Dexamethasone 0.5mg/5ml Elixir
It is used for many health problems like allergy signs, asthma, adrenal gland problems, blood problems, skin rashes, or swelling problems. This is not a list of all health problems that this drug may be used for. Talk with the doctor.
Drug Class
Corticosteroid, Glucocorticoid
Pharmacologic Class
Adrenocortical steroid; Glucocorticoid receptor agonist
Pregnancy Category
Category C
FDA Approved
May 1958
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dexamethasone is a type of steroid medication that works like natural hormones your body makes. It's used to reduce inflammation (swelling and redness), suppress the immune system (to treat autoimmune diseases or prevent organ rejection), and treat certain cancers or allergic reactions. It can also help with nausea and swelling in the brain.
How to Use This Medicine
Taking Your Medication Correctly
To ensure you get the most benefit from your medication, follow these guidelines:
Take your medication exactly as directed by your doctor. Read all the information provided with your prescription and follow the instructions carefully.
If you take your medication once a day, take it in the morning.
To minimize the risk of an upset stomach, take your medication with food.
It's essential to use the correct liquid strength, as there are multiple strengths available. Measure your liquid doses accurately using the measuring device provided with your medication. If one is not included, ask your pharmacist for a suitable measuring device.
Continuing Your Medication Regimen
Continue taking your medication as instructed by your doctor or healthcare provider, even if you start to feel better.
If you are also taking cholestyramine, you may need to take it at a different time than your current medication. Consult with your pharmacist to determine the best schedule.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom.
Do not freeze your medication.
Keep all medications in a safe and secure location, out of the reach of children and pets.
Missing a Dose
If you miss a dose, take it as soon as you remember.
If it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at the same time or take extra doses to make up for a missed dose.
To ensure you get the most benefit from your medication, follow these guidelines:
Take your medication exactly as directed by your doctor. Read all the information provided with your prescription and follow the instructions carefully.
If you take your medication once a day, take it in the morning.
To minimize the risk of an upset stomach, take your medication with food.
It's essential to use the correct liquid strength, as there are multiple strengths available. Measure your liquid doses accurately using the measuring device provided with your medication. If one is not included, ask your pharmacist for a suitable measuring device.
Continuing Your Medication Regimen
Continue taking your medication as instructed by your doctor or healthcare provider, even if you start to feel better.
If you are also taking cholestyramine, you may need to take it at a different time than your current medication. Consult with your pharmacist to determine the best schedule.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom.
Do not freeze your medication.
Keep all medications in a safe and secure location, out of the reach of children and pets.
Missing a Dose
If you miss a dose, take it as soon as you remember.
If it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
Do not take two doses at the same time or take extra doses to make up for a missed dose.
Lifestyle & Tips
- Take exactly as prescribed; do not stop abruptly without consulting your doctor, as this can lead to serious withdrawal symptoms.
- Take with food or milk to reduce stomach upset.
- Avoid contact with people who have infections (e.g., chickenpox, measles) if you are on high doses or long-term therapy, as your immune system is suppressed.
- Report any signs of infection, unusual bruising, swelling, or mood changes to your doctor.
- Limit sodium intake and ensure adequate calcium and vitamin D intake, especially with long-term use, to help prevent bone loss.
- Carry a medical alert card or bracelet if on long-term therapy, indicating you are taking a steroid.
