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   <title>Dexasone<sup>®</sup> Dexamethasone Sterile Injection 2 mg/mL</title>
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                  <paragraph>
                     <content styleCode="bold">Dexasone®</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Dexamethasone Sterile Injection 2 mg/mL</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Veterinary</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">NOT FOR USE IN HUMANS</content>
                     <br/>
                     <content styleCode="bold">KEEP OUT OF REACH OF CHILDREN</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">CAUTION</content>: Federal Law restricts this drug to use by or on the order of a licensed veterinarian.</paragraph>
                  <paragraph>
                     <content styleCode="bold">DESCRIPTION</content>
                     <br/>Dexasone<sup>®</sup> is a synthetic analogue of prednisolone, having similar but more potent anti-inflammatory therapeutic action and diversified hormonal and metabolic effects. Modification of the basic corticoid structure as achieved in Dexasone<sup>®</sup> offers enhanced anti-inflammatory effect compared to older corticosteroids. The dosage of Dexasone<sup>®</sup> required is markedly lower than that of prednisone and prednisolone.</paragraph>
                  <paragraph>Dexasone<sup>®</sup> is not species-specific; however, the veterinarian should read the sections on<content styleCode="bold"> INDICATIONS, DOSAGE, SIDE EFFECTS, CONTRAINDICATIONS, PRECAUTIONS,</content> and <content styleCode="bold">WARNINGS </content>before this drug is used.</paragraph>
                  <paragraph>Dexasone<sup>®</sup> is intended for <content styleCode="italics">intravenous or</content>
                     <content styleCode="italics"> intramuscular</content> administration. Each mL contains 2 mg dexamethasone, 500 mg polyethylene glycol 400, 9 mg benzyl alcohol, 1.8 mg methylparaben and 0.2 mg propylparaben as preservatives, 4.75% alcohol, HCl to adjust pH to approximately 4.9, water for injection q.s.</paragraph>
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               <title>EXPERIMENTAL STUDIES</title>
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                  <paragraph>Experimental animal studies on dexamethasone have revealed it possesses greater anti-inflammatory activity than many steroids. Veterinary clinical evidence indicates dexamethasone has approximately twenty times the anti-inflammatory activity of prednisolone and seventy to eighty times that of hydrocortisone. Thymus involution studies show dexamethasone possesses twenty-five times the activity of prednisolone. In reference to mineralocorticoid activity, dexamethasone does not cause significant sodium or water retention. Metabolic balance studies show that animals on controlled and limited protein intake will exhibit nitrogen losses on exceedingly high dosages.</paragraph>
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               <code code="34067-9" codeSystem="2.16.840.1.113883.6.1" displayName="INDICATIONS &amp; USAGE SECTION"/>
               <title>INDICATIONS</title>
               <text>
                  <paragraph>Dexasone<sup>®</sup> is indicated for the treatment of primary bovine ketosis and as an anti-inflammatory agent in the bovine and equine.</paragraph>
                  <paragraph>As supportive therapy, Dexasone<sup>®</sup> may be used in the management of various rheumatic, allergic, dermatologic, and other diseases known to be responsive to anti-inflammatory corticosteroids. Dexasone<sup>®</sup> may be used intravenously as supportive therapy when an immediate hormonal response is required.</paragraph>
                  <paragraph>
                     <content styleCode="italics">Bovine Ketosis </content>Dexasone<sup>®</sup> is offered for the treatment of primary ketosis. The gluconeogenic effects of Dexasone<sup>®</sup>, when administered intramuscularly, are generally noted within the first 6 to 12 hours. When Dexasone® is used intravenously, the effects may be noted sooner. Blood sugar levels rise to normal levels rapidly and generally rise to above normal levels within 12 to 24 hours. Acetone bodies are reduced to normal concentrations usually within 24 hours. The physical attitude of animals treated with Dexasone<sup>®</sup> brightens and appetite improves, usually within 12 hours. Milk production, which is suppressed as a compensatory reaction in this condition, begins to increase. In some instances, it may even surpass previous peaks. The recovery process usually takes from 3 to 7 days.</paragraph>
