Taperdex 6-Day 1.5mg Pack
It is used for many health problems like allergy signs, asthma, adrenal gland problems, blood problems, skin rashes, or swelling problems. This is not a list of all health problems that this drug may be used for. Talk with the doctor.
Drug Class
Glucocorticoid
Pharmacologic Class
Corticosteroid
Pregnancy Category
Category C
FDA Approved
May 1958
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dexamethasone is a type of steroid medicine that works like a natural hormone your body makes. It's used to treat many conditions, including inflammation, allergies, and certain types of cancer. It helps reduce swelling, redness, itching, and allergic reactions. Taperdex is a specific package designed to help you gradually reduce your dose over several days.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely.
If you take your medication once a day, it's best to take it in the morning.
Take your medication with food to help prevent stomach upset.
Continue taking your medication as directed by your doctor or healthcare provider, even if you start to feel well.
If you're also taking cholestyramine, you may need to take it at a different time than your other medication. Be sure to talk to your pharmacist about the best schedule for your medications.
Storing and Disposing of Your Medication
To keep your medication safe and effective:
Store it at room temperature in a dry place, away from the bathroom.
Keep all medications in a secure location, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of your medication. You may also want to explore drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However:
If it's close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not take two doses at the same time or take extra doses to make up for a missed one.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely.
If you take your medication once a day, it's best to take it in the morning.
Take your medication with food to help prevent stomach upset.
Continue taking your medication as directed by your doctor or healthcare provider, even if you start to feel well.
If you're also taking cholestyramine, you may need to take it at a different time than your other medication. Be sure to talk to your pharmacist about the best schedule for your medications.
Storing and Disposing of Your Medication
To keep your medication safe and effective:
Store it at room temperature in a dry place, away from the bathroom.
Keep all medications in a secure location, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of your medication. You may also want to explore drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However:
If it's close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not take two doses at the same time or take extra doses to make up for a missed one.
Lifestyle & Tips
- Take with food or milk to reduce stomach upset.
- Do not stop taking this medication suddenly, especially if you have been on it for more than a few days, as it can lead to serious withdrawal symptoms. Follow your doctor's tapering schedule carefully.
- Avoid contact with people who are sick or have infections (e.g., chickenpox, measles) as your immune system may be weakened.
- Report any signs of infection (fever, sore throat, body aches) to your doctor immediately.
- Limit salt intake to help prevent fluid retention and high blood pressure.
- Monitor blood sugar if you have diabetes, as this medication can raise blood sugar levels.
- Carry a medical alert card or bracelet if you are on long-term steroid therapy, indicating your steroid use.
- Discuss any planned vaccinations with your doctor, as live vaccines may be contraindicated.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
Dosing is highly individualized based on condition and patient response. For anti-inflammatory/immunosuppressive effects, initial doses range from 0.75 mg to 9 mg daily, often divided. Taperdex 6-Day 1.5mg Pack implies a pre-set tapering schedule, typically starting higher and decreasing over 6 days.
Dose Range:
0.75 - 9 mg
Condition-Specific Dosing:
allergic_disorders:
Initial 1.5-3 mg/day, tapered.
inflammatory_conditions:
Initial 0.75-9 mg/day, tapered.
cerebral_edema:
Initial 10 mg IV, then 4 mg IM/IV every 6 hours until symptoms subside, then tapered.
multiple_myeloma:
40 mg orally once daily on days 1-4, 9-12, 17-20 of each 28-day cycle (often in combination).
Pediatric Dosing
Neonatal:
Not established for routine use; specific conditions (e.g., bronchopulmonary dysplasia) may use 0.05-0.1 mg/kg/day divided, then tapered.
Infant:
0.02-0.3 mg/kg/day divided every 6-12 hours, depending on indication, then tapered.
Child:
0.02-0.3 mg/kg/day divided every 6-12 hours, depending on indication, then tapered. Max 10 mg/day.
Adolescent:
Similar to adult dosing, 0.02-0.3 mg/kg/day or adult doses for specific indications, then tapered.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed.
Moderate:
No specific adjustment needed.
