Dexamethasone Phos 120mg/30ml Inj

Dexamethasone is a synthetic adrenocortical steroid that is a glucocorticoid. It binds to specific cytoplasmic glucocorticoid receptors in target tissues, forming a 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., 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 emergency 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 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 insufficiency (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
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
Irritation at the injection site

Other Side Effects

Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention if they bother you or persist:

Nausea and vomiting
Difficulty 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. 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
+ 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. 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 all your other medications and health conditions. Do not initiate, stop, or modify 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. 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, so it is crucial to notify all your healthcare providers and lab workers that you are taking it. Additionally, be aware that this medication can cause high blood pressure, so your doctor may recommend regular blood pressure checks.

If you are scheduled to undergo allergy skin testing, inform your doctor and the lab workers that you are taking this medication, as it may interfere with 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). Your doctor can help you determine if you are at higher risk of developing osteoporosis or if you have any questions. You may need to reduce your salt intake and take potassium supplements, so consult with your doctor about this.

If you have diabetes, it is vital to monitor your blood sugar levels closely while taking this medication. Before consuming alcohol, talk to your doctor, and before receiving any vaccines, 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 close contact with anyone who has them, and if you have been exposed, inform 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 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 this medication, so inform your doctor if you have a history of these infections.

This medication can suppress the production of natural steroids in your body, which can affect your response to stress, such as fever, infection, surgery, or injury. Inform your doctor if you experience any of these conditions, as you may require additional steroid doses.

If you have been taking this medication for an extended period, do not stop taking it abruptly. Instead, consult with your doctor about gradually tapering 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 promptly.

Long-term use of this medication has been associated with an increased risk of developing Kaposi's sarcoma, a type of cancer. Discuss this risk with your doctor. Additionally, patients with cancer may be at 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 they may require regular growth checks. Inform your doctor if you have any concerns.

If you are allergic to sulfites, notify your doctor, as some products may contain sulfites. Be aware that administering this medication into the spine (epidural) has been associated with severe health problems, including paralysis, loss of vision, stroke, and death, although it is not an approved use for this medication.

This medication may 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 to discuss the potential benefits and risks to you and your baby. If you took this medication during pregnancy, inform your baby's doctor.

• Live or live attenuated vaccines (in immunosuppressed patients)
• Systemic fungal infections (unless used as life-saving therapy)

• 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 decrease.
• NSAIDs: Increased risk of GI ulceration/bleeding.
• Anticoagulants (e.g., warfarin): May alter anticoagulant effect (monitor INR).
• Diuretics (thiazide, loop): Increased risk of hypokalemia.
• Digoxin: Increased risk of digoxin toxicity due to hypokalemia.
• Antidiabetic agents (insulin, oral hypoglycemics): May increase blood glucose, requiring dose adjustment of antidiabetics.
• Neuromuscular blockers: Prolonged neuromuscular blockade (especially with non-depolarizing agents).

• Oral contraceptives/estrogens: May increase dexamethasone levels.
• Cyclosporine: Increased risk of seizures and other CNS effects.
• Fluoroquinolones: Increased risk of tendon rupture.
• Vaccines (inactivated): Reduced immune response to vaccines.

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

• Signs of infection (fever, sore throat, unusual fatigue, localized pain/redness)
• Symptoms of hyperglycemia (increased thirst, urination, hunger)
• Fluid retention (swelling in ankles/feet, rapid weight gain)
• Mood changes (irritability, anxiety, depression, euphoria)
• Sleep disturbances
• Muscle weakness or pain
• Stomach pain or black/tarry stools (GI bleeding)
• Vision changes (blurred vision, eye pain)
• Easy bruising or thinning skin
• Symptoms of adrenal insufficiency upon withdrawal (severe fatigue, weakness, nausea, vomiting, dizziness)

Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Dexamethasone crosses the placenta. Prolonged or repeated use during pregnancy may lead to fetal growth restriction or adrenal suppression in the neonate.

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; consider delaying breastfeeding for 3-4 hours after a dose or using the lowest effective dose.

Corticosteroids can cause growth retardation in children. Long-term use requires careful monitoring of growth and development. Adrenal suppression can occur, especially with prolonged use, requiring slow tapering. Increased susceptibility to infections. Bone density should be monitored with chronic use.

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

• Always taper dexamethasone slowly after prolonged therapy to prevent adrenal insufficiency. The rate of taper depends on the dose and duration of therapy.
• Administer oral doses with food or milk to minimize GI upset.
• Patients on long-term therapy should carry a steroid warning card.
• Dexamethasone has a long biologic half-life, allowing for once-daily dosing or even alternate-day dosing for some indications.
• Consider prophylactic measures for bone health (calcium, vitamin D, bisphosphonates) in patients on long-term corticosteroid therapy.
• Monitor for signs of infection, as corticosteroids can mask symptoms.
• For cerebral edema, dexamethasone is effective due to its ability to stabilize cell membranes and reduce capillary permeability, not primarily due to CNS penetration.

• Other systemic corticosteroids (e.g., prednisone, methylprednisolone, hydrocortisone)
• NSAIDs (for inflammatory conditions, if appropriate)
• Immunosuppressants (e.g., methotrexate, azathioprine, biologics for autoimmune diseases)
• Antiemetics (for CINV, e.g., ondansetron, aprepitant)
• Diuretics (for cerebral edema, e.g., mannitol, hypertonic saline, if appropriate)

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed otherwise, do not flush medications down the toilet or pour them down the drain. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the quantity, and the time of the incident.