Dextor

Indications

Dexamethasone is a strong, long-acting corticosteroid (steroid) medicine used for many conditions, including:

• Severe allergic reactions, and flare-ups of asthma and other lung diseases
• Inflammatory and autoimmune conditions such as rheumatoid arthritis, lupus and some skin and bowel diseases
• Swelling of the brain caused by tumours or injury
• Croup in children
• Preventing nausea and vomiting with cancer treatment, and as part of treatment for some blood cancers
• Severe infections where inflammation is harmful, such as some cases of meningitis or severe COVID-19 needing oxygen
• Helping a baby's lungs mature when early delivery is expected (injection)
• Eye and ear inflammation (drops)

How It Works

Dexamethasone copies the action of cortisol, a natural hormone made by the adrenal glands, but is much stronger. It reduces inflammation and swelling and calms an overactive immune system.

Dosage and Administration

The dose varies greatly with the condition, so it is always taken as prescribed. By mouth, many conditions are treated with about 0.5 to 9 mg a day; higher doses are used for specialist conditions such as brain swelling or cancer treatment. Injections are given by a doctor or nurse. Eye and ear drops are used as directed.

• Take tablets with or after food, usually in the morning.
• Do not stop suddenly if you have taken it for more than about 3 weeks or at high doses. The doctor will lower the dose slowly.

Interactions

• Painkillers such as Aspirin, Ibuprofen and Diclofenac increase the risk of stomach ulcers and bleeding.
• Rifampicin, Carbamazepine, Phenytoin and Phenobarbital reduce its effect.
• Ketoconazole, Itraconazole, Clarithromycin and Ritonavir can increase its effect and side effects.
• It can raise blood sugar, so doses of diabetes medicines may need changing.
• With diuretics such as Furosemide or Hydrochlorothiazide, potassium may fall too low, which is risky with Digoxin.
• It can change the effect of Warfarin.
• Live vaccines should be avoided during high-dose treatment.

Contraindications

• Untreated serious infections, especially fungal infections spread through the body.
• Allergy to dexamethasone or any ingredient of the product.
• Live vaccines while taking doses that suppress the immune system.
• Eye drops: viral, fungal or untreated bacterial eye infections.

Side Effects

Short-term: increased appetite, weight gain, raised blood sugar, mood changes, difficulty sleeping, indigestion and fluid retention. With long-term use: thinning skin and easy bruising, rounded face, weak bones, muscle weakness, high blood pressure, cataract and glaucoma, more infections, and slower growth in children.

Get urgent medical help for black stools or vomiting blood, severe stomach pain, fever or other signs of infection, contact with chickenpox or measles if you have not had them, severe mood changes, confusion or disturbing thoughts, blurred vision or eye pain, extreme thirst and frequent urination, swelling with breathlessness, or a severe allergic reaction.

Pregnancy and Lactation

It is used in pregnancy only when the benefit outweighs the risk, and is sometimes given on purpose to help a premature baby's lungs. It passes into breast milk; short courses are usually acceptable, but ask your doctor before using it while breastfeeding.

Precautions and Warnings

• Tell your doctor if you have diabetes, high blood pressure, heart failure, a stomach ulcer, weak bones, glaucoma, past tuberculosis, epilepsy, mental illness, or liver or kidney disease.
• Your body may need extra steroid during illness, injury or surgery; tell any doctor treating you that you take it.
• Avoid contact with people who have chickenpox, shingles or measles.
• Children on long-term treatment should have their growth checked.

Overdose

A single large dose is rarely dangerous. Taking too much for a long time can cause the long-term side effects listed above. Seek medical advice, and do not stop long-term treatment suddenly.

Therapeutic Class

Corticosteroid (glucocorticoid).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze injections or drops.