Available Forms & Alternatives
Available Strengths:
- Dexamethasone 0.1% Ophthsoln 5ml
- Dexamethasone 2mg Tablets
- Dexamethasone 1.5mg Tablets
- Dexamethasone Intensol 1mg/ml Soln
- Dexamethasone 0.5mg Tablets
- Dexamethasone 0.75mg Tablets
- Dexamethasone 4mg Tablets
- Dexamethasone 1mg Tablets
- Dexamethasone Pho 4mg/ml Injection
- Dexamethasone Sod Phos 10mg/ml Inj
- Dexamethasone 6mg Tablets
- Dexamethasone 0.5mg/5ml Oral Soln
- Dexamethasone Pho 4mg/ml Inj, 1ml
- Dexamethasone Pho 4mg/ml Inj, 5ml
- Dexamethasone 0.5mg/5ml Elixir
- Dexamethasone Sod Phos Inj, 10ml
- Dexamethasone Phos 120mg/30ml Inj
- Dexamethasone 6-Day 1.5mg Dose Pack
- Dexamethasone 10-Day 1.5mg Dose Pak
- Dexamethason 13-Day Tab
- Dexamethasone 2mg Tablets
- Dexamethasone 1.5mg Tablets
- Dexamethasone 6mg Tablets
- Dexamethasone 4mg Tablets
- Dexamethasone 0.5mg Tablets
- Dexamethasone 0.75mg Tablets
- Dexamethasone 1mg Tablets
- Dexamethasone 1mg Tablets
Dosing & Administration
Adult Dosing
Standard Dose:
Varies widely based on indication. For anti-inflammatory/immunosuppressive: 0.75 mg to 9 mg daily in single or divided doses. For cerebral edema: Initial 10 mg IV, then 4 mg IM/IV every 6 hours until symptoms subside. For antiemetic: 8-20 mg IV/PO prior to chemotherapy.
Dose Range:
0.75 - 9 mg
Condition-Specific Dosing:
antiInflammatory:
0.75 mg to 9 mg daily
cerebralEdema:
Initial 10 mg, then 4 mg q6h
antiemetic:
8-20 mg prior to chemotherapy
Pediatric Dosing
Neonatal:
Not established for routine use; specific conditions (e.g., bronchopulmonary dysplasia) may use 0.05-0.1 mg/kg/day divided q12-24h, tapered.
Infant:
0.02-0.3 mg/kg/day divided q6-12h for anti-inflammatory/immunosuppressive effects.
Child:
0.02-0.3 mg/kg/day divided q6-12h for anti-inflammatory/immunosuppressive effects. For croup: 0.15-0.6 mg/kg single dose (max 10 mg).
Adolescent:
Similar to adult dosing, adjusted for weight and condition.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed.
Moderate:
No specific adjustment needed.
Severe:
No specific adjustment needed.
Dialysis:
Not significantly removed by dialysis; no dose adjustment needed.
Hepatic Impairment:
Mild:
No specific adjustment needed.
Moderate:
Consider dose reduction in severe hepatic impairment, as metabolism may be impaired. Monitor for increased side effects.
Severe:
Consider dose reduction in severe hepatic impairment, as metabolism may be impaired. Monitor for increased side effects.
Pharmacology
Mechanism of Action
Dexamethasone is a synthetic adrenocortical steroid that is a glucocorticoid. It binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene expression. This leads to widespread effects including potent anti-inflammatory and immunosuppressive actions by inhibiting the synthesis of prostaglandins and leukotrienes, suppressing migration of polymorphonuclear leukocytes, and reversing increased capillary permeability. It also affects carbohydrate, protein, and fat metabolism.
Pharmacokinetics
Absorption:
Bioavailability:
80-90% (oral)
Tmax:
1-2 hours (oral)
FoodEffect:
Food may slightly delay absorption but does not significantly affect the extent of absorption.
Distribution:
Vd:
0.8 L/kg
ProteinBinding:
60-70%
CnssPenetration:
Yes
Elimination:
HalfLife:
3-4.5 hours (plasma); 36-54 hours (biological)
Clearance:
Not readily available, but primarily hepatic metabolism.
ExcretionRoute:
Urine (as inactive metabolites)
Unchanged:
<10%
Pharmacodynamics
OnsetOfAction:
Hours to days (anti-inflammatory effects); minutes to hours (IV for acute effects)
PeakEffect:
Varies with indication and route; generally within 1-2 days for full anti-inflammatory effect.
DurationOfAction:
36-72 hours (biological half-life dictates prolonged effect)
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of infection: fever, chills, severe sore throat, ear or sinus pain, cough, increased or discolored sputum, painful urination, mouth sores, or a wound that won't heal.
Signs of low potassium levels: muscle pain or weakness, muscle cramps, or an irregular heartbeat.
