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Clinical trials used structured titration schedules to minimize these side effects while allowing the body to adapt

Physical examination may reveal pallor, glossitis, neurological signs such as reduced vibration sense or proprioception, and in advanced cases, ataxia or cognitive impairment

Nature 1995

Subcutaneous planning from a 50 mg vial reconstituted with 3.0 mL BAC water (~16.7 mg/mL) Phase Days 12 (tolerance) Daily dose 2.5 mg once daily Units on U-100 syringe 15 units Volume 0.15 mL Phase Days 3+ (standard) Daily dose 5 mg once daily Units on U-100 syringe 30 units Volume 0.30 mL Phase Split option (BID) Daily dose 2.5 mg twice daily Units on U-100 syringe 15 units each Volume 0.15 mL each Subcutaneous doses are much smaller than oral doses because of injection volume limits and because direct subQ absorption skips the gut

Protect from excessive heat and direct sunlight

Dexamethasone (injection) patient education