Dexamethasone, Inj/Oral

Corticosteroid, Systemic · Corticosteroid

Indications

Cortisone therapy in: Immuno-allergology, rheumatology, endocrinology, dermatology, ophthalmology, gastro-enterology, cardiology, pulmonary disease, haematology. COVID-19: In patients who have tested to be COVID-19 positive and require oxygen support.

Dosage

Note: Dexamethasone 1 mg equiv to dexamethasone phosphate 1.2 mg equiv to dexamethasone sodium phosphate l.3 mg. Adults: Antiemetic: Prophylaxis: Oral/IV: 10-20 mg 15-30 min before treatment on each treatment day. Continuous infusion regimen: IV: 10 mg every 12 hrs on each treatment day. Mildly emetogenic therapy: Oral/IM/IV: 4 mg every 4-6 hrs. Delayed nausea vomiting: Oral: 4-10 mg 1-2 times/day for 2-4 days or 8 mg every 12 hrs for 2 days; then 4 mg every 12 hrs for 2 days or 20 mg 1 hr before chemotherapy; then 10 mg 12 hrs after chemotherapy; then 8 mg every 12 hrs for 4 doses; then 4 mg every 12 hrs for 4 doses. Anti-inflammatory: Oral/IM/IV (inj as sodium phosphate): 0.75-9 mg/day in divided doses every 6-12 hrs. Intra-articular, intralesional, or soft tissue (as sodium phosphate): 0.4-6 mg/day. Multiple myeloma: Oral/IV: 40 mg/day, days 1 to 4, 9 to 12, & 17 to 20, repeated…

Administration

IV: Administer IV as a 5-10 mins bolus; do not administer rapid IV inj. Inject undiluted IV dose directly into IV tubing of infusing compatible solution over 30 sec or less, as prescribed. IM: Shake IM solution before injecting deep into large muscle mass. Reconstitution: Injection should be diluted in 50-100 mL NS or D5W. Compatibility: Stable in D5W or NS. Y-site administration: Drug to Drug IV Compatibility: Acyclovir, amikacin, aztreonam, bumetanide, cephazolin, cefepime, ceftriaxone, cimetidine, cisatracurium, diltiazem, dopamine, enalapril, epinephrine, famotidine, fentanyl, fluconazole, furosemide, heparin, hydrocortisone, imipenem, insulin regular, ketorolac, lansoprazole, levofloxacin, linezolid, lorazepam, magnesium sulphate, meropenem, methylprednisolone, metoclopramide, milrinone, morphine, nitroglycerin, nitroprusside, norepinephrine, ondansetron, phenylephrine,…

Adverse Effects

Endocrine irregularities including menstrual problems, Cushingoid state, adrenal suppression, growth suppression in children. Increased susceptibility to infection, increased severity of infection. Fluid/electrolyte disturbance, hypertension, negative protein, nitrogen and calcium balance. Myopathy, tendon rupture, osteoporosis, osteonecrosis and fractures. Impaired wound healing, sweating, hirsutism, striae, telangiectasia, acne. GI disturbance, peptic ulceration, acute pancreatitis, candidiasis. Psychiatric effects, neurological effects, insomnia. Diabetes, impaired glucose tolerance, weight gain, increased appetite. Ocular disturbances including cataracts, raised intraocular pressure, optic nerve damage, corneal changes, glaucoma. Thromboembolism, leukocytosis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Systemic fungal infections unless specific anti-infective therapy is used. Head injury, stroke. Precautions: Active infections not controlled by antibiotics. Latent or active amoebiasis. History of TB, septicaemia, symptoms may be masked. Avoid or maintain extreme cautions in chickenpox, measles, psychiatric disorders, renal impairment, hepatic failure, cirrhosis, active peptic ulcer, Myasthaenia gravis, previous steroid myopathy, osteoporosis, epilepsy, hypothyroidism, diabetes, adrenal suppression, hypertension, recent MI, congestive heart failure, thromboembolic disorders, glaucoma, corneal perforation. WITHDRAWAL: Withdraw gradually. Withdrawal symptoms may include fever, myalgia, arthralgia, rhinitis, itchy skin nodules and weight loss.

Interactions

Live vaccines or other vaccines, anticoagulants, hypoglycaemia agents, antihypertensives, diuretics, erythromycin, rifamycin, amphotericin, azole antifungals, ritonavir, cyclosporin, cardiac glycosides. Oestrogens including oral contraceptives, somatropin. Carbamazepine, phenytoin, primidone, barbiturates. Muscle relaxants, NSAIDs, salicylates, sympathomimetics, mifepristone, methotrexate, theophylline, aprepitant.

Advice to Patient

Take with meals. Do not stop taking drug abruptly, gradually lower down the dose then stop. Contact prescriber if there is increased nervousness, sleep disturbances, sore throat, unrecovered injuries, easy bruising, loss of skin colour, excessive growth of body hair, changes in vision, sudden or rapid weight gain (>3 lb per week), swelling of face/ankles/hands/feet, difficulty in breathing, muscle weakness, dark stools or change in color of stool, amenorrhoea, constant abdominal pain or if there is no improvement or worsening of condition. Consult prescriber if you feel more stressed out than normal because dosage may need to be adjusted. Avoid alcohol, limit intake of caffeine and stimulants during therapy. Take a low-sodium, high-potassium, high-protein diet, if prescribed, to help minimize weight gain, which is common with dexamethasone therapy. If there is need, prescriber may…

Pharmacokinetics

Onset of action: IV: Rapid. Immune thrombocytopaenia: Oral: Initial response: 2-14 days; Peak response: 4-28 days. Duration: IV: Short. Absorption: Oral: 61%-86%. Metabolism: Hepatic. Half-life elimination: Extremely low birth-weight infants with BPD: 9.26 ± 3.34 hrs. Children 4 mth-16 yrs: 4.34 ± 4.14 hrs. Adults: Oral: 4 ± 0.9 hrs; IV: Approx. 1-5 hrs. Time to peak, serum: Oral: 1-2 hrs; IM: Approx. 30-120 mins.; IV: 5-10 mins. Excretion: Urine (approx. 10%).

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

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