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dexamethasone

Pronunciation

Generic Name: dexamethasone (injection) (DEX a METH a sone)
Brand Name: De-Sone LA, Dexacen-4, Dexasone, Dexasone LA, Solurex, Solurex LA

What is dexamethasone?

Dexamethasone is a steroid that prevents the release of substances in the body that cause inflammation.

Dexamethasone is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, breathing disorders, inflammatory eye conditions, blood cell disorders, leukemia, or endocrine disorders.

Dexamethasone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about dexamethasone?

You should not use this medication if you have a fungal infection anywhere in your body.

Slideshow: 2014 Update - First Time Brand-to-Generic Switches

What should I discuss with my healthcare provider before using dexamethasone?

You should not use this medication if you are allergic to dexamethasone or sulfites, or if you have a fungal infection anywhere in your body.

Steroid medication can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Before using this medication, tell your doctor about any illness or infection you have had within the past several weeks.

To make sure dexamethasone is safe for you, tell your doctor if you have:

  • tuberculosis;

  • cirrhosis or other liver disease;

  • kidney disease;

  • a thyroid disorder;

  • a history of malaria;

  • osteoporosis;

  • a muscle disorder such as myasthenia gravis;

  • glaucoma or cataracts;

  • herpes infection of the eyes;

  • stomach ulcers, ulcerative colitis, or diverticulitis;

  • depression or mental illness;

  • congestive heart failure;

  • high blood pressure; or

  • if you have recently had a heart attack.

FDA pregnancy category C. It is not known whether dexamethasone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Dexamethasone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

How is dexamethasone injection given?

Dexamethasone is often injected into a muscle or into a vein through an IV. A healthcare provider will give you this injection. Dexamethasone injection is usually given for only a few days.

Your dosage needs may change if you have any unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using dexamethasone.

After your treatment ends, you may have withdrawal symptoms such as fever, weakness, and joint or muscle pain. You should not stop using dexamethasone suddenly.

What happens if I miss a dose?

Because you will receive dexamethasone in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving dexamethasone?

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using a steroid.

Do not receive a "live" vaccine while using dexamethasone. Steroids may increase your risk of harmful effects from a live vaccine. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Dexamethasone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor at once if you have:

  • problems with your vision;

  • swelling, rapid weight gain, feeling short of breath;

  • severe depression, unusual thoughts or behavior, seizure (convulsions);

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate);

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or

  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Common side effects may include:

  • sleep problems (insomnia), mood changes;

  • acne, dry skin, thinning skin, bruising or discoloration;

  • slow wound healing;

  • increased sweating;

  • headache, dizziness, spinning sensation;

  • bloating; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Dexamethasone dosing information

Usual Adult Dose for Acute Mountain Sickness:

Oral, IV and IM (injections as sodium phosphate):
0.75 to 9 mg per day in divided doses every 6 to 12 hours
IM (as acetate):
8 to 16 mg, may repeat in 1 to 3 weeks
Intralesional (as acetate):
0.8 to 1.6 mg
Intraarticular and soft tissue as acetate):
4 to 16 mg, may repeat in 1 to 3 weeks
Intraarticular, intralesional, or soft tissue (as sodium phosphate):
0.4 to 6 mg per day

Usual Adult Dose for Asthma -- Acute:

Oral, IV and IM (injections as sodium phosphate):
0.75 to 9 mg per day in divided doses every 6 to 12 hours
IM (as acetate):
8 to 16 mg, may repeat in 1 to 3 weeks
Intralesional (as acetate):
0.8 to 1.6 mg
Intraarticular and soft tissue as acetate):
4 to 16 mg, may repeat in 1 to 3 weeks
Intraarticular, intralesional, or soft tissue (as sodium phosphate):
0.4 to 6 mg per day

Usual Adult Dose for Croup:

Oral, IV and IM (injections as sodium phosphate):
0.75 to 9 mg per day in divided doses every 6 to 12 hours
IM (as acetate):
8 to 16 mg, may repeat in 1 to 3 weeks
Intralesional (as acetate):
0.8 to 1.6 mg
Intraarticular and soft tissue as acetate):
4 to 16 mg, may repeat in 1 to 3 weeks
Intraarticular, intralesional, or soft tissue (as sodium phosphate):
0.4 to 6 mg per day

