Dexamethasone 4mg Tablets

Dexamethasone is a potent synthetic glucocorticoid. It exerts its anti-inflammatory and immunosuppressive effects by binding to cytoplasmic glucocorticoid receptors, which then translocate to the nucleus. This complex modulates gene expression, leading to the synthesis of anti-inflammatory proteins (e.g., lipocortin-1) and inhibition of pro-inflammatory mediators (e.g., cytokines, chemokines, prostaglandins, leukotrienes) by inhibiting phospholipase A2 and cyclooxygenase-2. It also suppresses the immune system by inhibiting lymphocyte proliferation and function.

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, trouble 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 abnormal 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 belly, moon face, severe headache, or slow wound healing
Signs of high blood sugar: confusion, drowsiness, unusual 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 period
Bone or joint pain
Muscle pain or weakness
Changes in vision
Changes in behavior or mood
Seizures
Abnormal sensations (burning, numbness, or tingling)
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 may not experience any side effects or may only have mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention:

Nausea and vomiting
Trouble 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, 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.

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, 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. 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 may 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.

Prolonged use of this medication can also lead to osteoporosis (weak bones). Talk to your doctor to determine if you are at higher risk or if you have any questions about osteoporosis.

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.

Before consuming alcohol, discuss the potential risks with your doctor. Additionally, consult with your doctor before receiving any vaccinations, as some vaccines may not be effective 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 life-threatening in people taking steroid medications like this one. If you have been exposed to chickenpox or measles, notify your doctor immediately. Steroid medications, including this one, can increase the risk of infection, which can be mild or severe. To minimize this risk, wash your hands frequently, avoid close contact with individuals 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 suppress the production of natural steroids in your body. If you experience fever, infection, surgery, or injury, notify your doctor, as your body's response to these stresses may be affected. You may require additional steroid doses 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 adverse effects. If you have missed a dose or recently stopped taking this medication and experience fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness, notify your doctor immediately.

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. Additionally, patients with cancer may be at higher risk of developing tumor lysis syndrome (TLS), a potentially life-threatening condition. Consult with your doctor to understand this risk.

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 to monitor this potential effect. Discuss this risk with your doctor.

This medication may also lower sperm counts in some individuals. If you have concerns, consult with your doctor.

If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the potential benefits and risks of this medication with your doctor. If you took this medication during pregnancy, inform 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.

• Live or live attenuated vaccines (increased risk of infection)
• Mifepristone (antagonism of corticosteroid effect)
• CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, barbiturates - decreased dexamethasone levels)
• CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, clarithromycin - increased dexamethasone levels)

• NSAIDs (increased risk of GI ulceration/bleeding)
• Diuretics (thiazide and loop - increased risk of hypokalemia)
• Anticoagulants (warfarin - altered anticoagulant effect, monitor INR)
• Oral hypoglycemics/Insulin (may require increased dose of antidiabetic agents)
• Digoxin (increased risk of toxicity with hypokalemia)
• Cyclosporine (increased levels of both drugs)
• Fluoroquinolones (increased risk of tendon rupture, especially in elderly)

• Antacids (may reduce absorption, separate administration)
• Cholestyramine (may reduce absorption)

• Signs of infection (fever, sore throat, malaise, unusual pain)
• Adrenal insufficiency (fatigue, weakness, nausea, vomiting, hypotension, joint pain upon withdrawal)
• Hyperglycemia (increased thirst, urination, hunger)
• Fluid retention (swelling in ankles/feet, weight gain)
• Mood changes (irritability, anxiety, depression, euphoria)
• Gastrointestinal upset (stomach pain, black/tarry stools)
• Muscle weakness or pain
• Vision changes (blurred vision, eye pain)
• Skin changes (thinning, bruising, acne)

Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. Dexamethasone crosses the placenta. There is a potential for fetal growth restriction and adrenal suppression with prolonged or high-dose use.

Dexamethasone is excreted into breast milk. Low doses are generally considered compatible with breastfeeding, but high doses or prolonged use may cause adverse effects in the infant (e.g., growth suppression, interference with endogenous corticosteroid production). Monitor infant for signs of adrenal suppression or growth issues.

Long-term use can cause growth retardation and suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Children are more susceptible to systemic side effects. Monitor growth and development closely. Alternate day therapy may reduce growth suppression.

Elderly patients may be more susceptible to adverse effects, including osteoporosis, fluid retention, hypertension, and diabetes. Use with caution and monitor closely.

• Always taper the dose gradually when discontinuing, especially after prolonged therapy, to prevent adrenal insufficiency.
• Administer with food or milk to minimize gastrointestinal irritation.
• Patients on long-term therapy should be monitored for bone density, blood glucose, blood pressure, and ophthalmic changes.
• Immunosuppression increases the risk of infection; advise patients to report any signs of infection promptly.
• Dexamethasone has a long biological half-life, allowing for once-daily or alternate-day dosing for many conditions.
• Consider calcium and vitamin D supplementation for patients on long-term therapy to mitigate bone loss.

• Other corticosteroids (e.g., prednisone, methylprednisolone, hydrocortisone, betamethasone) depending on potency and duration of action required.
• Non-steroidal anti-inflammatory drugs (NSAIDs) for inflammatory conditions where corticosteroids are not indicated or as an adjunct.
• Disease-modifying antirheumatic drugs (DMARDs) or biologics for chronic inflammatory/autoimmune conditions.
• Immunosuppressants (e.g., azathioprine, methotrexate, cyclosporine) for conditions requiring long-term immune modulation.

If your symptoms or health issues persist or worsen, it's essential to contact your doctor promptly. To ensure safe use, 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 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.