Why it's used

Dexamethasone is used to treat allergic reactions including asthma, moderate to severe skin allergic reactions, stomach or intestinal disorders, blood cell disorders, respiratory disorders, and inflammatory disorders. It can also be used to treat hormone secretion disorders including decreased hormone production in the adrenal glands, high blood calcium associated with cancer, and thyroid gland infection. This medicine works by suppressing the immune system and thereby reduce inflammation. Dexamethasone is also used to diagnose an abnormally elevated function of the adrenal cortex, roundworm, and bacterial infection, for the management of blood cell cancers, nervous system and eye disorders, to induce excessive production of urine or for the remission of a condition in which protein present in the urine, for the short-term treatment of different types of arthritis with other medicines, and to treat shock with other medicines.
When not to use
Dexamethasone should not be used to treat eye infection caused by herpes virus. Dexamethasone should not be used to treat inflamed nerves of the eyes (optic neuritis).
Glucocorticoids
Dexamethasone is a prescription medicine that belongs to a class of medicines called Glucocorticoids. Glucocorticoids.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Dexamethasone. Use this medicine as per your doctor's instructions.
Dexamethasone is used with food. This medicine can cause stomach upset. So, it is advised to take this medicine with food or milk.

Typical Dosage

The typical adult dose of Dexamethasone is 30 mg for a week followed by 4-12 mg/day for one month (acute worsening of brain and spinal cord disease) or 3.3 mg/ml for injection.
Dexamethasone is to be used for longer periods of time.
The injection form of the medicine may be used on the large joint (for example, knee), small joints, small pouch around a joint (bursae), synovial membrane layer around the tendon (tendon sheaths), soft-tissue, or nerve cell cluster (ganglia). The injection form of the medicine should not be used on the unstable joints Discard the unused drug immediately after use.

Talk to Your Doctor

Tell your doctor if you develop new symptoms. Talk to your doctor if mental health problems, feeling depressed, and suicidal thinking. Consult with your doctor before stopping the use of Dexamethasone.
To see the impact of Dexamethasone on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully. Older patients may see an increase in the risk of side-effects. Hence, a lower dose may be recommended.
When stopping this medicine, it is possible that you may experience withdrawal symptoms such as fever, muscle pain, joint pain, a feeling of discomfort, decreased secretion of hormones from adrenal gland (acute adrenal insufficiency), low blood pressure, and possibly fatal. You may need to gradually decrease the dose of this medicine before stopping.

Use in Children

If you are giving Dexamethasone to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. Consult with your doctor if the product package does not provide specific information for children.

Limit Alcohol

Limit drinking alcohol with Dexamethasone.

Storage

Store Dexamethasone at 20 to 25°C (68 to 77°F) and do not freeze, away from moisture, and away from light. Keep this medicine away from children and pets.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Dexamethasone for symptoms for which it was not prescribed. Do not give Dexamethasone to others who may have similar symptoms as you. Self-medication can cause harm.

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How to take Dexamethasone

Your dose and how often you take Dexamethasone will depend on the following factors:
  • weight

Dexamethasone Dosage

Dosage for worsened brain and spinal cord disease

Adult
  • Recommended: 30 mg for a week followed by 4 to 12 mg every day for a month

Dosage for brain swelling

Adult
  • Initial: 10 mg into the veins followed by 4 mg after every six hours into the muscle until the symptoms of brain swelling lower

Dosage for palliative care

Adult (pain relieving management of patients with repeated or inoperable brain tumors)
  • Recommended: a dose of 2 mg two or three times daily or Dexamethasone sodium phosphate injection as a maintenance therapy

Dosage for allergic disorders

Adult
  • Recommended: Dexamethasone Sodium Phosphate injection is given as 4 mg/ml. The dose regimen is of 8 days and its follow up is as on the first day it should be taken as 1 or 2 mL intramuscularly and Dexamethasone tablets as 0.75 mg, on second day 4 tablets divided into two doses, on third day 4 tablets into two divided doses, on the fourth day 2 tablets in two divided doses, 1 tablet each on fifth and sixth day, then no treatment on seventh day, on eighth day follow-up visit. This plan is designed to assure sufficient therapy during acute episodes while reducing the risk of overdosage in long-term cases.

