How does this medication work? What will it do for me?

Dexamethasone belongs to the group of medications known as corticosteroids. It may be used to treat a wide variety of conditions. It can be used to replace cortisone in people who are deficient in cortisone. It can also be used to treat a number of other conditions, including respiratory diseases (such as asthma), skin diseases, severe allergies, certain eye diseases, rheumatoid arthritis, inflammatory bowel disease, certain blood disorders, and certain types of cancer. In all of these conditions, inflammation plays a part in causing disease. This medication works by reducing inflammation.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each white, pentagonal, flat, bevelled-edged tablet, with a "4" on one side and a score on the other side, contains dexamethasone 4 mg. Nonmedicinal ingredients: cornstarch, lactose, and magnesium stearate.

How should I use this medication?

The recommended dose varies widely according to the condition being treated and the circumstances of the person being treated.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Large doses of corticosteroids should be taken with meals, and antacids should be taken between meals to help to prevent stomach ulcers and stomach upset.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take dexamethasone if you:

  • are allergic to dexamethasone or any ingredients of the medication
  • have an internal fungal infection
  • have tuberculosis (although there are special exceptions)

Anyone currently taking this medication should not receive a live virus vaccine.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • constipation
  • darkening or lightening of skin colour
  • diarrhea
  • difficulty sleeping
  • dizziness or lightheadedness
  • flushing of face or cheeks
  • hiccups
  • indigestion
  • increased or decreased appetite
  • increased sweating
  • indigestion
  • nausea
  • nervousness or restlessness
  • redness, swelling, or pain at the place of injection
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blurred or reduced vision
  • changes in menstrual periods
  • confusion
  • excitement
  • hallucinations
  • muscle weakness
  • mood swings
  • rapid or pounding heartbeat
  • restlessness
  • shortness of breath
  • seizures
  • signs of depression, e.g.:
    • changes in sleep
    • changes in weight
    • decreased interest in activities
    • poor concentration
    • thoughts of suicide
  • signs of uncontrolled blood sugar (e.g., increased thirst, frequent urination, increased urination at night)
  • signs of gastrointestinal bleeding (e.g., black, tarry stools, vomiting of material that looks like coffee grounds, rectal bleeding)
  • signs of reduced ability for blood to clot, e.g.:
    • blood in urine
    • bloody nose
    • coughing blood
    • cuts that don't stop bleeding
  • skin rash
  • unusual infections, symptoms may include:
    • fever or chills
    • headache
    • listlessness
    • prolonged dizziness
    • severe diarrhea
    • shortness of breath
    • stiff neck
    • weight loss

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction, i.e.:
    • abdominal cramps
    • difficulty breathing
    • nausea and vomiting
    • swelling of the face and throat

The following side effects may occur if you take this medicine for a long time. Check with your doctor if any of the following side effects occur:

  • abdominal or stomach pain or burning (continuing)
  • acne
  • bloody or black, tarry stools
  • changes in vision
  • eye pain
  • filling or rounding out of the face
  • headache
  • irregular heartbeat
  • menstrual problems
  • muscle cramps or pain
  • muscle weakness
  • nausea
  • pain in arms, back, hips, legs, ribs, or shoulders
  • reddish-purple lines on arms, face, groin, legs, or trunk
  • redness of eyes
  • sensitivity of eyes to light
  • stunting of growth (in children)
  • swelling of feet or lower legs
  • tearing of eyes
  • thin, shiny skin
  • difficulty sleeping
  • unusual bruising
  • unusual increase in hair growth
  • unusual tiredness or weakness
  • vomiting
  • weight gain (rapid)
  • wounds that will not heal

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

General precautions: Advise all doctors involved in your care that you have been using this medication.

Diabetes: Dexamethasone may cause an increase in blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

People with diabetes or those at risk for developing diabetes should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Eye Problems: Like other corticosteroids, the use of dexamethasone for a long period of time may cause cataracts and glaucoma or cause glaucoma to worsen. Damage to the optic nerves is possible. People with glaucoma or those at risk for developing glaucoma should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you notice any changes to your vision, contact your doctor as soon as possible.

Fertility: Steroids such as dexamethasone may increase or decrease the quality and quantity of sperm production.