Severe:
No specific adjustment needed.
Dialysis:
Not significantly removed by dialysis; no supplemental dose needed post-dialysis.
Hepatic Impairment:
Mild:
No specific adjustment needed.
Moderate:
Consider dose reduction in severe hepatic impairment due to altered metabolism and elimination.
Severe:
Consider dose reduction due to altered metabolism and elimination; monitor for increased side effects.
Pharmacology
Mechanism of Action
Dexamethasone is a synthetic adrenocortical steroid that is approximately 25 times more potent than hydrocortisone and 5 times more potent than prednisone. It exerts its effects by binding to specific cytoplasmic glucocorticoid receptors in target cells. The activated receptor-steroid complex then translocates into the nucleus, where it modulates gene expression by binding to glucocorticoid response elements (GREs) in the promoter regions of target genes. This leads to the synthesis of anti-inflammatory proteins (e.g., lipocortin-1, which inhibits phospholipase A2, thereby reducing prostaglandin and leukotriene synthesis) and the repression of pro-inflammatory genes (e.g., cytokines, chemokines, adhesion molecules). It also stabilizes lysosomal membranes, inhibits phagocytosis, and suppresses the immune response by reducing lymphocyte proliferation and activity.
Pharmacokinetics
Absorption:
Bioavailability:
80-90% (oral)
Tmax:
1-2 hours (oral)
FoodEffect:
Food may slightly delay absorption but does not significantly affect the extent of absorption.
Distribution:
Vd:
0.8 L/kg
ProteinBinding:
77% (primarily to albumin, less to corticosteroid-binding globulin than other corticosteroids)
CnssPenetration:
Yes (readily crosses the blood-brain barrier)
Elimination:
HalfLife:
Plasma half-life: 3-4.5 hours; Biological half-life: 36-54 hours (due to prolonged tissue effects)
Clearance:
Not available (highly variable)
ExcretionRoute:
Renal (primarily as inactive metabolites)
Unchanged:
<10%
Pharmacodynamics
OnsetOfAction:
Hours (oral)
PeakEffect:
1-2 days (anti-inflammatory/immunosuppressive effects)
DurationOfAction:
36-72 hours (biological effect)
Safety & Warnings
Side Effects
Urgent 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 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 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, increased 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.
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. However, 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:
Nausea and vomiting.
Insomnia.
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.
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 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 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, increased 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.
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. However, 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:
Nausea and vomiting.
Insomnia.
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.
Seek Immediate Medical Attention If You Experience:
- Severe stomach pain, black or tarry stools (signs of GI bleeding)
- Swelling in your hands, ankles, or feet (fluid retention)
- Unusual weight gain, especially in the face and upper back (Cushingoid features)
- Blurred vision, eye pain, or seeing halos around lights (cataracts, glaucoma)
- Increased thirst or urination (high blood sugar)
- Muscle weakness, severe tiredness, nausea, vomiting, dizziness (adrenal insufficiency, especially if stopping suddenly)
- Signs of infection (fever, chills, sore throat, body aches, cough, skin sores)
- Mood changes (severe depression, euphoria, irritability, confusion)
- Shortness of breath, chest pain
Before Using This Medicine
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. Be sure to 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 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. Be sure to 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.
Precautions & Cautions
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). Talk to your doctor to determine if you are at a higher risk or if you have any concerns. 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 it with your doctor. Additionally, consult with your doctor before receiving any vaccines, as some vaccines may not work as well or may increase the risk of infection when taken with this medication.
It is essential to be aware that chickenpox and measles can be severe or even life-threatening in people taking steroid medications like this one. Avoid close contact with anyone who has chickenpox or measles if you have not had these illnesses before. 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. They can also make it more challenging to detect signs of infection. To minimize the risk of infection, wash your hands frequently, avoid people with infections, colds, or flu, and notify your doctor if you experience any symptoms 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 your body's natural production of steroids. 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 doses of steroids in these situations.