                  <paragraph>
                     <content styleCode="italics">Supportive Therapy</content> Dexasone<sup>®</sup> may be used as supportive therapy in mastitis, metritis, traumatic gastritis, and pyelonephritis, while appropriate primary therapy is administered. In these cases, the corticosteroid combats accompanying stress and enhances the feeling of general well-being. Dexasone<sup>®</sup> may also be used as supportive therapy in inflammatory conditions, such as arthritic conditions, snake bite, acute mastitis, shipping fever, pneumonia, laminitis, and retained placenta.</paragraph>
                  <paragraph>
                     <content styleCode="italics">
                        <content styleCode="italics">Equine</content>
                     </content> Dexasone<sup>®</sup> is indicated for the treatment of acute musculoskeletal inflammations, such as bursitis, carpitis, osselets, tendonitis, myositis, and sprains. If boney changes exist in any of the conditions, joints, or accessory structures, responses to Dexasone<sup>®</sup> cannot be expected.  In addition, Dexasone<sup>®</sup> may be used as supportive therapy in fatigue, heat exhaustion, influenza, laminitis, and retained placenta provided that the primary cause is determined and corrected.</paragraph>
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               <title>ADMINISTRATION AND DOSAGE</title>
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                  <paragraph>Therapy with Dexasone<sup>®</sup>, as with any other potent corticosteroid, should be individualized according to the severity of the condition being treated, anticipated duration of steroid therapy, and the animal's threshold or tolerance for steroid excess.</paragraph>
                  <paragraph>Treatment may be changed over to Dexasone<sup>®</sup> from any other glucocorticoid with proper reduction or adjustment of dosage.</paragraph>
                  <paragraph>
                     <content styleCode="italics">Bovine</content> - Dexasone<sup>®</sup> - 5 to 20 mg intravenously or intramuscularly.</paragraph>
                  <paragraph>Dexamethasone Powder may be administered or the parenteral dose repeated as needed.</paragraph>
                  <paragraph>
                     <content styleCode="italics">Equine</content> - Dexasone<sup>®</sup> - 2.5 to 5 mg intravenously or intramuscularly.</paragraph>
                  <paragraph>Dexamethasone Powder may be administered or the parenteral dose repeated as needed.</paragraph>
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               <title>CONTRAINDICATIONS</title>
               <text>
                  <paragraph>Except for emergency therapy, do not use in animals with chronic nephritis and hypercorticalism (Cushing's syndrome). Existence of congestive heart failure, diabetes, and osteoporosis are relative contraindications. Do not use in viral infections during the viremic stage.</paragraph>
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               <title>PRECAUTIONS</title>
               <text>
                  <paragraph>Animals receiving Dexasone<sup>®</sup> should be under close observation. Because of the anti-inflammatory action of corticosteroids, signs of infection may be masked and it may be necessary to stop treatment until a further diagnosis is made. Overdosage of some glucocorticoids may result in sodium retention, fluid retention, potassium loss, and weight gain.</paragraph>
                  <paragraph>Dexasone<sup>®</sup> may be administered to animals with acute or chronic bacterial infections providing the infections are controlled with appropriate antibiotic or chemotherapeutic agents.</paragraph>
                  <paragraph>Doses greater than those recommended in horses may produce a transient drowsiness or lethargy in some horses. The lethargy usually abates in 24 hours.</paragraph>
                  <paragraph>Use of corticosteroids, depending on dose, duration, and specific steroid, may result in inhibition of endogenous steroid production following drug withdrawal. In patients presently receiving or recently withdrawn from systemic corticosteroid treatments, therapy with a rapid acting corticosteroid should be considered in unusually stressful situations.</paragraph>
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               <title>WARNINGS</title>
               <text>
                  <paragraph>Clinical and experimental data have demonstrated that corticosteroids administered orally or parenterally to animals may induce the first stage of parturition when administered during the last trimester of pregnancy and may precipitate parturition followed by dystocia, fetal death, retained placenta, and metritis.</paragraph>
