DEXAMETHASONE

Long-acting synthetic corticosteroid hormone. Anti inflammatory medicine

Dosage Forms

Tablet

0.5 mg
4 mg

Powder for injection

4 mg/ml

Eye drops

0.1%

Eye drops

dexamethasone 0.1% + neomycin 0.35%

Eye drops

dexamethasone 0.1% + tobramycin 0.3%

Uses

  • Suppress allergic and inflammatory disorders
  • Obstructed breathing in croup
  • Inflammation
  • Anaphylaxis
  • Adjunct in cancer treatment (specialist use only)
  • Foetal lung maturation in preterm labour

Dose and Duration

Allergy
Adult:0.5‒10 mg by mouth once daily in the morning
Child:10‒100 micrograms once daily in the morning
Allergy/inflammation in eye/ear
Adult and Child:Apply eye drops every 30‒60 minutes until symptoms reduce, then reduce frequency to every 8 hours. If signs of infection are present, give formulation with antibiotic
Croup
Child:150‒300 micrograms/kg IM every 6 hours as needed
Anaphylaxis
Adult: 0.5‒24 mg by slow IV injection or infusion
Adult: 200‒400 micrograms by slow IV injection or in fusion
Foetal lung maturation in preterm labour
Give 6 mg IM to mother every 6 hours for a total of 4 doses. Do not use if there are signs of infection

Contraindications

  • Untreated systemic infection
  • Ocular fungal, herpes simplex and other viral, ocular tuberculosis or untreated purulent eye infection

Side Effects

  • Nausea, dyspepsia
  • Hypersensitivity reactions
  • Irritation at injection site
  • Inhibition of growth in children ( on long term use)
  • Cushing syndrome (on long term use)
  • Stinging, burning, redness, watering of eyes and increased intraocular pressure (longer than 2 weeks treatment) in ocular application

Interactions

  • Live vaccines (no effect of vaccines due to impaired immune response)
  • Insulin (reduced effect of insulin)
  • Amphotericin B (increased risk of hypokalaemia)
  • Carbamazepine, rifampicin, phenytoin, phenobarbital (reduced effect of dexamethasone)
  • Lopinavir (reduced concentration of lopinavir)
  • Methotrexate (increased risk of blood disorders)

Patient Instructions

  • Take in the morning
  • Do not use this medication for more than 1 week unless you have consulted your ophthalmologist
  • Do not wear contact lenses during the treatment period
  • In case of transient blurring of vision, do not operate hazardous machinery or drive until vision is clear
  • Discard the remaining drops 28 days after first opening

Pregnancy

  • Can be used

Breastfeeding

  • Can be used

⚠️ Caution

  • Can exacerbate infections e.g. tuberculosis
  • Use with caution in diabetes mellitus. Can cause hyperglycaemia and reduce the effect of insulin
  • Use with caution in severe liver disease, can exacerbate oedema and ascites
  • Avoid giving for longer than necessary durations
  • Use with caution in patients with glaucoma or a family history of glaucoma
  • Do not use for longer than 1 week unless under ophthalmic supervision; prolonged use may lead to a rise in intraocular pressure and secondary ocular infections