If you have been taking this medication for an extended period, consult with your doctor before stopping or reducing the dose. You may need to gradually taper off the medication to avoid withdrawal symptoms. If you have missed a dose or recently stopped taking this medication and experience 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. 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 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 teenagers, so regular growth checks may be necessary. Additionally, it 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.
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). Talk to your doctor to determine if you are at a higher risk or if you have any concerns. 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 it with your doctor. Additionally, consult with your doctor before receiving any vaccines, as some vaccines may not work as well or may increase the risk of infection when taken with this medication.
It is essential to be aware that chickenpox and measles can be severe or even life-threatening in people taking steroid medications like this one. Avoid close contact with anyone who has chickenpox or measles if you have not had these illnesses before. 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. They can also make it more challenging to detect signs of infection. To minimize the risk of infection, wash your hands frequently, avoid people with infections, colds, or flu, and notify your doctor if you experience any symptoms 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 your body's natural production of steroids. 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 doses of steroids in these situations.
If you have been taking this medication for an extended period, consult with your doctor before stopping or reducing the dose. You may need to gradually taper off the medication to avoid withdrawal symptoms. If you have missed a dose or recently stopped taking this medication and experience 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. 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 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 teenagers, so regular growth checks may be necessary. Additionally, it 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.
Overdose Information
Overdose Symptoms:
- Acute overdose is rare but may include: increased blood pressure, fluid retention, hypokalemia, hyperglycemia, and gastrointestinal irritation. Chronic overdose can lead to Cushing's syndrome (moon face, buffalo hump, central obesity, thin skin, easy bruising, muscle weakness).
What to Do:
Seek immediate medical attention or call Poison Control at 1-800-222-1222. Treatment is generally supportive and symptomatic. There is no specific antidote.
Drug Interactions
Contraindicated Interactions
- Live or live-attenuated vaccines (during immunosuppressive doses)
Major Interactions
- CYP3A4 inducers (e.g., rifampin, phenytoin, barbiturates, carbamazepine) - decrease dexamethasone levels.
- CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, clarithromycin) - increase dexamethasone levels.
- NSAIDs (e.g., ibuprofen, naproxen) - increased risk of GI ulceration/bleeding.
- Anticoagulants (e.g., warfarin) - altered anticoagulant effect (may increase or decrease).
- Diuretics (thiazide or loop) - enhanced potassium loss, increased risk of hypokalemia.
- Antidiabetic agents (e.g., insulin, metformin) - increased blood glucose, requiring dose adjustment of antidiabetics.
- Digoxin - increased risk of digitalis toxicity due to hypokalemia.
- Neuromuscular blockers (e.g., pancuronium) - prolonged neuromuscular blockade.
Moderate Interactions
- Oral contraceptives - may increase dexamethasone levels.
- Cholestyramine - may decrease dexamethasone absorption.
- Antacids - may decrease dexamethasone absorption.
- Cyclosporine - increased risk of seizures and other CNS effects.
- Vaccines (inactivated) - diminished antibody response.
Minor Interactions
- Grapefruit juice - may slightly increase dexamethasone levels (CYP3A4 inhibition).
Monitoring
Baseline Monitoring
Blood Pressure
Rationale: Corticosteroids can cause hypertension.
Timing: Before initiation
Blood Glucose
Rationale: Corticosteroids can induce hyperglycemia or worsen existing diabetes.
Timing: Before initiation
Serum Electrolytes (especially Potassium)
Rationale: Risk of hypokalemia.
Timing: Before initiation
Weight
Rationale: Fluid retention and weight gain are common side effects.
Timing: Before initiation
Ophthalmic Exam (if long-term use anticipated)
Rationale: Risk of cataracts and glaucoma.
Timing: Before initiation
Bone Mineral Density (if long-term use anticipated)
Rationale: Risk of osteoporosis.
