Dexamethasone 2mg Tablets

Dexamethasone is a synthetic adrenocortical steroid, a glucocorticoid. It binds to specific cytoplasmic glucocorticoid receptors in target tissues. The activated receptor-steroid complex then translocates into the nucleus, where it modulates gene expression by binding to glucocorticoid response elements (GREs) in DNA. This leads to the synthesis of anti-inflammatory proteins (e.g., lipocortins) and inhibition of pro-inflammatory mediators (e.g., prostaglandins, leukotrienes, cytokines). It suppresses migration of polymorphonuclear leukocytes and reverses increased capillary permeability. It also has immunosuppressive effects by reducing the activity and volume of the lymphatic system, decreasing immunoglobulin and complement concentrations, and inhibiting the release of lymphokines from activated lymphocytes.

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 experience 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, dizziness, fainting, or changes in vision.
Signs of adrenal gland problems: 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, 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 spots 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 experience any of the following side effects, or if they bother you or don't go away, contact your doctor:

Nausea or vomiting.
Difficulty sleeping.
Restlessness.
Excessive sweating.
Hair loss.
Headache.
Dizziness, fatigue, or weakness.
Weight gain.
Increased appetite.
Hiccups.

This is not a comprehensive list of all 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 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 condition. 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 personnel that you are taking this drug. Be aware that medications like this one can cause high blood pressure, so regular blood pressure checks, as advised by your doctor, are necessary.

This medication may also affect the results of allergy skin tests, so be sure to inform your doctor and lab workers that you are taking this medication. 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 lead to weak bones (osteoporosis), so talk to your doctor to determine if you are at a higher risk or if you have any questions. 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 this with your doctor. Additionally, consult with your doctor before receiving any vaccines, as some vaccines may not work as effectively or may increase the risk of infection when taken with this medication.

If you are taking this medication, it is essential to avoid close contact with individuals who have chickenpox or measles, as these infections can be severe or even life-threatening 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 but also severe and potentially life-threatening. To minimize this 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. If you have a history of these infections, inform your doctor. This medication can suppress the production of natural steroids in your body, so if you experience fever, infection, surgery, or injury, notify 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 symptoms such as 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, so 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 consult with your doctor about this.

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 if you have questions or 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 this medication to you and your baby. If you took this medication during pregnancy, inform your baby's doctor.

• Systemic fungal infections (unless used as part of specific anti-fungal therapy)
• Live or live-attenuated vaccines (during immunosuppressive doses)

• CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, barbiturates): May decrease dexamethasone levels, requiring dose increase.
• CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, clarithromycin): May increase dexamethasone levels, requiring dose reduction.
• Warfarin: Dexamethasone may potentiate or inhibit anticoagulant effects; monitor INR closely.
• NSAIDs (e.g., ibuprofen, naproxen): Increased risk of GI ulceration and bleeding.
• Diuretics (thiazide, loop): Increased risk of hypokalemia.
• Digoxin: Increased risk of digoxin toxicity due to hypokalemia.
• Antidiabetic agents (insulin, oral hypoglycemics): Dexamethasone increases blood glucose, requiring increased doses of antidiabetic agents.
• Vaccines (live or live-attenuated): Risk of severe adverse reactions due to immunosuppression.
• Aminoglutethimide: May decrease dexamethasone efficacy.

• Cyclosporine: Increased risk of seizures and other CNS effects with concomitant use.
• Oral contraceptives/Estrogens: May increase dexamethasone levels.
• Fluoroquinolones: Increased risk of tendon rupture.
• Neuromuscular blockers: May prolong neuromuscular blockade.
• Cholestyramine, colestipol: May decrease dexamethasone absorption.
• Antacids: May decrease dexamethasone absorption (separate administration by 2 hours).

• Potassium-depleting agents (e.g., amphotericin B): Increased risk of hypokalemia.
• Aspirin (high dose): Increased salicylate clearance; withdrawal of dexamethasone may lead to salicylate toxicity.

• Signs of infection (fever, sore throat, unusual fatigue)
• Mood changes (irritability, depression, euphoria, insomnia)
• Gastrointestinal upset (stomach pain, black/tarry stools)
• Muscle weakness or pain
• Swelling in ankles or feet
• Unusual bruising or bleeding
• Vision changes
• Excessive thirst or urination (signs of hyperglycemia)
• Slow wound healing
• Signs of adrenal insufficiency upon withdrawal (fatigue, weakness, nausea, vomiting, dizziness)

Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. Dexamethasone crosses the placenta. Animal studies have shown teratogenic effects.

Dexamethasone is excreted into breast milk. While the amount is generally small, 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; monitor infant for adverse effects. Consider using the lowest effective dose for the shortest duration.

Children are more susceptible to growth retardation and adrenal suppression with long-term corticosteroid therapy. Monitor growth and development closely. Alternate-day therapy may reduce some side effects. Increased risk of intracranial hypertension in children.

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

• Always taper dexamethasone doses gradually after prolonged therapy to prevent adrenal insufficiency. Abrupt discontinuation can be life-threatening.
• Administer with food or milk to minimize gastrointestinal irritation.
• Patients on long-term therapy should carry a steroid warning card.
• Dexamethasone has a long biological half-life, allowing for once-daily or even alternate-day dosing for some conditions.
• It is a potent glucocorticoid with minimal mineralocorticoid activity, making it less likely to cause significant fluid retention compared to hydrocortisone or prednisone.
• Consider prophylactic measures for osteoporosis (calcium, vitamin D, bisphosphonates) in patients on long-term therapy.
• Monitor for signs of infection, as corticosteroids can mask symptoms and increase susceptibility.

• Other systemic corticosteroids (e.g., Prednisone, Methylprednisolone, Hydrocortisone)
• NSAIDs (for inflammatory conditions, if appropriate)
• Immunosuppressants (e.g., Methotrexate, Azathioprine, Cyclosporine, Biologics - depending on the specific autoimmune or inflammatory condition)
• Disease-modifying antirheumatic drugs (DMARDs) for rheumatic diseases
• Antihistamines (for allergic reactions)
• Bronchodilators (for asthma/COPD 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 medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.