Decadron

Indications

Dexamethasone sodium phosphate is a strong corticosteroid (steroid) available as an injection and as eye or ear drops, alone or combined with an antibiotic. The injection is used for severe allergic reactions, severe asthma attacks, swelling of the brain, severe inflammation of joints, skin or bowel, croup in children, and to prevent nausea and vomiting with cancer treatment. Doctors also give it to women in early labour to help the baby's lungs mature, and to some patients with severe COVID-19 or other serious illnesses. The drops treat inflammation of the eye, for example after eye surgery or in allergic eye disease.

How It Works

It works like cortisol, a natural hormone, but much more strongly. It switches off the chemical signals that cause swelling, redness, pain and allergic reactions, and calms the immune system.

Dosage and Administration

Injection: given into a vein or muscle by a doctor or nurse. The dose depends on the condition and the patient's weight and response, and is decided by the doctor; use as prescribed. Eye drops: usually 1 drop in the affected eye 4 to 6 times a day, reducing as the eye improves, or as prescribed by the eye doctor; wait at least 5 minutes between different eye drops. Ear drops: as prescribed. Do not stop high-dose or long courses suddenly; the doctor will reduce the dose slowly.

Interactions

Taken with anti-inflammatory painkillers (NSAIDs) or Aspirin it increases the risk of stomach ulcers and bleeding. It can raise blood sugar, so medicines for diabetes may need adjusting. With water tablets (diuretics) or Amphotericin B, potassium may fall too low. Rifampicin, Phenytoin and Carbamazepine weaken its effect; Ketoconazole, Ritonavir and Clarithromycin strengthen it. It can change the effect of Warfarin. Live vaccines should be avoided during high-dose treatment.

Contraindications

• Untreated serious infection, especially fungal infection of the body.
• Recent or planned live vaccines during high-dose treatment.
• Eye drops: viral (such as herpes), fungal or tuberculous eye infections, or an untreated eye infection with pus.
• Allergy to dexamethasone or any ingredient.

Side Effects

Short courses: raised blood sugar, increased appetite, trouble sleeping, mood changes, indigestion, and a brief burning or itching in the groin area if the injection is given quickly. Longer use: weight gain, rounded face, high blood pressure, thin bones, muscle weakness, easy bruising, more infections and slow wound healing. Eye drops: stinging, blurred vision, and with long use raised eye pressure and cataract. Get urgent medical help for signs of infection (fever, chills), black stools or vomiting blood, severe stomach pain, very high blood sugar (great thirst, passing a lot of urine), severe mood changes or confusion, eye pain or loss of vision, or signs of a serious allergic reaction.

Pregnancy and Lactation

Used in pregnancy when the doctor decides the benefit is greater than the risk, including on purpose to help the unborn baby's lungs. Small amounts pass into breast milk; short courses are generally considered acceptable, but the doctor will decide.

Precautions and Warnings

Use with care if you have diabetes, high blood pressure, heart failure, stomach ulcers, thin bones, glaucoma, epilepsy, past tuberculosis, liver or kidney disease, or a history of depression or other mental illness. Avoid contact with people who have chickenpox, shingles or measles, and see a doctor if you are exposed. Use eye drops only for the time prescribed and have eye pressure checked if used for more than 10 days.

Overdose

A single large dose rarely causes serious harm. High doses over a long time cause the side effects of long-term steroid use. Seek medical advice; do not stop the medicine suddenly without guidance.

Therapeutic Class

Corticosteroid (glucocorticoid).

Storage

Store below 30°C, protected from light, and do not freeze. Keep out of the reach of children. Throw away eye or ear drops 4 weeks after opening.