Dexamethasone 6-Day 1.5mg Dose Pack

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 binds to glucocorticoid response elements (GREs) on DNA, modulating gene expression. This leads to the synthesis of anti-inflammatory proteins (e.g., lipocortins) 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.

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 immediately or seek 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 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 problems): 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 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, 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.
Burning, numbness, or tingling sensations that are not normal.
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:

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

This is not a complete list of possible side effects. If you have questions or concerns about side effects, talk to 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. 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, such as:
+ Diverticulitis
+ Ulcerative colitis
+ Ulcers
+ Recent bowel surgery

This list is not exhaustive, and it is crucial to disclose all your health conditions and medications to your doctor. Provide your doctor and pharmacist with a comprehensive list of:

All prescription and over-the-counter (OTC) medications you are taking
Natural products and vitamins you are using
* Any health problems you have

Verify with your doctor that it is safe to take this medication with your existing medications and health conditions. Do not initiate, stop, or adjust the dosage of any medication without consulting your doctor.

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 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 potassium supplements, so discuss this with your doctor.

If you have diabetes, it is crucial to closely monitor your blood sugar levels. Before consuming alcohol, consult your doctor. Additionally, before receiving any vaccines, discuss this 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 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.

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, so notify your doctor if you experience fever, infection, surgery, or injury, 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 your doctor before stopping or reducing the dose, as this may need to be done gradually. If you miss 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 developing Kaposi's sarcoma, a type of cancer. Discuss this with your doctor. 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 affect growth in children and adolescents, 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 of corticosteroids)
• Systemic fungal infections

• CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, barbiturates): May decrease dexamethasone levels and efficacy.
• CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, clarithromycin): May increase dexamethasone levels and side effects.
• Anticoagulants (e.g., warfarin): May alter anticoagulant effect (increase or decrease).
• NSAIDs (e.g., ibuprofen, naproxen): Increased risk of GI ulceration/bleeding.
• Diuretics (thiazide or loop): Increased risk of hypokalemia.
• Antidiabetic agents (e.g., insulin, metformin): May increase blood glucose, requiring dose adjustment of antidiabetics.
• Cholestyramine, colestipol: May decrease dexamethasone absorption.
• Digoxin: Increased risk of digitalis toxicity due to hypokalemia.

• Oral contraceptives/estrogens: May increase dexamethasone effects.
• Cyclosporine: Increased risk of seizures and other CNS effects for both drugs.
• Fluoroquinolones: Increased risk of tendon rupture.
• Muscle relaxants (non-depolarizing): May prolong or antagonize neuromuscular blockade.
• Vaccines (inactivated): Reduced immune response.

• Antacids: May decrease dexamethasone absorption (separate administration).

• Mood changes (irritability, anxiety, depression, euphoria)
• Sleep disturbances (insomnia)
• Fluid retention (swelling in ankles/feet, weight gain)
• Increased appetite/weight gain
• Muscle weakness or pain
• Vision changes (blurred vision, cataracts, glaucoma)
• Easy bruising or thinning skin
• Increased thirst or urination (signs of hyperglycemia)
• Signs of infection (fever, sore throat, cough, painful urination)
• Stomach pain or black/tarry stools (GI bleeding)

Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. Dexamethasone crosses the placenta. Prolonged or high-dose use, especially in the third trimester, may lead to fetal growth restriction, adrenal suppression in the neonate, and increased risk of cleft palate (though data are conflicting).

Dexamethasone is excreted into breast milk. While generally considered compatible with breastfeeding at low doses, high doses or prolonged use may cause adverse effects in the infant (e.g., growth suppression, interference with endogenous corticosteroid production). Monitor the infant for signs of adrenal suppression or other adverse effects. Consider administering the dose immediately after feeding to minimize infant exposure.

Corticosteroids can cause growth retardation in children. Monitor growth and development carefully. Adrenal suppression can occur, especially with prolonged use; gradual tapering is crucial. Increased susceptibility to infections. Use the lowest effective dose for the shortest possible duration.

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

• Dexamethasone has a long biological half-life (36-54 hours), allowing for once-daily dosing or alternate-day dosing for some conditions.
• Always emphasize the importance of following the tapering schedule precisely, especially with dose packs, to prevent adrenal insufficiency.
• Advise patients to take dexamethasone in the morning to minimize sleep disturbances.
• Patients on long-term therapy should be advised about bone health (calcium, vitamin D, weight-bearing exercise) and regular eye exams.
• Immunosuppressive effects mean patients are at increased risk of infection; advise avoiding sick contacts and reporting any signs of infection promptly.
• Dexamethasone is a potent glucocorticoid with minimal mineralocorticoid activity, meaning less fluid retention compared to hydrocortisone or prednisone at equivalent anti-inflammatory doses.

• Prednisone
• Methylprednisolone
• Hydrocortisone
• Betamethasone
• Triamcinolone
• NSAIDs (for inflammatory conditions where corticosteroids are not required or as an alternative)
• Specific immunomodulators/biologics (for autoimmune conditions)

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's a good idea 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 overdose, including the medication taken, the amount, and the time it occurred.