Fluid and electrolyte balance: Average and large doses of corticosteroids, including dexamethasone, can cause increases in blood pressure, salt and water retention, and excretion of potassium. Dietary salt restriction and potassium supplementation may be necessary (ask your doctor). If you notice dry mouth, thirst, weakness, fatigue, muscle pain and cramps, fast heartbeat, or decreased urination, see your doctor.

Gastrointestinal problems: As with other corticosteroids, dexamethasone may cause stomach ulcers to worsen or develop. If you have a history of digestive system problems, such as ulcerative colitis, stomach ulcers, and diverticulitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infection: Dexamethasone can reduce your body's ability to fight infections and may hide signs of infection that is developing. This medication may also worsen internal fungal infections. If you experience signs of infection such as sore throat, fever, sneezing, or coughing, contact your doctor as soon as possible.

Kidney disease: Dexamethasone may not leave the body at the expected rate in cases where the kidney is not working properly. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver: Dexamethasone may not leave the body at the expected rate in cases where the liver is not working properly. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Mood changes: Corticosteroids have been known to cause mood swings and symptoms of depression. People with depression or a history of depression should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.

Myasthenia gravis: Myasthenia gravis is a condition that causes specific muscle weakness. Dexamethasone can cause muscle wasting, decreasing muscle. If you have myasthenia gravis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Osteoporosis: Long-term use of corticosteroids such as dexamethasone may result in bones losing thickness, causing them to be at increased risk for fracture. If you take corticosteroid medications on a continuous basis, speak to your doctor about your particular risk for osteoporosis.

Stress: People taking dexamethasone who are subjected to any unusual stress should increase the dosage of medication before, during, and after the stressful situation as prescribed by their doctor.

Withdrawal: After using this medication for a long time, stopping dexamethasone may result in symptoms of withdrawal including fever, muscle and joint pain, and malaise. When stopping dexamethasone after having used it for a prolonged period, reduce the dose slowly as prescribed by your doctor.

Pregnancy: Dexamethasone should not be taken during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking dexamethasone, it may interfere with your child's own corticosteroid production, slow growth, or cause other unwanted effects for the baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Children may be more likely to experience the side effects encountered by using this class of medication for long periods of time (e.g., slowing down of growth, delayed weight gain). The use of this medication by children should be limited to the smallest dose that will be effective. Discuss with your doctor the risks and benefits of the use of this medication by children.

What other drugs could interact with this medication?

There may be an interaction between dexamethasone and any of the following:

  • aldesleukin
  • amphotericin B
  • antacids (aluminum hydroxide, calcium carbonate, magnesium hydroxide) with oral dexamethasone only
  • antidiabetic medications (e.g., glyburide, insulin, metformin, repaglinide, rosiglitazone)
  • anti-HIV medications (e.g., delaviridine, lopinavir, ritonavir)
  • antihypertensive medications (e.g., metoprolol)
  • antipsychotic medications (e.g., haloperidol, quetiapine, acetylsalicylic acid [ASA])
  • aprepitant
  • azole antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • benzodiazepines (e.g., alprazolam, diazepam)
  • birth control pills
  • calcitriol
  • calcium channel blockers (e.g., diltiazem, nisoldipine, verapamil)
  • carbamazepine
  • caspofungin
  • cholestyramine
  • colestipol
  • cyclosporine
  • dasatinib
  • digoxin
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
  • donepezil
  • echinacea
  • estrogens
  • imatinib
  • isoniazid
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • mitotane
  • muscle relaxants (e.g., atracurium, pancuronium, rocuronium)
  • nefazodone
  • neostigmine
  • nilotinib
  • nonsteroidal anti-inflammatory medications (NSAIDs; e.g., celecoxib, ibuprofen, naproxen)
  • phenobarbital
  • pimecrolimus
  • phenytoin
  • pyridostigmine
  • quinidine
  • quinine
  • quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, norfloxacin)
  • rifabutin
  • rifampin
  • salbutamol
  • sildenafil
  • tacrolimus
  • tadalafil
  • tamoxifen
  • tamsulosin
  • tramadol
  • tuberculosis vaccine (BCG)
  • vaccines (e.g., vaccines for measles, mumps, rubella)
  • vincristine
  • vinblastine
  • warfarin
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.