Signs of pancreatitis (pancreas problem): severe stomach pain, severe back pain, or severe nausea and vomiting.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Signs of a weak adrenal gland: severe nausea and vomiting, severe dizziness or fainting, muscle weakness, fatigue, mood changes, decreased appetite, or weight loss.
Signs of Cushing's syndrome: weight gain in the upper back or abdomen, moon face, severe headache, or slow wound healing.
Signs of high blood sugar: confusion, drowsiness, excessive thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath.
Shortness of breath, sudden weight gain, or swelling in the arms or legs.
Skin changes: acne, stretch marks, slow healing, or excessive hair growth.
Purple, red, blue, brown, or black bumps or patches on the skin or in the mouth.
Abnormal heartbeat: fast, slow, or irregular.
Chest pain or pressure.
Swelling, warmth, numbness, color changes, or pain in a leg or arm.
Changes in menstrual periods.
Bone or joint pain.
Muscle pain or weakness.
Changes in vision.
Changes in behavior or mood.
Seizures.
Unusual burning, numbness, or tingling sensations.
Unexplained bruising or bleeding.
Severe stomach pain.
Black, tarry, or bloody stools, or vomiting blood or coffee ground-like material.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Nausea and vomiting.
Difficulty sleeping.
Restlessness.
Excessive sweating.
Hair loss.
Headache.
Dizziness, fatigue, or weakness.
Weight gain.
Increased appetite.
Hiccups.
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of infection: fever, chills, severe sore throat, ear or sinus pain, cough, increased or discolored sputum, painful urination, mouth sores, or a wound that won't heal.
Signs of low potassium levels: muscle pain or weakness, muscle cramps, or an irregular heartbeat.
Signs of pancreatitis (pancreas problem): severe stomach pain, severe back pain, or severe nausea and vomiting.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Signs of a weak adrenal gland: severe nausea and vomiting, severe dizziness or fainting, muscle weakness, fatigue, mood changes, decreased appetite, or weight loss.
Signs of Cushing's syndrome: weight gain in the upper back or abdomen, moon face, severe headache, or slow wound healing.
Signs of high blood sugar: confusion, drowsiness, excessive thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath.
Shortness of breath, sudden weight gain, or swelling in the arms or legs.
Skin changes: acne, stretch marks, slow healing, or excessive hair growth.
Purple, red, blue, brown, or black bumps or patches on the skin or in the mouth.
Abnormal heartbeat: fast, slow, or irregular.
Chest pain or pressure.
Swelling, warmth, numbness, color changes, or pain in a leg or arm.
Changes in menstrual periods.
Bone or joint pain.
Muscle pain or weakness.
Changes in vision.
Changes in behavior or mood.
Seizures.
Unusual burning, numbness, or tingling sensations.
Unexplained bruising or bleeding.
Severe stomach pain.
Black, tarry, or bloody stools, or vomiting blood or coffee ground-like material.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Nausea and vomiting.
Difficulty sleeping.
Restlessness.
Excessive sweating.
Hair loss.
Headache.
Dizziness, fatigue, or weakness.
Weight gain.
Increased appetite.
Hiccups.
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe stomach pain, black or tarry stools (signs of GI bleeding)
- Swelling in your face, ankles, or hands (fluid retention)
- Unusual weight gain
- Muscle weakness or severe fatigue
- Vision problems (blurred vision, eye pain)
- Increased thirst or urination (high blood sugar)
- Mood swings, depression, or confusion
- Signs of infection (fever, chills, persistent sore throat, body aches)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
If you have an active infection, including bacterial, viral, or fungal infections, such as:
+ Amoeba infection (e.g., traveler's diarrhea)
+ Herpes infection of the eye
+ Malaria infection in the brain
+ Threadworm infestation
+ Any other type of infection
If you have nerve problems in the eye
If you have any stomach or bowel problems, including:
+ Diverticulitis
+ Ulcerative colitis
+ Ulcers
+ Recent bowel surgery
This list is not exhaustive, and it is crucial to discuss all your health conditions and medications with your doctor.