Dosage for non-endocrine corticosteroid-responsive conditions

Adult
  • Recommended: 3.3 mg/ml solution for injection

Dosage for soft-tissue or joint disorders

Adult
  • Recommended: 3.3 mg/ml solution for injection

Dosage for selected skin disorders

Adult (Dexamethasone injection can be injected directly into the skin lesion (intralesionally) in selected skin disorders such as pimples, skin itching, and raised scar.)
  • Recommended: 3.3 mg/ml solution for injection

Forms

Injection
Strength: 4 mg/ml and 10 mg/ml
Implant
Strength: 0.5 mg and 0.7 mg
Injection Solution
Strength: 4 mg/1ml and 10 mg/1ml
Injection suspension
Strength: 0.517 mg/0.005 ml
Insert
Strength: 0.4 mg
Liquid
Strength: 0.1%, 0.5 mg, 1 mg, 4 mg, and 10 mg
Ointment
Strength: 0.10%

Missed Dose

Take the missed dose as soon as you remember. Skip the missed dose if it is time for the next dose. Avoid taking a double dose to make up for the missed dose.

Overdose

What to do if you overdose on Dexamethasone?
Supportive and symptomatic treatment should be given after the overdose. Supportive therapy may include the process of cleaning out the contents of the stomach or through vomiting. Allergic reactions may be treated with positive-pressure artificial respiration.
Symptoms of an overdose of Dexamethasone
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Dexamethasone, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Dexamethasone

Before you use Dexamethasone, tell your doctor of your medical and health history including the following:
  • a mental disorder that affects the thinking and behavior (schizophrenia)
  • an eye infection with the herpes virus
  • an infection caused by an amoeba (amoebiasis)
  • bone weakness (osteoporosis)
  • cancer of blood cells (hematological malignancy)
  • diabetes
  • epilepsy
  • heart attack
  • heart failure
  • high blood pressure
  • increased pressure in the eye (glaucoma)
  • kidney problems
  • liver problems
  • muscle weakness with this or other steroids
  • skeletal muscle weakness
  • stomach or duodenal ulcer
  • symptoms of metabolic abnormalities which can occur during the cancer treatment (tumor lysis syndrome)
  • tuberculosis
Before you use Dexamethasone, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic any of the following substances: aspirin, or tartrazine.
Before having surgery during the use of Dexamethasone, discuss with your doctor and dentist about the medicinal products you use including prescription/non-prescription/herbal medicines.
The use of this medicine may change calcium. The excretion of calcium may increase while using this medicine.
The use of this medicine may change sodium and potassium levels. This medicine may increase the excretion of potassium and elevate the sodium level.
The use of Dexamethasone may change blood pressure. Patients may have increased levels of blood pressure while using this medicine.
The use of this medicine may change the pressure inside the eyes. This medicine may increase the pressure inside the eyes (intraocular pressure). So, it is advised to monitor pressure inside the eyes when using this medicine.
The use of Dexamethasone may change water retention. This medicine may elevate the accumulation of fluid (water retention) in the body.

Seizures

Dexamethasone can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Dexamethasone can worsen the sleepiness. Dexamethasone may cause rarely seizures in some people. If you perform any activities where a loss of consciousness may cause harm to you (or others), you should discuss with your doctor.

Use in Pregnancy

The use of Dexamethasone during pregnancy should only be when required. Dexamethasone should be used in pregnant women only if the benefit of using this medicine is greater than the potential risk to the fetus as there are no well-controlled and adequate studies. There are increased chances of the occurrence of abnormalities in the baby including an opening in the roof of the mouth and lips (cleft palate) and affects brain growth and development of the baby.

Use while Breastfeeding

Consult with your doctor on the use of Dexamethasone during breastfeeding. Dexamethasone may pass into breast milk which may lead to decreased growth and may interfere with the hormonal production by adrenal glands. Therefore, the benefits and risks of this medicine should be considered before breastfeeding.

Alcohol

Limit drinking alcohol with Dexamethasone. Drinking alcohol may cause stomach irritation, and stomach ulcer.

Increased Risks

This medicine can increase your risk of getting infections or worsen existing infections. Hence you should reduce your chances of getting new infections. Wash your hands regularly. Avoid people who have infectious diseases. Avoid vaccination without discussing with your doctor first. Prevent any cuts, bruises or injuries. Dexamethasone may weaken the immune response to the micro-organisms leading to an increased risk of infection including bacterial, viral, protozoan, fungal, or helminthic.

