Dexamethasone 6mg Tablets

Dexamethasone is a synthetic adrenocortical steroid, a glucocorticoid. It binds to specific intracellular glucocorticoid receptors in target tissues, forming a hormone-receptor complex that translocates to the nucleus. This complex then interacts with DNA (glucocorticoid response elements), modulating gene transcription. This leads 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 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 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, 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 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 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
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
Insomnia
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, 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 symptoms you experienced.
The presence of any infections, 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 your eyes
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 issues with your doctor and pharmacist. They will help determine if 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.

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.

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), so talk to your doctor about your risk factors and any concerns you may have. You may need to reduce your salt intake and increase your potassium consumption, so consult with your doctor about making these adjustments.

If you have diabetes, it is crucial to closely monitor your blood sugar levels while taking this medication. Before consuming alcohol, consult with your doctor, and before receiving any vaccinations, discuss the potential risks and benefits with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.

Be cautious when interacting with individuals who have chickenpox or measles, as these infections can be severe or even fatal in people taking steroid medications like this one. If you have not had these infections before, avoid exposure to them, and if you have been exposed, notify 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 this risk, practice good hygiene by washing 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 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 steroid doses, so notify your doctor.

If you have been taking this medication for an extended period, do not stop abruptly without consulting your doctor, as this can lead to withdrawal symptoms such as fatigue, weakness, shakiness, rapid heartbeat, confusion, sweating, or dizziness.

A rare type of cancer called Kaposi's sarcoma has been associated with long-term use of medications like this one, so discuss this risk 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 risk.

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 teenagers, so regular growth checks may be necessary. Additionally, this medication can lower sperm counts, so if you have concerns, discuss them with your doctor.

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

• Live vaccines (risk of disseminated infection)
• Mifepristone (antagonizes corticosteroid effects)
• CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, barbiturates - decrease dexamethasone levels)
• CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, clarithromycin - increase dexamethasone levels)
• Warfarin (may alter anticoagulant effect, monitor INR)

• NSAIDs (increased risk of GI ulceration/bleeding)
• Diuretics (thiazide and loop - increased risk of hypokalemia)
• Antidiabetic agents (may increase blood glucose, requiring dose adjustment)
• Digoxin (hypokalemia may potentiate digoxin toxicity)
• Cyclosporine (increased levels of both drugs)
• Oral contraceptives (may increase dexamethasone levels)
• Fluoroquinolones (increased risk of tendon rupture, especially in elderly)

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

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

Dexamethasone is classified as Pregnancy Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It crosses the placenta. Use in the first trimester is generally avoided if possible. It is sometimes used in the second/third trimester for fetal lung maturation or to treat congenital adrenal hyperplasia.

Dexamethasone is excreted into breast milk. While the amount is generally small, high doses or prolonged use may lead to 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 to minimize infant exposure.

Children are more susceptible to growth retardation and adrenal suppression with long-term corticosteroid therapy. Dosing must be carefully individualized and the lowest effective dose used for the shortest possible duration. Monitor growth and development closely. Alternate-day therapy may reduce some adverse effects.

Elderly patients may be more susceptible to adverse effects such as osteoporosis, fluid retention, hypertension, and diabetes. Close monitoring is warranted. Use the lowest effective dose for the shortest duration.

• Always taper dexamethasone doses gradually when discontinuing therapy, especially after prolonged use, to prevent adrenal insufficiency.
• Administer with food or milk to minimize gastrointestinal irritation.
• Dexamethasone has a long biological half-life, allowing for once-daily dosing for many indications, which can improve adherence.
• Be vigilant for signs of infection, as corticosteroids can mask symptoms and increase susceptibility.
• Patients on long-term therapy should be advised to carry a steroid warning card.
• Consider bone protection (calcium, vitamin D, bisphosphonates) for patients on chronic corticosteroid therapy.
• Dexamethasone is a potent glucocorticoid with minimal mineralocorticoid activity, meaning it causes less fluid retention than some other corticosteroids.

• Prednisone
• Methylprednisolone
• Hydrocortisone
• Betamethasone
• Triamcinolone

If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist. 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 seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.