Timing: Before initiation
Routine Monitoring
Blood Pressure
Frequency: Regularly (e.g., weekly to monthly, depending on duration)
Target: <140/90 mmHg
Action Threshold: >140/90 mmHg or significant increase from baseline
Blood Glucose (fasting or HbA1c)
Frequency: Regularly (e.g., weekly to monthly, depending on duration and risk)
Target: Individualized, typically <126 mg/dL (fasting)
Action Threshold: Persistent hyperglycemia, consider antidiabetic therapy or dose adjustment
Serum Electrolytes (especially Potassium)
Frequency: Periodically (e.g., monthly for long-term use)
Target: 3.5-5.0 mEq/L
Action Threshold: <3.5 mEq/L
Weight
Frequency: Regularly (e.g., weekly)
Target: Stable or within acceptable range
Action Threshold: Significant or rapid weight gain
Signs of Infection
Frequency: Continuously
Target: Absence of fever, localized pain, redness, swelling
Action Threshold: Any signs of infection (corticosteroids can mask symptoms)
Symptom Monitoring
- Signs of infection (fever, sore throat, malaise, localized pain/redness)
- Fluid retention (swelling in ankles/feet, weight gain)
- Mood changes (irritability, anxiety, depression, euphoria)
- Sleep disturbances (insomnia)
- Gastrointestinal upset (heartburn, indigestion, abdominal pain)
- Muscle weakness or pain
- Skin changes (thinning, bruising, acne)
- Vision changes (blurred vision, eye pain)
- Increased thirst or urination (signs of hyperglycemia)
- Signs of adrenal insufficiency upon withdrawal (fatigue, weakness, nausea, vomiting, hypotension, joint/muscle pain)
Special Patient Groups
Pregnancy
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 increase the risk of fetal growth restriction and adrenal suppression in the neonate.
Trimester-Specific Risks:
First Trimester:
Potential for increased risk of oral clefts (though data are conflicting and overall risk is low).
Second Trimester:
Risk of fetal growth restriction and adrenal suppression increases with prolonged use.
Third Trimester:
Risk of fetal growth restriction and adrenal suppression in the neonate. Monitor neonates for signs of hypoadrenalism.
Lactation
L3 (Moderately Safe). Dexamethasone is excreted into breast milk in small amounts. Low doses are generally considered compatible with breastfeeding. High or prolonged doses may cause adverse effects in the infant (e.g., growth suppression, adrenal suppression) or decrease milk supply. Monitor infant for signs of adrenal suppression.
Infant Risk:
Low risk with short-term or low-dose use. Higher risk with prolonged or high-dose use.
Pediatric Use
Corticosteroids can cause growth retardation in children. Long-term use requires careful monitoring of growth and development. Adrenal suppression can occur, especially with abrupt discontinuation. Increased susceptibility to infections. Bone mineral density should be monitored with prolonged use.
Geriatric Use
Elderly patients may be at increased risk for adverse reactions, including osteoporosis, fluid retention, hypertension, diabetes, and cataracts. Use the lowest effective dose for the shortest duration possible. Close monitoring is recommended.
Clinical Information
Clinical Pearls
- Always emphasize the importance of tapering dexamethasone, especially after prolonged use, to prevent adrenal insufficiency. Taperdex is designed for this purpose.
- Advise patients to take dexamethasone with food or milk to minimize gastrointestinal irritation.
- Educate patients about the signs of infection, as corticosteroids can mask symptoms.
- For patients on long-term therapy, consider calcium and vitamin D supplementation to mitigate bone loss.
- Monitor blood glucose levels, especially in diabetic or pre-diabetic patients, as dexamethasone can cause hyperglycemia.
- Warn patients about potential mood changes (e.g., euphoria, irritability, depression) and encourage them to report these to their healthcare provider.
- Dexamethasone has a long biological half-life, allowing for once-daily dosing or alternate-day therapy for some conditions.
Alternative Therapies
- Prednisone
- Methylprednisolone
- Hydrocortisone
- Prednisolone
- Triamcinolone
- NSAIDs (for inflammatory conditions, if appropriate)
- Immunosuppressants (e.g., methotrexate, azathioprine, biologics for chronic inflammatory/autoimmune conditions)
- Antihistamines (for allergic reactions)
Cost & Coverage
Average Cost:
$10 - $50 per 30 tablets (generic 0.5mg-4mg)
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (generic)
General Drug Facts
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 emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.