Generic Name and Formulations:
Dexamethasone 0.5mg, 0.75mg, 1mg, 1.5mg, 2mg, 4mg, 6mg; tabs.
Various generic manufacturers
Indications for Dexamethasone :
See full labeling. Initially 0.75–9mg daily.
See full labeling. Initially 0.02–0.3mg/kg/day in 3–4 divided doses.
Systemic fungal infection. Live vaccination.
Cerebral malaria, optic neuritis, active ocular herpes simplex: not recommended. Strongyloides infestation. Tuberculosis. Latent or active amebiasis. If exposed to chickenpox or measles, consider prophylactic passive immune therapy. Recent MI. CHF. Hypertension. Renal insufficiency. Peptic ulcers. Diverticulitis. Intestinal anastomoses. Ulcerative colitis. Cirrhosis. Postmenopausal women (osteoporosis risk). Diabetes. Thyroid disorder. Myasthenia gravis. Supplement with additional steroids in physiologic stress. Avoid abrupt cessation. Monitor thyroid, weight, growth, fluid, electrolyte balance and intraocular pressure (w. therapy >6wks). Pregnancy (Cat.C). Nursing mothers: not recommended.
Potentiated by CYP3A4 inhibitors (eg, ketoconazole, macrolides), cyclosporine, estrogens. Antagonized by CYP3A4 inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin), ephedrine. May potentiate cyclosporine. May antagonize anticoagulants (monitor), isoniazid, other CYP3A4 substrates (eg, indinavir, erythromycin). Increased risk of arrhythmias with digitalis. May need to adjust dose of antidiabetic agents. Increased GI effects with aspirin or other NSAIDs. Monitor for hypokalemia with potassium-depleting drugs (eg, amphotericin B, diuretics). Toxic epidermal necrolysis possible with thalidomide. Concomitant indomethacin: may get false-negative on dexamethasone suppression test. May suppress reactions to skin tests.
HPA axis suppression, masks infection, increased susceptibility to infection, glaucoma, cataracts, secondary infections, hypokalemia, hypocalcemia, hypernatremia, hypertension, psychic disorders, myopathy, osteoporosis, peptic ulcer, dermal atrophy, increased intracranial pressure, hyperglycemia.
Formerly known under the brand names Decadron, Dexone, Hexadrol.
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