Dexamethasone 1.5mg Tablets

Dexamethasone is a synthetic adrenocortical steroid that is a potent glucocorticoid. It binds to specific cytoplasmic glucocorticoid receptors, forming a complex that translocates to the nucleus. This complex then interacts with DNA (glucocorticoid response elements), modulating gene expression. This leads to the synthesis of anti-inflammatory proteins (e.g., lipocortin-1) and inhibition of pro-inflammatory mediators (e.g., prostaglandins, leukotrienes, cytokines like IL-1, IL-6, TNF-alpha). It also suppresses immune responses by inhibiting lymphocyte proliferation and function, and reducing the activity of macrophages and other immune cells.

Serious 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 or seek medical attention immediately:

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 changed sputum production, 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 adrenal insufficiency (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, increased thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath.
Shortness of breath, significant 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 Side Effects

Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you're bothered by any of the following side effects or if they don't go away, contact your doctor or seek medical attention:

Nausea or vomiting.
Difficulty sleeping.
Restlessness.
Excessive sweating.
Hair thinning.
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, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

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. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
The presence of any infection, including bacterial, viral, or fungal infections, as well as specific conditions like:
+ Amoeba infection (e.g., traveler's diarrhea)
+ Herpes infection of the eye
+ Malaria infection in the brain
+ Threadworm infestation
+ Any other type of infection
Nerve problems affecting the eye
Stomach or bowel problems, such as:
+ Diverticulitis
+ Ulcerative colitis
+ Ulcers
+ Recent bowel surgery

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine whether it is safe to take this medication with your existing treatments and health conditions. Never start, stop, or adjust the dosage of any medication without consulting your doctor first.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests, as directed by your doctor, are crucial to monitor your health. Additionally, if you are taking this medication long-term, you may need to have your eye pressure and bone density checked.

This medication can interfere with certain laboratory tests, so it is vital to notify all your healthcare providers and lab workers that you are taking it. Be aware that drugs like this one can cause high blood pressure, so regular blood pressure checks, as advised by your doctor, are necessary.

If you are scheduled to undergo allergy skin tests, inform your doctor and lab workers that you are taking this medication, as it may affect the test results. Long-term use of this medication may increase the risk of developing cataracts or glaucoma, so discuss this with your doctor.

Prolonged use of this medication can also lead to weak bones (osteoporosis). Talk to your doctor to determine if you are at a higher risk or if you have any concerns. You may need to reduce your salt intake and take extra potassium, so consult with your doctor about this. If you have diabetes, it is crucial to closely monitor your blood sugar levels.

Before consuming alcohol, discuss it with your doctor. Additionally, consult with your doctor before receiving any vaccines, as some vaccines may not work as well or may increase the risk of infection when taken with this medication.

It is essential to be aware that chickenpox and measles can be severe or even life-threatening in people taking steroid medications like this one. Avoid close contact with anyone who has chickenpox or measles if you have not had these illnesses before. If you have been exposed to chickenpox or measles, inform your doctor immediately.

Steroid medications, including this one, can increase the risk of infection, which can be mild or severe, and even life-threatening. The risk of infection is typically higher with higher doses of steroids. To minimize the risk, wash your hands frequently, avoid close contact with people who have infections, colds, or flu, and notify your doctor if you experience any signs of infection.

Some infections, such as tuberculosis and hepatitis B, can reactivate in patients taking medications like this one. 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, and you may require additional steroid doses.

If you have been taking this medication for an extended period, consult with your doctor before stopping, as you may need to gradually taper off the medication. 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 a type of cancer called Kaposi's sarcoma. Discuss this with your doctor. Patients with cancer may be at a higher risk of developing a potentially life-threatening condition called tumor lysis syndrome (TLS), so 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 teenagers, so regular growth checks may be necessary. Additionally, this medication can lower sperm counts, so discuss this with your doctor if you have concerns.

If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor, as you will need to discuss the benefits and risks of this medication to you and your baby. If you took this medication during pregnancy, inform your baby's doctor.

• Live or live-attenuated vaccines (during immunosuppressive doses)

• CYP3A4 inducers (e.g., Phenytoin, Carbamazepine, Rifampin, Barbiturates): Decreased dexamethasone efficacy.
• CYP3A4 inhibitors (e.g., Ketoconazole, Itraconazole, Ritonavir, Clarithromycin): Increased dexamethasone levels and toxicity.
• NSAIDs (e.g., Ibuprofen, Naproxen): Increased risk of gastrointestinal ulceration and bleeding.
• Anticoagulants (e.g., Warfarin): May alter anticoagulant effect (monitor INR).
• Diuretics (e.g., Thiazides, Loop diuretics): Increased risk of hypokalemia.
• Antidiabetics (e.g., Insulin, Metformin): May increase blood glucose, requiring dose adjustment of antidiabetics.
• Digoxin: Increased risk of digitalis toxicity due to hypokalemia.
• Cholestyramine, Colestipol: May decrease dexamethasone absorption.

• Oral contraceptives/Estrogens: May increase dexamethasone effects.
• Cyclosporine: Increased levels of both drugs, increased risk of seizures.
• Fluoroquinolones: Increased risk of tendon rupture.
• Vaccines (inactivated): Reduced immune response to vaccines.

• Grapefruit juice: May slightly increase dexamethasone levels (CYP3A4 inhibition).

• Signs of infection (fever, sore throat, malaise, localized pain/redness)
• Mood changes (irritability, anxiety, depression, euphoria, insomnia)
• Gastrointestinal upset (heartburn, indigestion, abdominal pain, black/tarry stools)
• Fluid retention (swelling in ankles/feet, weight gain)
• Muscle weakness or pain
• Vision changes (blurred vision, eye pain)
• Skin changes (thinning, bruising, acne)
• Increased thirst or urination (signs of hyperglycemia)

Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Dexamethasone crosses the placenta. There is a potential for fetal growth restriction, adrenal suppression, and cleft palate (especially with first-trimester exposure, though data are conflicting).

L3 (Moderately safe). Dexamethasone is excreted into breast milk in small amounts. Low doses are generally considered compatible with breastfeeding. High doses or prolonged use may cause adverse effects in the infant (e.g., growth suppression, adrenal suppression).

Corticosteroids can cause growth retardation in children. Monitor growth velocity carefully. Use the lowest effective dose for the shortest possible duration. Increased risk of intracranial hypertension in children.

Elderly patients may be at increased risk for adverse effects, including osteoporosis, hypertension, diabetes, and fluid retention. Use with caution and the lowest effective dose.

• Always taper the dose of dexamethasone gradually when discontinuing, especially after prolonged therapy, to prevent adrenal insufficiency.
• Take dexamethasone with food or milk to minimize gastrointestinal irritation.
• Patients on long-term therapy should be advised to carry a steroid identification card.
• Dexamethasone has a long biological half-life, allowing for once-daily dosing or alternate-day therapy for some conditions.
• Be vigilant for signs of infection, as corticosteroids can mask inflammatory responses.
• Monitor blood glucose levels, especially in diabetic or pre-diabetic patients, as corticosteroids can elevate blood sugar.

• Other systemic corticosteroids (e.g., Prednisone, Methylprednisolone, Hydrocortisone) - choice depends on potency, duration, and specific indication.
• NSAIDs (for inflammatory conditions, if appropriate and less severe)
• Immunosuppressants (e.g., Methotrexate, Azathioprine, Cyclosporine - for autoimmune diseases)
• Biologic agents (for specific inflammatory or autoimmune conditions)
• Antihistamines (for allergic reactions)
• Bronchodilators (for asthma exacerbations)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to 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 seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.