Side-effects in Older Patients

Dexamethasone may cause increased incidence of side-effects in older patients. Elderly patients may see an increased risk of high blood sugar level (diabetes mellitus), accumulation of fluid (fluid retention), high blood pressure, bone weakness (osteoporosis), low potassium level, susceptibility to an infection, and thinning of the skin.

Side-effects in Children

Dexamethasone may cause an increased risk of side-effects in children. Children using this medicine may see an increased risk of growth suppression.

Long-term Use

The prolonged use of Dexamethasone may cause clouding of the lens (posterior subcapsular cataracts) and increased pressure inside the eyes with damage to the optic nerves. It may also enhance eye infections due to viruses or fungi and reduce hormone production by adrenal gland (adrenal insufficiency). The prolonged use of its injection in the blood vessels can cause joint damage with bone tissue death (joint destruction with bone necrosis).

What precautions should be taken during Pregnancy and Nursing, and administering Dexamethasone to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: Dexamethasone should be used in pregnant women only if the benefit of using this medicine is greater than the potential risk to the fetus as there are no well-controlled and adequate studies. There are increased chances of the occurrence of abnormalities in the baby including an opening in the roof of the mouth and lips (cleft palate) and affects brain growth and development of the baby.

Breastfeeding

Only When Necessary
Warning: Dexamethasone may pass into breast milk which may lead to decreased growth and may interfere with the hormonal production by adrenal glands. Therefore, the benefits and risks of this medicine should be considered before breastfeeding.

Younger Adults Population

Precaution
Warning: The use of Dexamethasone may cause growth suppression in children. So, it is advised to use the lowest effective dose.

Older Adults Population

Precaution
Warning: Use of Dexamethasone in elderly patients may cause side effects such as bone weakness (osteoporosis), high blood pressure, low potassium level, high blood sugar level (diabetes), thinning of the skin, accumulation of fluid (fluid retention) and susceptibility to infection. When using this medicine, the close monitoring of the patient is advised.

Dexamethasone Side-effects

The following side-effects may commonly occur when using Dexamethasone. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
  • increased weight
The following side-effects may commonly occur in older patients on the use of Dexamethasone. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • high sugar level
  • low potassium level
  • resistance to infection
  • thinning of the skin
  • weak bones
Rarely, the use of Dexamethasone may cause the following side-effects:
  • a weakening of the upper and lower limbs (steroid myopathy)
  • abnormal fat deposits
  • abnormal sensation in the body
  • abnormal wound healing
  • acne
  • an abnormal amount of hair growth over the body (hypertrichosis)
  • an insufficient release of adrenocortical and pituitary hormones
  • compressed bones of the spine (vertebral compression fractures)
  • decreased resistance to infection
  • discoloration of the skin (ecchymoses)
  • dry scaly skin
  • emotional instability
  • fainting
  • feeling of discomfort
  • fluid retention
  • fracture of long bones
  • headache
  • hiccups
  • hives
  • increased sweating
  • insomnia
  • intense feelings of well-being and happiness (euphoria)
  • loss of muscle mass
  • menstrual irregularities
  • mood swings
  • moon face
  • muscle weakness
  • nausea
  • negative nitrogen balance
  • personality changes
  • purple, red, or brown spots on the skin (petechiae)
  • redness of the skin (erythema)
  • skin rash (allergic dermatitis)
  • stomach swelling
  • stretch marks (striae)
  • suppression of growth
  • suppression of reactions to skin tests
  • swelling
  • swelling in the arms and legs
  • tendon rupture
  • thin fragile skin
  • thinning scalp hair
  • unwanted hair-growth (hirsutism)
  • vertigo
  • weakened bones (osteoporosis)
The following severe side-effects may also occur when using Dexamethasone:
  • Heart-related disorders
    Symptoms: increased or decreased heart rate, sudden loss of heart function, irregular heartbeat, heart enlargement, abnormally low blood pressure (circulatory collapse), heart failure, disruption to blood supply (fat embolism), increased blood pressure, heart becomes thickened (hypertrophic cardiomyopathy), obstruction of a blood vessel by a blood clot (thromboembolism), inflammation of a vein (thrombophlebitis) inflammation of the blood vessels (vasculitis)
  • Endocrine disorders
    Symptoms: complex hormonal condition with facial puffiness and weight gain (cushingoid state), decreased carbohydrate tolerance, decreased glucose tolerance, excretion of glucose into the urine (glycosuria), high sugar level increased requirements for insulin
  • Stomach and intestinal disorders
    Symptoms: elevation in blood liver enzyme levels, enlarged liver, increased appetite, pancreas inflammation, stomach ulcer with a hole in the small and large intestine inflammation of the lining of the esophagus (ulcerative esophagitis)
  • Musculoskeletal disorders
    Symptoms: permanent damage of bone tissue (aseptic necrosis of femoral and humeral heads)
  • Allergic reactions
    Symptoms: allergic reactions swelling of the area under the tissues
  • Nervous system disorders/mental disorders
    Symptoms: irregular movement of the body (convulsions), depression, increased pressure inside the skull with optic disc swelling, inflammation of the optic nerve, tingling or numbness in the hands and feet abnormal thinking and perceptions (psychic disorders)
  • Fluid and electrolyte disturbances
    Symptoms: heart failure, increased blood potassium level (hypokalemic alkalosis), potassium loss sodium retention
  • Ophthalmic disorders
    Symptoms: a large eyeball (exophthalmos), damage to the optic nerve (glaucoma), fluid pressure inside the eye cloudy region on the lens (posterior subcapsular cataracts)
Your doctor has prescribed Dexamethasone because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Dexamethasone.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Dexamethasone by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:
  • increased appetite

