Dexamethasone 1mg Tablets

Dexamethasone is a synthetic adrenocortical steroid that is approximately 25 times more potent than hydrocortisone and 5-10 times more potent than prednisone. It binds to specific cytoplasmic glucocorticoid receptors in target tissues, forming a steroid-receptor complex that translocates into the nucleus. This complex then binds to specific DNA sequences (glucocorticoid response elements), modulating the transcription of various genes. This leads to altered protein synthesis, resulting in anti-inflammatory, immunosuppressive, and metabolic effects. It inhibits the release of inflammatory mediators (e.g., prostaglandins, leukotrienes), suppresses immune cell function (e.g., lymphocytes, macrophages), and affects carbohydrate, protein, and fat metabolism.

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 experience any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of infection, including:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or changed sputum production
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Signs of low potassium levels, such as:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Signs of pancreatitis (pancreas problems), including:
+ Severe stomach pain
+ Severe back pain
+ Severe nausea or vomiting
Signs of high blood pressure, such as:
+ Severe headache
+ Dizziness or fainting
+ Changes in vision
Signs of a weak adrenal gland, including:
+ Severe nausea or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Fatigue
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, such as:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow wound healing
Signs of high blood sugar, including:
+ Confusion
+ Drowsiness
+ Increased thirst or hunger
+ Frequent urination
+ Flushing
+ Rapid breathing
+ Fruity-smelling breath
Shortness of breath
Sudden weight gain
Swelling in the arms or legs
Skin changes, such as:
+ Acne
+ Stretch marks
+ Slow wound healing
+ 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 cycle
Bone or joint pain
Muscle pain or weakness
Changes in vision
Changes in behavior
Depression or mood changes
Seizures
Burning, numbness, or tingling sensations
Unexplained bruising or bleeding
Severe stomach pain
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material

Other Possible Side Effects

Most people experience few or no side effects while taking this medication. However, if you experience any of the following side effects, contact your doctor or seek medical attention if they bother you or persist:

Upset stomach or nausea
Insomnia
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 the 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
+ Other types of infections
Nerve problems affecting the eye
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. Please inform your doctor and pharmacist about:

All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your complete medical history, including any health problems

Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to ensure your safety. It is vital to verify that it is safe to take this medication with all your other medications and health conditions.

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 undergo eye pressure and bone density checks.

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). Consult with your doctor to determine if you are at a higher risk of developing weak bones or if you have any questions. You may need to reduce your salt intake and take extra potassium, so discuss this with your doctor.

If you have diabetes, it is crucial to closely monitor your blood sugar levels. Before consuming alcohol, consult with your doctor. Additionally, before receiving any vaccines, discuss this with your doctor, as some vaccines may not work as effectively or may increase the risk of infection when taken with this medication.

It is essential to avoid close contact with individuals who have chickenpox or measles, as these infections can be severe or even deadly in people taking steroid medications like this one. 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. To minimize the risk of infection, 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.

In some cases, this medication can reactivate latent infections, such as tuberculosis or hepatitis B. Inform your doctor if you have a history of these infections. This medication can also suppress your body's natural production of steroids, which can affect your response to stress, such as fever, infection, surgery, or injury. In such situations, you may require additional doses of steroids, so notify your doctor.

If you have been taking this medication for an extended period, consult with your doctor before stopping or reducing the dosage, as this can cause withdrawal symptoms such as fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness.

Long-term use of this medication has been associated with an increased risk of developing Kaposi's sarcoma, a type of cancer. Discuss this with your doctor. Additionally, patients with cancer may be at a higher risk of developing tumor lysis syndrome (TLS), a potentially life-threatening condition, 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 also affect growth in children and adolescents, so regular growth checks may be necessary. Furthermore, this medication can lower sperm counts, so if you have concerns, discuss this with your doctor.

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 taking this medication. If you took this medication during pregnancy, notify your baby's doctor.

