Dexamethasone

Dexamethasone Brand Names

AK-Dex | Baycadron | Dalalone | Dalalone D.P | Dalalone L.A | Decadron | Decadron-LA | Dexacort PH Turbinaire | Dexacort Respihaler | DexPak Jr TaperPak | DexPak TaperPak | Dextenza | DEXYCU | DoubleDex | Dxevo | HiDex | Maxidex | Ocu-Dex | Ozurdex | Simplist Dexamethasone | Solurex | TaperDex | Zema-Pak | ZoDex | ZonaCort 11 Day | ZonaCort 7 Day

What is Dexamethasone

Dexamethasone and its derivatives, dexamethasone sodium phosphate and dexamethasone acetate, are synthetic glucocorticoids used as anti-inflammatory or immunosuppressive agents.

Dexamethasone has little to no mineralocorticoid activity and is therefore not used by itself in the management of adrenal insufficiency.

Dexamethasone is usually selected for management of cerebral edema because of its superior ability to penetrate the CNS.

As a glucocorticoid, dexamethasone is roughly 20 to 30 times more potent than hydrocortisone and 5 to 7 times more potent than prednisone. It is one of the longest acting corticosteroids used in clinical medicine.

Dexamethasone is available as oral, parenteral, and topical (spray) dosage forms, as well as topical ophthalmic and intraocular dosage forms.

Indications

1. acne rosacea
2. acute lymphocytic leukemia (ALL)
3. acute respiratory distress syndrome (ARDS)
4. Addison’s disease
5. adrenocortical insufficiency
6. adrenogenital syndrome
7. allergic conjunctivitis
8. allergic rhinitis
9. alopecia
10. altitude sickness
11. altitude sickness prophylaxis
12. amyloidosis
13. anaphylactic shock
14. anaphylaxis
15. angioedema
16. ankylosing spondylitis
17. anterior segment inflammation
18. asthma
19. atopic dermatitis
20. berylliosis
21. bronchiolitis
22. bursitis
23. cerebral edema
24. chemotherapy-induced nausea/vomiting
25. chemotherapy-induced nausea/vomiting prophylaxis
26. chronic lung disease (CLD)
27. chronic obstructive pulmonary disease (COPD)
28. Churg-Strauss syndrome
29. congenital adrenal hyperplasia
30. contact dermatitis
31. corneal abrasion
32. corneal ulcer
33. Crohn’s disease
34. cutaneous T-cell lymphoma (CTCL)
35. cyclitis
36. dermatitis
37. dermatitis herpetiformis
38. dermatomyositis
39. diabetic macular edema
40. discoid lupus erythematosus
41. epicondylitis
42. erythema multiforme
43. erythroblastopenia
44. exfoliative dermatitis
45. food allergy
46. gouty arthritis
47. graft-versus-host disease (GVHD)
48. granuloma annulare
49. hemolytic anemia
50. herpes zoster ocular infection
51. Hodgkin lymphoma
52. hypercalcemia
53. hypoplastic anemia
54. hypothalamic-pituitary-adrenal (HPA) suppression diagnosis
55. immune thrombocytopenic purpura (ITP)
56. infertility
57. iritis
58. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
59. keloids
60. keratitis
61. kidney transplant rejection
62. laryngeal edema prophylaxis
63. laryngotracheobronchitis (croup)
64. lichen planus
65. lichen simplex
66. Loeffler’s syndrome
67. macroglobulinemia
68. macular edema following retinal vein occlusion
69. meningitis
70. mixed connective tissue disease
71. multiple myeloma
72. multiple sclerosis
73. myasthenia gravis
74. mycosis fungoides
75. necrobiosis lipoidica diabeticorum
76. neonatal respiratory distress syndrome prophylaxis
77. nephrotic syndrome
78. non-Hodgkin’s lymphoma (NHL)
79. ocular pain
80. osteoarthritis
81. otitis externa
82. pemphigus
83. perennial allergies
84. pneumonitis
85. polyarteritis nodosa
86. polychondritis
87. polymorphous light eruption
88. polymyositis
89. post-operative nausea/vomiting (PONV)
90. post-operative nausea/vomiting (PONV) prophylaxis
91. postoperative ocular inflammation
92. proteinuria
93. pruritus
94. psoriasis
95. psoriatic arthritis
96. pulmonary edema
97. rheumatic carditis
98. rheumatoid arthritis
99. Rhus dermatitis
100. sarcoidosis
101. seasonal allergies
102. seborrheic dermatitis
103. serum sickness
104. spinal cord compression
105. Stevens-Johnson syndrome
106. systemic lupus erythematosus (SLE)
107. temporal arteritis
108. tenosynovitis
109. thrombocytopenia
110. thyroiditis
111. trichinosis
112. tuberculosis infection
113. ulcerative colitis
114. urticaria
115. uveitis
116. vernal keratoconjunctivitis
117. viral conjunctivitis
118. Wegener’s granulomatosis