                  <paragraph>Additionally, corticosteroids administered to dogs, rabbits, and rodents during pregnancy have produced cleft palate. Other congenital  anomalies including deformed forelegs phocomelia, and anasarca have been reported in offspring of dogs which received corticosteroids during pregnancy.</paragraph>
                  <paragraph>
                     <content styleCode="bold">A withdrawal period has not been established for this product in pre-ruminating calves. Do not use in calves to be processed for veal.</content>
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               <code code="34084-4" codeSystem="2.16.840.1.113883.6.1" displayName="ADVERSE REACTIONS SECTION"/>
               <title>SIDE EFFECTS</title>
               <text>
                  <paragraph>Side effects, such as SAP and SGPT enzyme elevations, weight loss, anorexia, polydipsia, and polyuria have occurred following the use of synthetic corticosteroids in dogs. Vomiting and diarrhea (occasionally bloody) have been observed in dogs and cats.</paragraph>
                  <paragraph>Cushing's syndrome in dogs has been reported in association with prolonged or repeated steroid therapy.</paragraph>
                  <paragraph>Corticosteroids reportedly cause laminitis in horses.</paragraph>
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               <title>CONTACT INFORMATION</title>
               <text>
                  <paragraph>To report suspected adverse<br/>events, for technical assistance or to obtain a copy of the<br/>Safety Data Sheet, contact Sparhawk Laboratories Inc. at<br/>1-800-255-6388 or 1-913-888-7500. For additional<br/>information about adverse drug experience reporting<br/>for animal drugs, contact FDA at 1-888-FDA-VETS or<br/>http://www.fda.gov/reportanimalae</paragraph>
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               <title>HOW SUPPLIED</title>
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                  <paragraph>Dexasone<sup>®</sup>, 2 mg/mL, 100 mL multiple dose vial.</paragraph>
                  <paragraph>
                     <content styleCode="bold">Store at controlled room temperature of 20°C to 25°C (68° to 77°F), excursions permitted between 15°C and 30°C (between 59°F and 86°F).</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Protect from freezing.</content>
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                  <paragraph>
                     <content styleCode="bold">Manufactured for:</content>
                     <br/>Aspen Veterinary Resources®, Ltd.<br/>Liberty, MO 64068<br/>www.aspenveterinaryresources.com</paragraph>
                  <paragraph>
                     <content>
                        <content styleCode="bold">﻿Approved by FDA under ANADA # 200-324</content>
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                     <content styleCode="bold">Each mL contains</content>:<br/>Dexamethasone..........................2 mg<br/>Polyethylene glycol 400...........500 mg<br/>Benzyl alcohol............................9 mg<br/>Methylparaben (preservative).....1.8 mg<br/>Propylparaben (preservative)......0.2 mg<br/>Water for Injection...........................qs<br/>4.75% alcohol; HCl to adjust pH to approximately 4.9</paragraph>
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               <title>Usual Dose</title>
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                  <paragraph>For intravenous or intramuscular injection</paragraph>
                  <paragraph>Bovine-5 to 20 mg<br/>Equine-2.5 to 5 mg</paragraph>
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               <title>WARNING</title>
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                  <paragraph>
                     <content styleCode="bold">A withdrawal period has not been established for this product in pre-ruminating calves. Do not use in calves to be processed for veal.</content>
                  </paragraph>
                  <paragraph>Store at 20°C to 25°C (68° to 77°F), excursions permitted between 15°C and 30°C (between 59°F and 86°F).</paragraph>
                  <paragraph>
                     <content styleCode="bold">Protect from freezing.</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">READ ACCOMPANYING DIRECTIONS CAREFULLY.</content>
                  </paragraph>
                  <paragraph>Approved by FDA under ANADA # 200-324</paragraph>
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