• Live or live attenuated vaccines (risk of disseminated infection)
• Strong CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, phenobarbital - decreased dexamethasone efficacy)
• Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, clarithromycin - increased dexamethasone levels/toxicity)
• NSAIDs (increased risk of GI ulceration/bleeding)
• Anticoagulants (e.g., warfarin - altered anticoagulant effect, monitor INR)
• Diuretics (especially thiazide and loop diuretics - increased risk of hypokalemia)
• Antidiabetic agents (e.g., insulin, oral hypoglycemics - increased blood glucose, require dose adjustment)
• Digoxin (increased risk of digitalis toxicity due to hypokalemia)
• Mifepristone (antagonizes glucocorticoid effects)

• Cyclosporine (increased levels of both drugs, increased risk of seizures)
• Fluoroquinolones (increased risk of tendon rupture, especially in elderly)
• Cholestyramine, colestipol (may decrease dexamethasone absorption)
• Oral contraceptives (may increase dexamethasone levels)
• Aminoglutethimide (may decrease dexamethasone efficacy)
• Neuromuscular blockers (prolonged weakness/myopathy with long-term concomitant use)

• Antacids (may decrease absorption, separate administration)
• Grapefruit juice (potential for minor increase in dexamethasone levels)

• Signs of infection (fever, sore throat, malaise)
• Signs of adrenal insufficiency (fatigue, weakness, nausea, vomiting, hypotension) upon withdrawal
• Signs of Cushingoid features (moon face, buffalo hump, striae, acne)
• Mood changes (irritability, depression, euphoria, psychosis)
• Gastrointestinal symptoms (abdominal pain, black/tarry stools, vomiting blood)
• Muscle weakness or pain
• Vision changes (blurred vision, eye pain)
• Swelling in ankles/feet
• Unusual bruising or bleeding
• Increased thirst or urination

Category C. Dexamethasone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown teratogenic effects. Human data are limited but suggest a potential for increased risk of oral clefts with first-trimester use, though this risk is low and controversial. Neonates exposed to corticosteroids in utero should be observed for signs of hypoadrenalism.

Dexamethasone is excreted into breast milk. While the amount is generally low, long-term or high-dose use may cause adverse effects in the infant (e.g., growth suppression, interference with endogenous corticosteroid production). Use with caution; consider delaying breastfeeding for 3-4 hours after a dose or using an alternative if high doses are required.

Children are more susceptible to the adverse effects of corticosteroids, including growth retardation, adrenal suppression, and increased intracranial pressure. Use the lowest effective dose for the shortest possible duration. Monitor growth and development closely.

Elderly patients may be at increased risk for adverse reactions, including osteoporosis, fluid retention, hypertension, diabetes, and cataracts. Use the lowest effective dose and monitor closely for side effects.

• Dexamethasone has a long biological half-life, allowing for once-daily dosing, which can improve adherence.
• Due to its potent anti-inflammatory and immunosuppressive effects, it is crucial to taper the dose gradually after prolonged therapy to prevent adrenal insufficiency.
• Patients on long-term dexamethasone should be advised about the risk of infection and to report any signs of illness promptly.
• Consider bone protection strategies (calcium, vitamin D, bisphosphonates) for patients on chronic corticosteroid therapy.
• Dexamethasone is often preferred over other corticosteroids in conditions requiring CNS penetration (e.g., cerebral edema, spinal cord compression) due to its good blood-brain barrier penetration.
• Administering dexamethasone in the morning (before 9 AM) can help minimize disruption of the hypothalamic-pituitary-adrenal (HPA) axis.

• Prednisone (oral corticosteroid, intermediate-acting)
• Methylprednisolone (oral/IV corticosteroid, intermediate-acting)
• Hydrocortisone (oral/IV corticosteroid, short-acting)
• Betamethasone (oral corticosteroid, long-acting, similar to dexamethasone)
• Non-steroidal anti-inflammatory drugs (NSAIDs) for inflammatory conditions (less potent)
• Immunosuppressants (e.g., methotrexate, azathioprine, biologics) for chronic inflammatory/autoimmune diseases (often used as steroid-sparing agents)

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 come with an additional patient information leaflet, so it is a good idea to consult with your pharmacist. If you have any questions or concerns about this medication, do not 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 seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.