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Children

Following are the side-effects of this medicine in young patients:
  • suppression of growth

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
  • anaphylactoid reaction
  • anaphylaxis
  • swelling of the area under the tissues
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Ophthalmics

Use of corticosteroids may produce cloudy region on the lens (posterior subcapsular cataracts), damage to the optic nerves, and may enhance the establishment of eye infections due to viruses, bacteria, or fungi. The use of oral corticosteroids is not advised in the therapy of inflamed optic nerves and may lead to an increased risk of new events. Corticosteroids including Dexamethasone should not be used in active eye infection due to the virus.

Viral Infections

Chickenpox and measles can have a more severe or even fatal progression in children and adult patients on corticosteroids including Dexamethasone. Children and adult patients who did not have these diseases, special care should be used to avoid exposure. If exposed to chickenpox, pretreatment with a vaccine (varicella zoster immune globulin) may be advised. If exposed to measles, pretreatment with immune globulin may be suggested. If chickenpox develops, therapy with antiviral agents should be taken into consideration.

Vaccination

Use of vaccine which does not kill the virus entirely (attenuated vaccines) should not be used in patients receiving small doses of corticosteroids.

Tuberculosis

Active tuberculosis patients treated with corticosteroids are at an increased risk. It should be restricted to use Dexamethasone for the management of active and severe tuberculosis in combination with a proper antituberculous regimen. If Dexamethasone is indicated in patients with inactive tuberculosis, close observation is needed as reactivation of the disease may happen. During prolonged corticosteroid therapy, these patients should use drugs to prevent disease.

Special Pathogens

The inactive disease may get activated or worsening of infections occurring during another condition due to pathogens, such as Amoeba, Cryptococcus etc. In such patients, Dexamethasone-induced suppression of the immune system may lead to spreading and hyperinfection of threadworm. It may often be accompanied by severe inflammation of the digestive tract and potentially fatal bloodstream infection. It is recommended that parasitic infection of the colon should be eliminated before starting Dexamethasone therapy in any patient diarrhea. Also, corticosteroids should be used with intensive care in patients with threadworm infection. Patients with cerebral malaria should not use Dexamethasone.

Infections

Patients who are on Dexamethasone therapy are more sensitive to infections as compared to healthy individuals. The increased dose may increase the rate of existence of infectious complications. Use of Dexamethasone alone or in combination with other immunosuppressive drugs is related to infection with any kind of pathogen e.g. protozoa or bacteria. Corticosteroids including Dexamethasone may worsen systemic fungal infections. In some cases, a combination of amphotericin B and hydrocortisone should not be used due to heart enlargement and heart failure. Dexamethasone should not be used in the presence of fungal infections unless they are required to control reactions which are life-threatening.