Side Effects

1. abdominal pain
2. acne vulgaris
3. acneiform rash
4. adrenocortical insufficiency
5. alopecia
6. amenorrhea
7. amnesia
8. anaphylactoid reactions
9. anemia
10. angina
11. angioedema
12. anorexia
13. anxiety
14. appetite stimulation
15. arrhythmia exacerbation
16. arthralgia
17. arthropathy
18. avascular necrosis
19. blurred vision
20. bone fractures
21. bradycardia
22. candidiasis
23. cardiac arrest
24. cardiomyopathy
25. cataracts
26. conjunctival hyperemia
27. conjunctivitis
28. constipation
29. corneal edema
30. corneal erosion
31. Cushing’s syndrome
32. delirium
33. depression
34. diabetes mellitus
35. diaphoresis
36. diarrhea
37. dizziness
38. dysmenorrhea
39. ecchymosis
40. edema
41. EEG changes
42. elevated hepatic enzymes
43. emotional lability
44. endophthalmitis
45. erythema
46. esophageal ulceration
47. euphoria
48. exfoliative dermatitis
49. exophthalmos
50. fever
51. fluid retention
52. foreign body sensation
53. gastritis
54. GI bleeding
55. GI perforation
56. glossitis
57. glycosuria
58. growth inhibition
59. hallucinations
60. headache
61. heart failure
62. hepatomegaly
63. hiccups
64. hirsutism
65. hypercholesterolemia
66. hyperemia
67. hyperglycemia
68. hypernatremia
69. hypertension
70. hyperthyroidism
71. hypocalcemia
72. hypokalemia
73. hypotension
74. hypothalamic-pituitary-adrenal (HPA) suppression
75. hypothyroidism
76. immunosuppression
77. impaired cognition
78. impaired wound healing
79. increased intracranial pressure
80. infection
81. injection site reaction
82. insomnia
83. iritis
84. irritability
85. keratitis
86. keratoconjunctivitis
87. lacrimation
88. lethargy
89. leukocytosis
90. lupus-like symptoms
91. macular edema
92. malaise
93. mania
94. memory impairment
95. menstrual irregularity
96. metabolic alkalosis
97. myalgia
98. mydriasis
99. myocardial infarction
100. myopathy
101. nausea
102. neuritis
103. ocular hemorrhage
104. ocular hypertension
105. ocular hypotonia
106. ocular infection
107. ocular inflammation
108. ocular irritation
109. ocular pain
110. ocular pruritus
111. optic neuritis
112. osteopenia
113. osteoporosis
114. palpitations
115. pancreatitis
116. papilledema
117. paresthesias
118. peptic ulcer
119. perineal pain
120. peripheral neuropathy
121. petechiae
122. phlebitis
123. photophobia
124. physiological dependence
125. postmenopausal bleeding
126. pruritus
127. pseudotumor cerebri
128. psychosis
129. ptosis
130. pulmonary edema
131. purpura
132. rash
133. restlessness
134. retinal detachment
135. retinopathy
136. seizures
137. sinus tachycardia
138. skin atrophy
139. skin hyperpigmentation
140. skin hypopigmentation
141. sodium retention
142. striae
143. stroke
144. syncope
145. telangiectasia
146. tendon rupture
147. thromboembolism
148. thrombosis
149. tumor lysis syndrome (TLS)
150. urticaria
151. vasculitis
152. vertigo
153. visual impairment
154. vomiting
155. weakness
156. weight gain
157. weight loss
158. withdrawal
159. xerophthalmia
160. xerosis

Monitoring Parameters

• blood glucose
• blood pressure
• intraocular pressure
• ophthalmologic exam
• pulmonary function tests (PFTs)
• serum cortisol
• serum potassium

Contraindications

• abrupt discontinuation
• acne rosacea
• acne vulgaris
• asthma
• benzyl alcohol hypersensitivity
• breast-feeding
• cataracts
• children
• coagulopathy
• corneal abrasion
• corticosteroid hypersensitivity
• Cushing’s syndrome
• diabetes mellitus
• diverticulitis
• epidural administration
• fungal infection
• geriatric
• GI disease
• GI perforation
• glaucoma
• growth inhibition
• heart failure
• hepatic disease
• herpes infection
• herpes simplex keratitis (dendritic keratitis)
• hypertension
• hypothalamic-pituitary-adrenal (HPA) suppression
• hypothyroidism
• immunosuppression
• increased intracranial pressure
• increased intraocular pressure
• infection
• inflammatory bowel disease
• measles
• myasthenia gravis
• myocardial infarction
• myopia
• neonates
• occlusive dressing
• ocular exposure
• ocular infection
• open-angle glaucoma
• osteoporosis
• peptic ulcer disease
• perioral dermatitis
• peripheral vascular disease
• pregnancy
• premature neonates
• psychosis
• renal disease
• rupture of posterior ocular lens capsule
• seizure disorder
• skin abrasion
• sulfite hypersensitivity
• surgery
• thromboembolic disease
• tuberculosis
• ulcerative colitis
• vaccination
• varicella
• viral infection
• visual disturbance

Interactions

• Abatacept
• Abemaciclib
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetazolamide
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• Adalimumab
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• Aldesleukin, IL-2
• Alefacept
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• Alogliptin; Metformin
• Alosetron
• Alpha-glucosidase Inhibitors
• Altretamine
• Ambenonium Chloride
• Amifampridine
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
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• Amiodarone
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amoxicillin; Clarithromycin; Lansoprazole
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• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
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• Hydrochlorothiazide, HCTZ; Moexipril
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• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone
• Hydrocodone; Ibuprofen
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• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
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• Vigabatrin
• Vinblastine
• Vincristine
• Vincristine Liposomal
• Vorapaxar
• Voriconazole
• Vorinostat
• Voxelotor
• Warfarin
• Zafirlukast
• Zanubrutinib
• Zileuton
• Zolpidem
• Zonisamide