Usual Adult Dose for Anti-inflammatory:

Oral, IV and IM (injections as sodium phosphate):
0.75 to 9 mg per day in divided doses every 6 to 12 hours
IM (as acetate):
8 to 16 mg, may repeat in 1 to 3 weeks
Intralesional (as acetate):
0.8 to 1.6 mg
Intraarticular and soft tissue as acetate):
4 to 16 mg, may repeat in 1 to 3 weeks
Intraarticular, intralesional, or soft tissue (as sodium phosphate):
0.4 to 6 mg per day

Usual Adult Dose for Cerebral Edema:

Initial 10 mg IV once, followed by 4 mg IM every 6 hours until symptoms of cerebral edema subside. Dosage may be reduced after 2 to 4 days, and discontinued slowly over a period of 5 to 7 days.

Usual Adult Dose for Cushing's Syndrome:

Suppression test or diagnosis for Cushing's syndrome:
1 mg orally at 11 p.m. Blood plasma cortisol measurement at 8 a.m. the next morning.
or
0.5 mg by mouth every 6 hours for 48 hours (with 24 hour urine collection for 17 hydroxycorticosteroid excretion).

Differentiation of Cushing's syndrome due to ACTH excess from Cushing's due to other causes: Oral: Dexamethasone 2 mg every 6 hours for 48 hours (with 24 hour urine collection for 17 hydroxycorticosteroid excretion).

Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:

Prophylaxis:
10 mg to 20 mg orally or IV, 15 to 30 minutes before treatment on each treatment day
For continuous infusion of chemotherapy:
10 mg orally or IV every 12 hours on each treatment day.
For mildly emetogenic therapy: 4 mg oral, IV or IM every 4 to 6 hours.
Delayed nausea and vomiting:
8 mg orally every 12 hours for 2 days; then 4 mg every 12 hours for 2 days.
or
20 mg orally 1 hour before chemotherapy; then 10 mg orally 12 hours after chemotherapy; then 8 mg orally every 12 hours for 4 doses; then 4 mg orally every 12 hours for 4 doses.

Usual Adult Dose for Shock:

Addisonian crisis/shock:
4 to 10 mg IV as single dose, repeat if necessary.

Unresponsive shock:
1 to 6 mg/kg IV as a single dose or up to 40 mg initially followed by repeat doses every 2 to 6 hours while shock persists.

Usual Adult Dose for Multiple Myeloma:

Multiple myeloma: Oral, IV: 40 mg/day, days 1 to 4, 9 to 12, and 17 to 20, repeated every 4 weeks (alone or as part of a regimen).

Usual Adult Dose for Multiple Sclerosis:

Multiple sclerosis (acute exacerbation): Oral: 30 mg/day for 1 week, followed by 4 to 12 mg/day for 1 month.

Usual Adult Dose for Adrenal Insufficiency:

Physiological replacement: Oral, IM, IV (should be given as sodium phosphate): 0.03 to 0.15 mg/kg/day or 0.6 to 0.75 mg/m2/day in divided doses every 6 to 12 hours.

Usual Pediatric Dose for Cerebral Edema:

Initial loading dose: 1 to 2 mg/kg once orally, IV or IM.
Maintenance: 1 to 1.5 mg /kg/day, give in divided doses every 4 to 6 hours for 5 days then taper for 5 days, then discontinue. Maximum dose: 16 mg/day.

Usual Pediatric Dose for Meningitis -- Meningococcal:

(Not approved by FDA):

Meningitis (H. influenzae type b): Infants and Children 6 weeks or older: IV: 0.15 mg/kg/dose every 6 hours for the first 2 to 4 days of antibiotic treatment; start dexamethasone 10 to 20 minutes before or with the first dose of antibiotic. If antibiotics have already been administered, dexamethasone use has not been shown to improve patient outcome and is not recommended. Note: For pneumococcal meningitis, data has not shown clear benefit from dexamethasone administration; risk and benefits should be considered prior to use.

