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Brand Name:Apo-Dexamethasone, Ciprodex, Dexasone, Maxidex, Maxitrol, PMS-Dexamethasone, ratio-Dexamethasone Sodium Phosphate Injection USP

Prescription needed: Yes

What is this drug used for?

Dexamethasone belongs to a class of drugs called “corticosteroids” and is used most commonly for medical conditions that involve inflammation. Some examples are arthritis, allergic reactions, asthma and other inflammatory conditions of the stomach, intestines, skin, blood, kidney, eye, and thyroid. It may also be used with other drugs to treat or prevent nausea or vomiting caused by some chemotherapy drugs.

Dexamethasone and other corticosteroids are similar to the body’s natural hormone, cortisone, and works in many parts of the body to decrease inflammation. These medications are often needed when the body is not producing enough of its own hormone, cortisone, to keep things in balance.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to dexamethasone or if you have a fungal infection in some place other than on your skin. Before taking this medication, tell your doctor if you have or have ever had:

• problems with your kidney or liver
• problems with stomach ulcers, bleeding of the stomach or heartburn
• diabetes
• congestive heart failure
• problems with swelling of your feet or ankles
• high blood pressure
• osteoporosis
• problems with frequent infections
• low thyroid hormone (hypothyroidism)
• problems with depression, hallucinations or other mental illness
• myasthenia gravis
• herpes eye infection or shingles (herpes zoster infection)
• tuberculosis
• glaucoma or cataracts
• problems with low potassium or calcium in the blood
• side effects to other corticosteroid medications

What about possible side effects?

The most common side effects to dexamethasone are:

• upset stomach, vomiting, heartburn
• increase in appetite with possible weight gain
• swelling of the feet and ankles
• swelling of the face
• dizziness
• difficulty falling or staying asleep, nightmares
• feeling depressed, anxious or restless
• feeling “high” or euphoric
• acne
• changes in the skin (easy bruising, skin thinning, increased hair growth over body, presence of small blood vessels)
• changes or absence of menstrual periods
• decrease in bone strength and osteoporosis

Some of these side effects are more likely with higher doses and some are more likely with long-term use. Talk to your doctor or pharmacist.

Less common and sometimes severe side effects include:

• high blood pressure
• increase in blood sugars
• feeling weak in the muscles
• stopping your body’s own ability to produce its natural hormone, cortisone (with high doses and long-term use)
• a condition called avascular necrosis of bone
• changes in vision (call you doctor)
• increased chance of infection or slow recovery from an infection (call your doctor)
• decrease growth rate in children

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

• other pain medications that include ASA & other anti-inflammatories (e.g. ibuprofen, naproxen, voltaren, diclofenac) (can increase your chances of having side effects, especially those in the stomach)
• water pills (e.g. hydrochlorothiazide, furosemide) (this medication may cause swelling of the ankles and feet and may interfere with how well the water pills can work; as well, there is an increased chance for side effects such as low potassium in the blood)
• digoxin (potassium levels in the blood may need to be monitored)
• cyclosporine (may change the amount of dexamethasone or cyclosporine in the blood)
• ketoconazole, itraconazole (may increase chances for dexamethasone side effects)
• birth control pills (may increase chances for dexamethasone side effects)
• phenobarbital, phenytoin, rifampin (may decrease the amount of dexamethasone in the body)
• live vaccines
• warfarin

If you are taking medications to treat high blood pressure, this medication may interfere with how well your blood pressure medication can work and your blood pressure may increase. Your doctor will likely check your blood pressure periodically while you are taking this medication.

If you are taking medications for congestive heart failure, this medication may make your symptoms of congestive heart failure worse and interfere with how well your medications can work. Call your doctor immediately if you notice that your symptoms of heart failure are getting worse.

If you are taking medications for diabetes, this medication may increase your blood sugars and interfere with how well your medications can work.

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Special instructions

• This drug makes you more susceptible to illnesses, including chicken pox, measles, and tuberculosis. Talk to your doctor if you are exposed to any of these infections.
• Do not have a vaccination, other immunization, or any skin test while you are taking dexamethasone without first talking to your doctor.
• You may need to take extra doses of dexamethasone during periods of stress (injuries, infections, and severe asthma attacks), especially if you have recently stopped taking the medication.
• If you need to take this medication for a long period of time, you may be at risk for osteoporosis. Talk to your doctor or pharmacist about taking calcium (1000mg-1500mg/day) and vitamin D (400-800 IU/day). As well, your doctor may prescribe a different medication to prevent this side effect from happening.
• It is extremely important that you do not stop taking this medication without talking to your doctor first. Since this medication can cause your body to stop producing its own natural hormone after long-term use, stopping the medication could cause severe side effects (e.g. confusion, drowsiness, fever, headache, joint and muscle pain, low blood pressure, loss of appetite, peeling skin, upset stomach, vomiting and weight loss).

Lab and Other Tests:

• Your doctor may send you for periodic bone mineral density scans to check your bones while taking this medication.
• You may need to check your blood sugar more often while taking this medication since this medication can increase your blood sugar.

Children: Can be used. The lowest effective dose is used to decrease the chances for long-term side effects.

Seniors: Lower doses may be necessary to decrease the chances for side effects.

Pregnant women: While harm to the unborn child is not likely at low doses, you should always discuss this with your doctor.

Women who are nursing: Dexamethasone does pass through breast milk but it is unlikely to harm your baby at low does. Talk to your doctor.

People who drive or operate machinery: No known problems.

Alcohol: May increase the risk of stomach irritation and side effects to dexamethasone. Try to limit alcohol consumption.

Overdose: If you notice any unusual symptoms, call your doctor immediately.

Stopping the drug: Do not stop taking this drug until you have discussed it with your doctor. He/she may need to decrease the dose slowly over time.

If you miss a dose: Take the missed dose as soon as you remember it unless it is within 2 hours of your next scheduled dose, in which case take the missed dose and skip the next scheduled dose. Never take a double dose of this medicine.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and direct light; always out of reach of children.

Dietary precautions: If you are taking dexamethasone for an extended period of time, your doctor may advise you to follow a low-sodium, high-potassium, and high calcium diet. You may want to take this medication with food to decrease the chance of having an upset stomach.