contained chlorhexidine with climbazole and phytosphingosine discontinued and replaced the product. Stability of DEX in the new product is unknown.  

  • Dogs should be monitored closely for efficacy and adverse effects, as clinical efficacy and safety studies have not been conducted.