Usual Pediatric Dose for Meningitis -- Haemophilus influenzae:

(Not approved by FDA):

Meningitis (H. influenzae type b): Infants and Children 6 weeks or older: IV: 0.15 mg/kg/dose every 6 hours for the first 2 to 4 days of antibiotic treatment; start dexamethasone 10 to 20 minutes before or with the first dose of antibiotic. If antibiotics have already been administered, dexamethasone use has not been shown to improve patient outcome and is not recommended. Note: For pneumococcal meningitis, data has not shown clear benefit from dexamethasone administration; risk and benefits should be considered prior to use.

Usual Pediatric Dose for Meningitis -- Pneumococcal:

(Not approved by FDA):

Meningitis (H. influenzae type b): Infants and Children 6 weeks or older: IV: 0.15 mg/kg/dose every 6 hours for the first 2 to 4 days of antibiotic treatment; start dexamethasone 10 to 20 minutes before or with the first dose of antibiotic. If antibiotics have already been administered, dexamethasone use has not been shown to improve patient outcome and is not recommended. Note: For pneumococcal meningitis, data has not shown clear benefit from dexamethasone administration; risk and benefits should be considered prior to use.

Usual Pediatric Dose for Meningitis - Listeriosis:

(Not approved by FDA):

Meningitis (H. influenzae type b): Infants and Children 6 weeks or older: IV: 0.15 mg/kg/dose every 6 hours for the first 2 to 4 days of antibiotic treatment; start dexamethasone 10 to 20 minutes before or with the first dose of antibiotic. If antibiotics have already been administered, dexamethasone use has not been shown to improve patient outcome and is not recommended. Note: For pneumococcal meningitis, data has not shown clear benefit from dexamethasone administration; risk and benefits should be considered prior to use.

Usual Pediatric Dose for Anti-inflammatory:

0.08 to 0.3 mg/kg/day or 2.5 to 5 mg/m2/day in divided doses every 6 to 12 hours.

Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:

(Not approved by FDA):

Prior to chemotherapy:
10 mg/meter squared IV for first dose (maximum 20 mg) then 5 mg/meter squared/dose every 6 hours as needed.

Usual Pediatric Dose for Asthma -- Acute:

Asthma exacerbation: Oral, IM, IV: 0.6 mg/kg once (maximum dose: 16 mg)

Usual Pediatric Dose for Croup:

(Not approved by FDA):

Croup (laryngotracheobronchitis): Oral, IM, IV: 0.6 mg/kg once (maximum: 20 mg). A single dose of 0.15 mg/kg has also been shown effective.

Usual Pediatric Dose for Adrenal Insufficiency:

Physiological replacement: Oral, IM, IV (should be given as sodium phosphate): 0.03 to 0.15 mg/kg/day or 0.6 to 0.75 mg/m2/day in divided doses every 6 to 12 hours.

Usual Pediatric Dose for Acute Mountain Sickness:

(Not approved by FDA):
Acute mountain sickness (AMS)/high altitude cerebral edema (HACE); treatment: Oral, IM, IV: 0.15 mg/kg/dose every 6 hours; consider using for high altitude pulmonary edema because of associated HACE with this condition.

Usual Pediatric Dose for Bronchopulmonary Dysplasia:

(Not approved by FDA):
Bronchopulmonary dysplasia, facilitation of ventilator wean: postnatal age =7 days: Oral, IV: Initial: 0.15 mg/kg/day given in divided doses every 12 hours for 3 days, then tapered every 3 days over 7 days; total dexamethasone dose: 0.89 mg/kg given over 10 days; others have used 0.2 mg/kg/day given once daily and tapered every 3 days over 7 days (total dexamethasone dose: 1 mg/kg) ( or tapered over 14 days (total dexamethasone dose: 1.9 mg/kg). Note: High doses (0.5 mg/kg/day) do not confer additional benefit over lower doses, are associated with higher incidence of adverse effects (including adverse neurodevelopmental outcomes), and are not recommended for use. However, a meta-analysis reported total cumulative doses greater than 4 mg/kg reduced the relative risk for the combined outcome, mortality, or bronchopulmonary dysplasia; further studies are needed.

What other drugs will affect dexamethasone?

Many drugs can interact with dexamethasone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with dexamethasone. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about dexamethasone.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03. Revision Date: 2013-11-19, 3:35:07 PM.

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