To ensure your safety, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Natural products
Vitamins
Health problems
Verify with your doctor that it is safe to take this medication with all your other medications and health conditions. Do not initiate, stop, or adjust the dose of any medication without consulting your doctor.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
If you have an active infection, including bacterial, viral, or fungal infections, such as:
+ Amoeba infection (e.g., traveler's diarrhea)
+ Herpes infection of the eye
+ Malaria infection in the brain
+ Threadworm infestation
+ Any other type of infection
If you have nerve problems in the eye
If you have any stomach or bowel problems, including:
+ Diverticulitis
+ Ulcerative colitis
+ Ulcers
+ Recent bowel surgery
This list is not exhaustive, and it is crucial to discuss all your health conditions and medications with your doctor.
To ensure your safety, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Natural products
Vitamins
Health problems
Verify with your doctor that it is safe to take this medication with all your other medications and health conditions. Do not initiate, stop, or adjust the dose of any medication without consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Your doctor will likely recommend regular blood tests to monitor your condition. If you are taking this medication long-term, you may also need to have your eye pressure and bone density checked.
This medication can affect the results of certain laboratory tests. Be sure to notify all your healthcare providers and laboratory personnel that you are taking this medication.
There is a risk of developing high blood pressure while taking this medication. Your doctor will monitor your blood pressure regularly, so it is crucial to follow their instructions for checking your blood pressure.
This medication can also interfere with allergy skin tests. Inform your doctor and laboratory personnel that you are taking this medication to ensure accurate test results.
Long-term use of this medication may increase the risk of developing cataracts or glaucoma. Discuss this potential risk with your doctor. Additionally, prolonged use can lead to weak bones (osteoporosis). Talk to your doctor to determine if you are at higher risk or if you have any questions.
You may need to reduce your salt intake and increase your potassium consumption while taking this medication. Consult with your doctor to determine the best approach for your specific situation.
If you have diabetes, it is crucial to closely monitor your blood sugar levels while taking this medication. You should also discuss your alcohol consumption with your doctor, as it may interact with the medication.
Before receiving any vaccinations, consult with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
It is essential to be aware that steroid medications like this one can increase the risk of infection. Chickenpox and measles can be severe or even life-threatening in people taking this medication. Avoid close contact with anyone who has chickenpox or measles, and inform your doctor if you have been exposed. Steroid medications can also cause active infections to worsen and make it more challenging to detect signs of infection. To minimize the risk of infection, wash your hands frequently, avoid people with infections, and notify your doctor if you experience any symptoms of infection.
Some infections, such as tuberculosis and hepatitis B, can reactivate in patients taking this medication. Inform your doctor if you have a history of these infections.
This medication can suppress the production of natural steroids in your body. If you experience fever, infection, surgery, or injury, inform your doctor, as your body's response to these stresses may be affected. You may require additional doses of steroid medication in these situations.
If you have been taking this medication for an extended period, consult with your doctor before stopping or reducing the dosage. You may need to gradually taper off the medication to avoid withdrawal symptoms. If you have missed a dose or recently stopped taking this medication and experience fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, inform your doctor.
Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer. Discuss this potential risk with your doctor. Patients with cancer may be at higher risk of developing tumor lysis syndrome (TLS), a potentially life-threatening condition. Inform your doctor if you have cancer.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.
This medication can affect growth in children and adolescents. Regular growth checks may be necessary, so discuss this with your doctor. Additionally, this medication can lower sperm counts in some individuals. If you have concerns, talk to your doctor.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby. If you took this medication during pregnancy, notify your baby's doctor.
It is crucial to follow your doctor's instructions and attend all scheduled appointments to ensure safe and effective use of this medication.
This medication can affect the results of certain laboratory tests. Be sure to notify all your healthcare providers and laboratory personnel that you are taking this medication.
There is a risk of developing high blood pressure while taking this medication. Your doctor will monitor your blood pressure regularly, so it is crucial to follow their instructions for checking your blood pressure.