Endocrine System Problems

Corticosteroids can produce suppression of the system that controls reactions to stress and other body processes with the potential for inadequate corticosteroid levels after withdrawal of therapy. The improper functioning of adrenal glands may result from too rapid withdrawal of corticosteroids including Dexamethasone. This effect may be minimized by a gradual lowering of dose. The volume of blood cleared of Dexamethasone is decreased in patients with low thyroid hormone and increased in patients with high thyroid level. In any condition of stress, the dose should not be discontinued. If the patient is already receiving steroids, the dose may increase. Patients with changes in thyroid hormone may need a dose adjustment.

Heart-Kidney Related Problems

Use of corticosteroids may lead to left ventricle wall rupture after a recent heart attack. All corticosteroids including Dexamethasone increase the excretion of calcium. Medium to high doses of corticosteroids including Dexamethasone can cause a rise in blood pressure, sodium and water retention, and increased potassium excretion. Treatment with corticosteroids should be done with caution in patients with a high risk. Restricted salt diet and potassium supplementation may be necessary.

Allergic Reaction

Rare cases of allergic reactions have occurred in patients taking corticosteroid therapy including Dexamethasone.

Interactions with Dexamethasone

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Dexamethasone. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Oral Anticoagulants

Your doctor's guidelines may need to be followed while taking this medicine along with oral anticoagulants (warfarin), which are used in the prevention and treatment of an obstruction in a blood vessel. The combined use of Dexamethasone and warfarin may result in interference of response to warfarin. Coagulation factors should be monitored regularly to maintain the desired effect of medicines that help to prevent blood clots.

Antibiotics

Dexamethasone interacts with antibiotics, which are used to kill or suppress the growth of bacteria. Macrolide antibiotics have been stated to cause a notable decrease in Dexamethasone clearance.

Potassium-Depleting Agents and Amphotericin B Injection

There may be an interaction of Dexamethasone with potassium-depleting agents, which increase loss of fluids and amphotericin B injection, which is used to treat serious and life-threatening fungal infections. The combined use of amphotericin B and hydrocortisone was followed by heart enlargement and heart failure. When corticosteroids are used in combination with potassium-depleting agents (e.g., diuretics and amphotericin B), patients should be examined for the development of low potassium level.

Aminoglutethimide

Dexamethasone may interact with an aromatase inhibitor (aminoglutethimide), which is used in the treatment of breast cancer and seizures. Aminoglutethimide may decrease cortisol production (adrenal suppression) when used with Dexamethasone. It increases the metabolic clearance of Dexamethasone, resulting in lowered blood levels and decreased physiological activity. The dosage may need to be adjusted. Interpretation of the Dexamethasone suppression tests should be done with caution during combined use of these drugs.

Anticholinesterases

Special instructions need to be followed while taking this medicine along with anticholinesterases, which are useful in treating serious muscle weakness. The combined use of anticholinesterase agents and Dexamethasone may produce severe weakness in patients with autoimmune neuromuscular disease. If possible, drugs that decrease the breakdown of acetylcholine (anticholinesterase agents) should be used at least 24 hours before starting Dexamethasone therapy.

Dexamethasone Suppression Test (DST)

Your doctor's guidelines may need to be followed while taking this medicine along with Dexamethasone suppression test (DST), which is used to assess adrenal gland function. Patients being treated with NSAID such as indomethacin showed false-negative results in the DST. DST results should be evaluated with caution in such patients.

Bile Acid Sequestrant

Dexamethasone interacts with bile acid sequestrant (cholestyramine), which is used to treat itching in individual with too much bile acid. Cholestyramine may enhance the clearance of Dexamethasone.

Cyclosporine

Special instructions need to be followed while taking this medicine along with immunosuppressants (cyclosporine), which is used to prevent organ rejection. Increased activity of both Dexamethasone and cyclosporine may occur when both are used together. Seizures have been seen with this combined use.

Antitubercular Drugs

There may be an interaction of Dexamethasone with antitubercular drugs, which are used for the treatment of mycobacterial infections. Blood levels of isoniazid may be decreased when used in combination with Dexamethasone.

Antidiabetics

Dexamethasone may interact with antidiabetics, which are used to prevent high blood sugar level. Dexamethasone may raise blood glucose levels. It is required to adjust the dose of antidiabetic agents.

Cardiac Glycosides

Dexamethasone may interact with cardiac glycosides (digitalis glycosides), which are used to treat various heart conditions. Patients who are on digitalis glycosides may be at higher risk of irregular heartbeat due to decreased potassium level.

