Dexamethasone

Dexamethasone is a prescription medication used to relieve inflammation and treat a variety of conditions that involve swelling, heat, redness, and pain in many body systems.

Dexamethasone belongs to a group of drugs called corticosteroids. These work by replacing natural hormones produced by your adrenal glands when your body cannot make enough.

This medication is available as an oral concentrate, an oral elixir, an oral solution, an oral tablet, eye drops, and ear drops. The directions and frequency of use will vary with the indication for dexamethasone.

This medication is also available as an intravitreal implant for injection into the eye by a healthcare professional.

This medication is also available in an injectable form to be given directly into a vein (IV), a muscle (IM), a joint (intra-articular), a lesion (intralesional), and soft tissue by a healthcare professional.

Common side effects of dexamethasone include upset stomach, vomiting, headache, insomnia, restlessness, depression, anxiety, acne, increased hair growth, easy bruising, increased appetite and weight gain, and irregular or absent menstrual periods.

Dexamethasone can also cause dizziness. Do not drive or operate heavy machinery until you know how dexamethasone affects you.

Oral/injectable:

Dexamethasone is a prescription medication used to relieve inflammation and treat a variety of conditions including:

• arthritis
• skin disorders
• blood disorders
• kidney disorders
• eye disorders
• thyroid disorders
• intestinal disorders
• systemic lupus erythematosus
• dermatitis
• psoriasis
• allergies
• asthma

Dexamethasone can also be used in the treatment of certain types of cancers.

Topical:

Dexamethasone is a prescription medication used to relieve inflammation and irritation, redness, burning, and swelling of the eye or ear caused by chemicals, heat, radiation, infection, allergy, or foreign bodies.

Intravitreal implant:

The intravitreal implant form of dexamethasone is used to treat macular edema, which involves fluid and protein deposits on the eye, and non-infectious uveitis, which is an inflammation of part of the eye.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Dexamethasone may be found in some form under the following brand names:

• Aeroseb-Dex

• AK-Dex

• AK-Neo-Dex

• AK-Trol

• Baycadron

• Ciprodex

• Dalalone

• De-Sone LA

• Decadron

• Decadron with Xylocaine

• Decadron-LA

• Decaspray

• Dexacidin

• Dexacine

• Dexacort Phosphate in Respihaler

• Dexacort Phosphate in Turbinaire

• Dexacort-LA

• DexaJect

• Dexamethasone Intensol

• Dexasol

• Dexasone

• Dexasporin

• Dexium

• Dextenza

• Hexadrol

• Maxidex

• Maxitrol

• Methadex

• Neo-Decadron

• Neo-Dex

• Neo-Dexair

• Ocu-Dex

• Ocu-Trol

• Ozurdex

• Poly-Dex

• Tobradex

• Tresaderm

Serious side effects have been reported with dexamethasone. See the “Dexamethasone Precautions” section.

Oral/injectable:

Common side effects of oral and injectable forms of dexamethasone include the following:

• upset stomach
• stomach irritation
• vomiting
• headache
• dizziness
• insomnia
• restlessness
• depression
• anxiety
• acne
• increased hair growth
• easy bruising
• irregular or absent menstrual periods
• increased appetite and weight gain

Topical:

Common side effects of topical forms of dexamethasone include the following:

• changes in vision, such as blurring and seeing halos around lights
• pressure and pain in the eye
• drooping of the eyelid
• stinging or burning at the site of application

Intravitreal implant:

Common side effects of the dexamethasone intravitreal implant include increased pressure in the eye and bleeding around the eye.

This is not a complete list of dexamethasone side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• aminoglutethimide (Cytadren)
• amphotericin B (Amphocin, Fungizone Intravenous)
• cholesterol-lowering drugs
• anticoagulants such as warfarin (Coumadin)
• antidiabetic agents
• isoniazid (Hyzyd, Laiazid, INH, Nydrazid, Rimifon, Stanozide, Tubizid)
• cholestyramine (Locholest, Prevalite, Questran)
• cyclosporine (Neoral, Sandimmune)
• digoxin (Lanoxin)
• diuretics
• ephedrine
• estrogens, including oral contraceptives
• barbiturates such as phenobarbital
• phenytoin (Dilantin)
• carbamazepine (Carbatrol, Epitol, Tegretol)
• rifampin (Rifadin)
• ketoconazole (Nizoral)
• erythromycin (EES, ERY-C, Ery-Tab, Erythrocin, Pediamycin)
• indinavir (Crixivan)
• nonsteroidal anti-inflammatory drugs, including aspirin, ibuprofen (Motrin), naproxen (Aleve), celecoxib (Celebrex), and piroxicam (Feldene)
• thalidomide (Thalomid)
• theophylline (Theo-Dur)

This is not a complete list of dexamethasone drug interactions. Ask your doctor or pharmacist for more information.