This medication can also interfere with allergy skin tests. Inform your doctor and laboratory personnel that you are taking this medication to ensure accurate test results.
Long-term use of this medication may increase the risk of developing cataracts or glaucoma. Discuss this potential risk with your doctor. Additionally, prolonged use can lead to weak bones (osteoporosis). Talk to your doctor to determine if you are at higher risk or if you have any questions.
You may need to reduce your salt intake and increase your potassium consumption while taking this medication. Consult with your doctor to determine the best approach for your specific situation.
If you have diabetes, it is crucial to closely monitor your blood sugar levels while taking this medication. You should also discuss your alcohol consumption with your doctor, as it may interact with the medication.
Before receiving any vaccinations, consult with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
It is essential to be aware that steroid medications like this one can increase the risk of infection. Chickenpox and measles can be severe or even life-threatening in people taking this medication. Avoid close contact with anyone who has chickenpox or measles, and inform your doctor if you have been exposed. Steroid medications can also cause active infections to worsen and make it more challenging to detect signs of infection. To minimize the risk of infection, wash your hands frequently, avoid people with infections, and notify your doctor if you experience any symptoms of infection.
Some infections, such as tuberculosis and hepatitis B, can reactivate in patients taking this medication. Inform your doctor if you have a history of these infections.
This medication can suppress the production of natural steroids in your body. If you experience fever, infection, surgery, or injury, inform your doctor, as your body's response to these stresses may be affected. You may require additional doses of steroid medication in these situations.
If you have been taking this medication for an extended period, consult with your doctor before stopping or reducing the dosage. You may need to gradually taper off the medication to avoid withdrawal symptoms. If you have missed a dose or recently stopped taking this medication and experience fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, inform your doctor.
Long-term use of this medication has been associated with an increased risk of Kaposi's sarcoma, a type of cancer. Discuss this potential risk with your doctor. Patients with cancer may be at higher risk of developing tumor lysis syndrome (TLS), a potentially life-threatening condition. Inform your doctor if you have cancer.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.
This medication can affect growth in children and adolescents. Regular growth checks may be necessary, so discuss this with your doctor. Additionally, this medication can lower sperm counts in some individuals. If you have concerns, talk to your doctor.
If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby. If you took this medication during pregnancy, notify your baby's doctor.
It is crucial to follow your doctor's instructions and attend all scheduled appointments to ensure safe and effective use of this medication.
Overdose Information
Overdose Symptoms:
- Acute overdose is rare but may include: severe nausea, vomiting, stomach pain, weakness, drowsiness, or confusion. Chronic overdose can lead to Cushing's syndrome symptoms (moon face, buffalo hump, striae, obesity, hypertension, diabetes).
What to Do:
Seek immediate medical attention or call a poison control center (1-800-222-1222). Treatment is supportive; no specific antidote. Chronic overdose requires gradual tapering of the drug under medical supervision.
Drug Interactions
Major Interactions
- Live or live-attenuated vaccines (risk of disseminated infection)
- Mifepristone (antagonizes glucocorticoid effect)
- Strong CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, barbiturates - decrease dexamethasone levels)
- Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, clarithromycin - increase dexamethasone levels)
- Anticoagulants (warfarin - may alter anticoagulant effect, monitor INR)
- NSAIDs (increased risk of GI ulceration/bleeding)
- Diuretics (thiazide, loop - increased risk of hypokalemia)
- Digoxin (increased risk of toxicity with hypokalemia)
- Antidiabetic agents (insulin, oral hypoglycemics - increased blood glucose, require dose adjustment)
Moderate Interactions
- Cyclosporine (increased levels of both drugs)
- Oral contraceptives (may increase dexamethasone levels)
- Fluoroquinolones (increased risk of tendon rupture)
- Neuromuscular blockers (prolonged blockade)
- Cholestyramine (decreased dexamethasone absorption)
- Antacids (decreased dexamethasone absorption)
Minor Interactions
- Grapefruit juice (potential minor increase in dexamethasone levels)
Monitoring
Baseline Monitoring
Blood pressure
Rationale: Corticosteroids can cause hypertension.
