Dexamethasone Injection Rx
Generic Name and Formulations:
Dexamethasone phosphate (as sodium); 4mg/mL, 10mg/mL; soln for IV or IM inj; contains sulfites.
Various generic manufacturers
Indications for Dexamethasone Injection:
Steroid-responsive disorders when oral therapy is not feasible.
Adults and Children:
See full labeling. Give by IV, IM, intra-articular, soft tissue, or intralesional inj. Initially usually 0.5–9mg daily.
Systemic fungal infection. Live vaccination.
Not for epidural use; serious neurologic events may occur. 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. Asthma. Recent MI. CHF. Hypertension. Renal insufficiency. Peptic ulcers. Diverticulitis. Intestinal anastomoses. Ulcerative colitis. Cirrhosis. Postmenopausal women (osteoporosis risk). Diabetes. Thyroid disorder. Myasthenia gravis. Avoid inj into previously infected or unstable joints. 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, inj site reactions.
Formerly known under the brand names Decadron, Hexadrol.
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