Oral/Injectable:

Serious side effects have been reported with oral and injectable forms of dexamethasone including the following:

• fluid and electrolyte disturbances. Tell your healthcare provider right away if you have some or all of the following symptoms of a fluid or electrolyte disturbance:
  • fluid retention
  • increased blood pressure
• muscle or skeletal problems. Tell your healthcare provider right away if you have some or all of the following symptoms of a muscle or skeletal problem:
  • muscle weakness
  • muscle pain
  • loss of muscle mass
  • osteoporosis
  • compression fractures of the vertebrae
  • tendon rupture
• ​gastrointestinal upset. Tell your healthcare provider right away if you have some or all of the following symptoms of gastrointestinal upset:
  • peptic ulcer
  • inflammation of the pancreas
  • abdominal distention or bloating
• ​dermatologic complications. Tell your healthcare provider right away if you have some or all of the following symptoms of a dermatologic complication:
  • skin wounds that will not heal
  • redness, itching, or swelling of the skin
  • increased sweating
  • small red or purple spots or discolorations on the body caused by broken blood vessels under the skin
  • changes in the color of the skin
• ​neurologic reactions. Tell your healthcare provider right away if you have some or all of the following symptoms of a neurologic reaction:
  • convulsions
  • vertigo
  • headache
  • psychic disturbances
• ​endocrine abnormalities. Tell your healthcare provider right away if you have some or all of the following symptoms of endocrine abnormalities:
  • menstrual irregularities
  • growth suppression in children
  • onset or worsening of diabetes mellitus
  • increased hair growth

​Topial:

Serious side effects have been reported with topical forms of dexamethasone including the following:

• ophthalmic complications. Tell your healthcare provider right away if you have some or all of the following symptoms of ophthalmic complications:
  • increased intraocular pressure
  • glaucoma
  • exophthalmus
  • corneal damage and infection
• ​myocardial rupture following recent heart attack

Intravitreal implant:

Serious side effects have been reported with the dexamethasone intravitreal implant including inflammation of the eye, increased intraocular pressure, glaucoma, and retinal detachment.

Do not take dexamethasone if you:

• are allergic to dexamethasone or to any of its ingredients
• have a systemic fungal infection

Patients who are taking dexamethasone should not receive live or live, attenuated vaccines. Killed or inactivated vaccines may be administered, but the patient’s response to the vaccines cannot be predicted.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of dexamethasone, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking dexamethasone, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to dexamethasone or to any of its ingredients
• are allergic to aspirin
• are allergic to tartrazine (a yellow dye used in processed foods and drugs)
• have a systemic fungal infection
• have or have had liver problems
• have or have had heart problems
• have or have had kidney problems
• have or have had intestinal problems
• have or have had diabetes
• have or have had thyroid problems
• have or have had high blood pressure
• have or have had mental illness
• have myasthenia gravis
• have osteoporosis
• have or have had seizures
• have or have had tuberculosis
• have or have had ulcers
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Dexamethasone falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Dexamethasone has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from dexamethasone, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Take dexamethasone exactly as prescribed.

Oral:

This medication is available as an oral concentrate, an oral elixir, an oral solution, and an oral tablet. Your doctor will prescribe the dose and schedule for use that is appropriate for your condition. Oral forms of dexamethasone may be taken with food or milk to decrease the risk of an upset stomach.

Topical:

This medication is available as a solution for eye and ear drops. Your doctor will prescribe the dose and schedule for use that is appropriate for your condition.

Injectable:

This medication is also available in an injectable form to be given directly into a vein (IV), a muscle (IM), a joint (intra-articular), a lesion (intralesional), and soft tissue by a healthcare professional.

Intravitreal implant:

This medication is also available as an intravitreal implant for injection directly into the eye by a healthcare professional.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take 2 doses of dexamethasone at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Oral:

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• how you respond to this medication

The initial recommended dose of oral dexamethasone ranges from 0.75 to 9 mg daily depending on the condition being treated.

Topical:

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• how you respond to this medication

The recommended dose of dexamethasone for the eye is 1 to 2 drops of solution into the eye every hour during the day and every 2 hours during the night as initial therapy. When a favorable response is observed, the dose may be reduced 1 drop every 4 hours. Later, the dose may be further reduced to 1 drop 3 or 4 times daily to control symptoms.

The recommended dose of dexamethasone for the ear is 3 or 4 drops 2 or 3 times a day instilled into the ear canal. When a favorable response is obtained, reduce dosage gradually and eventually discontinue.

Injectable:

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• how you respond to this medication

The initial recommended dose of dexamethasone for injection varies from 0.5 to 9 mg a day depending on the condition being treated and the method of administration.

Intravitreal implant:

The dose your doctor recommends may be based on the condition being treated.

The recommended dose of dexamethasone implant for treating certain conditions of the eye is 0.7 mg implanted into the eye in the solid polymer drug delivery system.

If you take too much dexamethasone, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If dexamethasone is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Oral:

• Store dexamethasone for oral use at room temperature.
• Protect from exposure to light.

Topical:

• Store dexamethasone solution for eye and ear drops at room temperature.

Injectable:

• Store dexamethasone for injection at room temperature.
• Protect from exposure to light.

Intravitreal implant:

• Store dexamethasone implant system at room temperature.

Keep this and all medicines out of the reach of children.