Testing of adrenal cortical hyperfunction; management of allergic and inflammatory ophthalmic processes, allergic states, cerebral edema associated with primary or metastatic brain tumor, collagen diseases, craniotomy or head injury, dermatologic diseases, edematous states (caused by nephrotic syndrome), endocrine disorders, GI diseases, hematologic disorders, multiple sclerosis, neoplastic diseases, renal diseases, respiratory diseases, rheumatic disorders, trichinosis with neurologic or myocardial involvement, and tuberculous meningitis.
Intra-articular or soft-tissue administration
Short-term adjunctive treatment for conditions such as acute gouty arthritis, posttraumatic osteoarthritis, rheumatoid arthritis, and synovitis of osteoarthritis.
Treatment for conditions such as alopecia areata, discoid lupus erythematosus, keloids, and psoriatic plaques.
Treatment of macular edema following branch retinal vein occlusion or central retinal vein occlusion; treatment of noninfectious uveitis affecting the posterior segment of the eye.
Treatment of steroid-responsive inflammatory conditions of palpebral and bulbar conjunctiva, lid, cornea, and anterior segment of globe; sympathetic ophthalmia; temporal arteritis; uveitis.
Otic (using ophthalmic solution)
Steroid-responsive inflammatory conditions of the external auditory meatus, such as allergic otitis externa.
Treatment of acute and chronic asthmatic bronchitis; acute calcium pyrophosphate deposition disease; adjunctive treatment for bacterial meningitis; adjunct treatment for brain neoplasm; adjunct treatment for fever caused by malignant neoplasm; airway-obstructing hemangioma in infants; cerebral ischemia; cerebri pseudomotor; connective tissue disease; croup; desquamative gingivitis; diagnosis of endogenous depression; hemolysis; localized cutaneous sarcoid; mixed breast and prostatic carcinoma; multiple myeloma; myasthenia gravis; nasal polyps; noncardiogenic pulmonary edema; nonrheumatic carditis; oral lesions associated with corticosteroid responsive disorder; organ transplant rejection; pemphigoid; pericarditis; polyarteritis nodosa; prevention of nausea and vomiting associated with chemotherapy, especially cisplatin-containing regimens; prophylaxis for acute mountain sickness; recurrent aphthous stomatitis; Reiter disease; relapsing polychondritis; respiratory distress syndrome; rheumatic fever; sarcoidosis; severe eczema; vasculitis.
• PO, IM, IV (Adults): Anti-inflammatory–0.75–9 mg daily in divided doses q 6–12 hr. Airway edema or extubation-0.5–2 mg/kg/day divided q 6 hr; begin 24 hr prior to extubation and continue for 24 hr post-extubation .
• PO, IM, IV (Children): Airway edema or extubation-0.5–2 mg/kg/day divided q 6 hr; begin 24 hr prior to extubation and continue for 24 hr post-extubation. Anti-inflammatory-0.08–0.3 mg/kg/day or 2.5–10 mg/m2/day divided q 6–12 hr. Physiologic replacement-0.03–0.15 mg/kg/day or 0.6–0.75 mg/m2/day divided q 6–12 hr.
• PO (Adults): Suppression test–1 mg at 11PM or 0.5 mg q 6 hr for 48 hr.
• IM, IV (Adults): Dexamethasone phosphate — 10 mg initially IV, 4 mg q 6 hr, may be decreased to 2 mg q 8–12 hr, then change to PO.
• IV (Children): Chemotherapy induced emesis — 5–20 mg given 15–30 min before treatment Cerebral edema-Loading dose 1–2 mg/kg followed by 1–1.5 mg/kg/day divided q 4–6 hr for 5 days (not to exceed 16 mg/day); then taper for 5 days Bacterial meningitis — 0.6 mg/kg/day divided q 6 hr x 16 doses (start at time of first antibiotic dose).
• IV, PO (Adults): Chemotherapy induced emesis-10–20 mg given 15–30 min before each treatment or 10 mg q 12 hr on each treatment day.
• IV, PO (Neonates): Bronchopulmonary dysplasia-0.5–0.6 mg/kg/day divided q 12 hr for 3–7 days then taper over 1–6 weeks.
• IV (Neonates): Airway edema or extubation-0.25 mg/kg/dose given 4 hr prior to extubation and continue q 8 hr for 3 doses post-extubation (not to exceed 1 mg/kg/day).
• IS (Adults): Sodium phosphate-0.4–6 mg/day.
|•||Topical (Adults): Apply to affected area(s) 2–4 times daily (depends on preparation and condition being treated).|
|•||Topical (Children): Apply to affected area(s) 1–2 times daily (depends on product, preparation, and condition being treated).|
Synthetic long-acting glucocorticoid that depresses formation, release, and activity of endogenous mediators of inflammation, including prostaglandins, kinins, histamine, liposomal enzymes, and complement expression. It also modifies the body’s immune response.