Timing: Prior to initiation
Blood glucose
Rationale: Corticosteroids can cause hyperglycemia.
Timing: Prior to initiation
Electrolytes (especially potassium)
Rationale: Risk of hypokalemia.
Timing: Prior to initiation
Bone mineral density (DEXA scan)
Rationale: For long-term therapy, risk of osteoporosis.
Timing: Prior to initiation for anticipated long-term use
Ophthalmic exam (intraocular pressure)
Rationale: Risk of glaucoma/cataracts with long-term use.
Timing: Prior to initiation for anticipated long-term use
Routine Monitoring
Blood pressure
Frequency: Regularly, especially during initiation and dose changes
Target: Normal limits for patient
Action Threshold: Sustained elevation requiring intervention
Blood glucose
Frequency: Regularly, especially in diabetics or with high doses
Target: Individualized
Action Threshold: Persistent hyperglycemia requiring intervention
Electrolytes (especially potassium)
Frequency: Periodically, especially with concomitant diuretics
Target: 3.5-5.0 mEq/L
Action Threshold: Potassium < 3.5 mEq/L
Weight and fluid balance
Frequency: Daily/weekly
Target: Stable
Action Threshold: Significant weight gain or edema
Growth in children
Frequency: Regularly (e.g., every 3-6 months)
Target: Normal growth curve
Action Threshold: Growth retardation
Symptom Monitoring
- Signs of infection (fever, chills, sore throat)
- Mood changes (irritability, depression, euphoria)
- Sleep disturbances
- Muscle weakness or pain
- Unusual bruising or bleeding
- Swelling in ankles/feet
- Increased thirst or urination
- Vision changes
- Stomach pain or black/tarry stools
Special Patient Groups
Pregnancy
Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Dexamethasone crosses the placenta. Prolonged or repeated use during pregnancy may lead to fetal adrenal suppression, requiring monitoring of the neonate for signs of hypoadrenalism.
Trimester-Specific Risks:
First Trimester:
Potential for increased risk of oral clefts, though data are conflicting and overall risk is low.
Second Trimester:
Risk of fetal growth restriction and adrenal suppression with prolonged use.
Third Trimester:
Risk of fetal adrenal suppression, requiring monitoring of the neonate post-delivery.
Lactation
Dexamethasone is excreted into breast milk. The amount is generally low, but potential for adverse effects on the infant (e.g., growth suppression, interference with endogenous corticosteroid production) exists, especially with high doses or prolonged use. Monitor infant for side effects. Consider using the lowest effective dose and taking the dose immediately after breastfeeding.
Infant Risk:
Low to moderate risk, depending on dose and duration. Monitor for signs of adrenal suppression (e.g., poor feeding, lethargy, poor weight gain).
Pediatric Use
Children are more susceptible to growth retardation and adrenal suppression with long-term corticosteroid therapy. Monitor growth and development carefully. Alternate-day therapy may reduce some side effects. Avoid live vaccines during immunosuppressive doses.
Geriatric Use
Elderly patients may be more susceptible to adverse effects, particularly osteoporosis, fluid retention, hypertension, and diabetes. Use the lowest effective dose for the shortest duration possible. Monitor closely for side effects.
Clinical Information
Clinical Pearls
- Always taper dexamethasone gradually after prolonged therapy to prevent adrenal insufficiency.
- Administer with food or milk to minimize gastrointestinal irritation.
- Patients on long-term therapy should carry identification stating they are on corticosteroids.
- Dexamethasone has a long biological half-life, allowing for once-daily or alternate-day dosing for many indications.
- It is a potent glucocorticoid with minimal mineralocorticoid activity, making it suitable when fluid retention is a concern.
Alternative Therapies
- Prednisone
- Methylprednisolone
- Hydrocortisone
- Betamethasone
Cost & Coverage
Average Cost:
$10 - $50 per 120ml bottle (0.5mg/5ml)
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may have additional patient information leaflets, so it's a good idea to check with your pharmacist for more details. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide information about the medication taken, the amount, and the time it occurred.