Ketoconazole

Your doctor's guidelines may need to be followed while taking this medicine along with Antifungal drug (ketoconazole), which is used to treat a variety of infections caused by fungi. Ketoconazole has been observed to decrease the absorption of certain corticosteroids leading to increased risk of Dexamethasone side effects. Ketoconazole alone can block adrenal corticosteroid synthesis which may cause improper adrenal gland function during corticosteroid withdrawal.

Liver Enzyme Substrates, Inducers, and Inhibitors

Special instructions need to be followed while taking this medicine along with liver enzyme substrates, inducers, and inhibitors. Drugs which induce drug-metabolizing enzyme activity (CYP450 3A4 e.g., barbiturates) may enhance the absorption of Dexamethasone as Dexamethasone is a moderate inducer of CYP3A4. Drugs which block CYP3A4 (e.g, erythromycin) have the possibility to result in increased blood levels of corticosteroids. Combined use with other drugs that are absorbed by CYP 3A4 (e.g., indinavir) may enhance their clearance, resulting in decreased blood levels. Drugs which induce cytochrome P450 3A4 enzyme activity demand an increase in the dose.

Estrogens (Oral Contraceptives)

Dexamethasone interacts with estrogens, which are used for the development and regulation of the female reproductive system including oral contraceptives. Estrogens may reduce the liver absorption of certain corticosteroids, thereby enhancing their effect.

Ephedrine

There may be an interaction of Dexamethasone with ephedrine, which is used as a stimulant, appetite suppressant, and to treat low blood pressure associated with temporary loss of sensation. Ephedrine may enhance the blood fluid clearance of Dexamethasone, resulting in lowered blood levels and diminished normal function of an organism. It is required to increase the corticosteroid dose.

Nonsteroidal Anti-Inflammatory Agents

Dexamethasone may interact with NSAIDs (aspirin), which is used to reduce pain, decrease fever and prevent blood clots. The combined use of Dexamethasone and aspirin increases the risk of stomach and intestinal side effects. The rate of clearance of salicylates may be increased with combined use of corticosteroids. Aspirin should be used cautiously when taken in combination with Dexamethasone in a deficiency of blood clotting substance prothrombin (hypoprothrombinemia).

Phenytoin

There may be an interaction of Dexamethasone with an antiseizure drug (phenytoin), which is used for the treatment of seizures. Irregular phenytoin levels are noticed when phenytoin is given with Dexamethasone, leading to changes in seizure control.

Skin Tests

Dexamethasone interacts with skin tests, which are used to diagnose allergies that provoke a small and controlled allergic response. Dexamethasone may suppress the reactions in response to skin tests.

Thalidomide

Special instructions need to be followed while taking this medicine along with sedative drug (thalidomide), which is used as a treatment of certain cancers. Severe skin reaction has been reported with combined use. Combined use with thalidomide should be done with caution.

Vaccines

Your doctor's guidelines may need to be followed while taking this medicine along with vaccines, which are used to provide active acquired immunity to a particular disease. Patients on Dexamethasone therapy may show a reduced response to inactivated toxin and live or inactivated vaccines due to the interference of antibody response. Corticosteroids may also increase the replication of some organisms contained in live attenuated vaccines. If possible, the routine use of vaccines or inactivated toxin should be delayed until corticosteroid therapy is discontinued.

Interactions of Dexamethasone by Severity

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Dexamethasone be not used?

Systemic Fungal Infections

This medicine should not be used in patients with systemic fungal infection. If this medicine is used in combination with amphotericin B and hydrocortisone, heart enlargement and congestive heart failure can occur.

Allergy

Dexamethasone should not be in patients with known allergic reaction to it. These patients may suffer from a severe allergic reaction. These patients may have the following symptoms if they use this medicine:
  • rash
  • hives
  • redness of the skin (erythema)
  • swelling of the hands and feet
  • swelling of the mouth and throat
  • difficulty in breathing

Vaccines

Patients who use corticosteroids such as Dexamethasone should not use live virus vaccines. If inactivated viral or bacterial vaccines used in such patients, the standard blood antibody response may not occur. However, immunization procedures can be used in patients with corticosteroids as replacement therapy.

Cerebral Malaria

This medicine should not be used in patients having malaria which affects the brain (cerebral malaria).

Active Ocular Herpes Simplex

This medicine should not be used in patients with herpes viral infection affecting the eyes (active ocular herpes simplex).

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Dexamethasone is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Dexamethasone .
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