Coadministration with live virus vaccines; hypersensitivity to any component of the products; IM use in idiopathic thrombocytopenic purpura; intranasal use in untreated localized infections involving nasal mucosa; ophthalmic use in acute superficial herpes simplex keratitis, fungal diseases of ocular structures, vaccinia, varicella, and ocular tuberculosis; systemic fungal infections; topical monotherapy in primary bacterial infections.
Active or suspected ocular or periocular infections, including most viral diseases of the cornea and conjunctiva including active epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, mycobacterial infections, and fungal diseases; advanced glaucoma; known hypersensitivity to any components of the product.
CV: Arrhythmias, bradycardia, cardiac arrest, cardiac enlargement, CHF, circulatory collapse, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent MI, pulmonary edema, syncope, tachycardia, thromboembolism, vasculitis.
CNS: Convulsions, emotional instability, euphoria, headache, increased appetite, increased intracranial pressure with papilledema (pseudotumor cerebri, usually following discontinuation of treatment), insomnia, malaise, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychic disorders, vertigo.
DERM: Acne; allergic dermatitis; dry, scaly skin; ecchymosis and petechiae; erythema; impaired wound healing; increased sweating; rash; striae; suppression of skin test reactions; thin, fragile skin; thinning scalp hair; urticaria.
EENT: Exophthalmos, glaucoma, increased IOP, posterior subcapsular cataracts.
ELECDIST: Fluid retention, hypokalemic alkalosis, potassium loss, sodium retention.
ENDO: Decreased carbohydrate and glucose tolerance, development of cushingoid state, glycosuria, hirsutism, hyperglycemia, hypertrichosis, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestation of latent diabetes mellitus, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness, suppression of growth in children.
GI: Abdominal distention, hiccups, nausea, pancreatitis, peptic ulcer and possible perforation and hemorrhage, perforation of the small and large intestine, ulcerative esophagitis.
GU: Decreased or increased motility and number of spermatozoa.
HEPA: Elevation in serum liver enzyme levels, hepatomegaly.
HYPERSEN: Anaphylactoid reactions, anaphylaxis, angioedema.
M/N: Abnormal fat deposits, moon face, negative nitrogen balance caused by protein catabolism, weight gain.
MUSC: Aseptic necrosis of femoral and humeral heads, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, steroid myopathy, tendon rapture, vertebral compression fractures.
IOP increased (25%); conjunctival hemorrhage (22%); eye pain (8%); conjunctival hyperemia (7%); cataract, ocular hypertension (5%); vitreous detachment (2%).
OTHER: Decreased resistance to infection, edema.
May decrease dexamethasone-induced adrenal suppression.
Cardiac enlargement and CHF have been reported.
May antagonize anticholinesterase effects in myasthenia gravis.
May alter anticoagulant dose requirements.
Dexamethasone may increase blood glucose levels, necessitating antidiabetic agent dosage adjustments.
Dexamethasone plasma levels may be elevated and the half-life prolonged, increasing the pharmacologic effects and adverse reactions.
Dexamethasone plasma levels may be reduced, decreasing the efficacy.
Activity of cyclosporine and dexamethasone may be increased. In addition, convulsions have been reported.
CYP3A4 substrates (eg, erythromycin, indinavir)
Plasma levels may be reduced by dexamethasone, decreasing efficacy.
Because of possible dexamethasone-induced hypokalemia, the risk of arrhythmias may be increased.
Hepatic enzyme inducers (eg, barbiturates, carbamazepine, phenytoin, rifampin)
Dexamethasone plasma levels may be reduced, decreasing the efficacy. In addition, seizure control with phenytoin may be altered.
Hepatic enzyme inhibitors (eg, azole antifungal agents [eg, ketoconazole], estrogens including oral contraceptives, macrolide antibiotics [eg, erythromycin])
Dexamethasone plasma levels may be elevated, increasing the pharmacologic effects and adverse reactions. In addition, ketoconazole can inhibit adrenal corticosteroid synthesis, causing adrenal insufficiency during dexamethasone withdrawal.
Risk of GI adverse reactions may be increased. In addition, salicylate levels and efficacy may be reduced.
Potassium-depleting agents (eg, amphotericin B, loop and thiazide diuretics)
Risk of hypokalemia may be increased.
Use with caution; TEN has been reported with concurrent use of dexamethasone.
Therapeutic Classification: corticosteroids
Absorption: Following intravitreal implantation, plasma dexamethasone concentrations were below the lower limit of quantitation (50 pg/mL) in the majority of patients.
Metabolism: Metabolized in the liver by CYP3A4.
Excretion: The half—life is 1.8 to 3.5 h.
Onset: Rapid (injection).
Duration: Short (injection).
|ORAL||UNKNOWN||1-2 HOUR||72 HOUR|