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dexamethasone sodium phosphate
generic
Adult Dosing .
Dosage forms: INJ: 4 mg per mL, 10 mg per mL
Dosage Form Details
- [formulation clarification]
- Info: 10 mg per mL vial for IM or IV use only
corticosteroid-responsive conditions
- [IM/IV route]
- Dose: 0.5-9 mg/day IM/IV divided q6-12h; Info: dose, frequency varies by condition; use lowest effective dose, shortest effective tx duration; taper dose gradually to D/C if high-dose or long-term use
- [intra-articular route, small joints]
- Dose: 0.8-1 mg intra-articularly x1; Info: use 4 mg per mL vial; dose, frequency varies by condition and injection site; use lowest effective dose, shortest effective tx duration; taper dose gradually to D/C if high-dose or long-term use
- [intra-articular route, large joints]
- Dose: 2-4 mg intra-articularly x1; Info: use 4 mg per mL vial; dose, frequency varies by condition and injection site; use lowest effective dose, shortest effective tx duration; taper dose gradually to D/C if high-dose or long-term use
- [soft tissue injection]
- Dose: 0.4-4 mg INJ into affected area x1; Info: use 4 mg per mL vial; dose, frequency varies by condition and injection site; use lowest effective dose, shortest effective tx duration; taper dose gradually to D/C if high-dose or long-term use
- [intralesional injection]
- Dose: individualize dose intralesionally x1; Info: use 4 mg per mL vial; dose, frequency varies by condition and injection site; use lowest effective dose, shortest effective tx duration; taper dose gradually to D/C if high-dose or long-term use
adrenal insufficiency
- [0.03-0.15 mg/kg/day IM/IV divided q6-12h]
cerebral edema, acute
- [4 mg IM/IV q6h]
- Start: 10 mg IV x1; Info: continue until symptoms subside, taper dose over 5-7 days to D/C; switch to PO when possible
COVID-19 (off-label)
- [6 mg IV qd for up to 10 days]
- Info: for hospitalized patients with suspected or confirmed severe COVID-19 requiring supplemental oxygen or mechanical ventilation; may use alternative glucocorticoids such as methylprednisolone 32 mg/day, prednisone 40 mg/day, hydrocortisone 160 mg/day
nausea/vomiting prevention, chemo-related (off-label)
- [highly-emetogenic parenteral chemo]
- Dose: 12 mg IV x1 on day 1 before chemo, then may give 8 mg IV qd on days 2-4; Info: part of multi-drug regimen; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool
- [moderately-emetogenic parenteral chemo]
- Dose: 12 mg IV x1 on day 1 before chemo, then may give 8 mg IV qd on days 2-3; Info: part of multi-drug regimen; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool
- [low-emetogenic parenteral chemo]
- Dose: 8-12 mg IV x1 before chemo; Info: may repeat 8-12 mg IV qd for multi-day chemo; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool
breakthrough nausea/vomiting, chemo-related (off-label)
- [12 mg IV qd]
- Info: search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool
nausea/vomiting prevention, XRT-related (off-label)
- [4 mg IV qd]
- Info: part of multi-drug regimen; give dose before each XRT
shock, unresponsive (off-label)
- [1-6 mg/kg/dose IV q2-6h prn]
- Start: 40 mg IV x1; Alt: 20 mg IV x1 then 3 mg/kg/24h IV; Info: dosing regimens vary; taper dose over 5-7 days to D/C
altitude sickness (off-label)
- [4 mg IM/IV q6h]
- Info: for high altitude cerebral edema, give loading dose 8 mg IM/IV x1
fetal lung maturation (off-label)
- [6 mg IM q12h x4 doses]
- Info: for pregnant patients 24 wk,0 days-33 wk,6 days gestation at high risk of preterm delivery; may consider for pregnant patients at least 23 wk,0 days gestation at high risk of preterm delivery within 7 days; may repeat x1 for pregnant patients <34wk,0 days gestation at imminent risk of preterm birth within 7 days and no prior antenatal steroid use within 14 days
malignant spinal cord compression (off-label)
- [16 mg/day IV divided q6h]
- Start: 10 mg IV x1; begin when neurological symptoms present; Info: taper dose gradually to D/C
ARDS, early (off-label)
- [20 mg IV qd x5 days, then 10 mg IV qd x5 days or until extubation]
- Start: within 24h of onset
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ: 4 mg per mL, 10 mg per mL
corticosteroid-responsive conditions
- [0.08-0.3 mg/kg/day IM/IV divided q6-12h]
- Info: dose, frequency varies by condition; taper dose gradually to D/C if high-dose or long-term use
adrenal insufficiency
- [0.03-0.3 mg/kg/day IM/IV divided q6-12h]
cerebral edema, acute
- [1-1.5 mg/kg/day IM/IV divided q4-6h]
- Start: 1-2 mg/kg/dose IM/IV x1; Max: 16 mg/day; Info: continue until symptoms subside, taper dose over 5-7 days to D/C; switch to PO when possible
COVID-19 (off-label)
- [0.15 mg/kg/dose IV qd for up to 10 days]
- Max: 6 mg/dose; Info: for hospitalized patients with suspected or confirmed severe COVID-19 requiring supplemental oxygen or mechanical ventilation; may use alternative glucocorticoids such as methylprednisolone 0.8 mg/kg/dose up to 32 mg/dose, prednisone 1 mg/kg/dose up to 40 mg/dose, or hydrocortisone 4 mg/kg/dose up to 160 mg/dose
croup (off-label)
- [0.6 mg/kg/dose IM/IV x1]
- Max: 20 mg/dose; Info: may use 0.15-0.3 mg/kg/dose IM/IV x1 for mild-moderate croup
chronic lung disease prevention (off-label)
- [premature neonates, 8-27 days old]
- Dose: 0.075 mg/kg/dose IV q12h x3 days, then 0.05 mg/kg/dose IV q12h x3 days, then 0.025 mg/kg/dose IV q12h x2 days, then 0.01 mg/kg/dose IV q12h x2 days; Info: for high-risk ventilator-dependent patients
airway edema (off-label)
- [0.5-2 mg/kg/day IM/IV divided q6h x4-6 doses after extubation]
- Start: 24h before extubation
nausea/vomiting prevention, chemo-related (off-label)
- [highly-emetogenic parenteral chemo]
- Dose: 6 mg/m^2/dose IV q6h; Info: part of multi-drug regimen
- [moderately-emetogenic parenteral chemo, BSA <0.6 m^2]
- Dose: 2 mg IV q12h; Info: part of multi-drug regimen
- [moderately-emetogenic parenteral chemo, BSA >0.6 m^2]
- Dose: 4 mg IV q12h; Info: part of multi-drug regimen
meningitis, bacterial (off-label)
- [>6 wk old]
- Dose: 0.6 mg/kg/day IV divided q6h x2 days; Start: with 1st dose antibiotic
malignant spinal cord compression (off-label)
- [0.25-0.5 mg/kg/dose IV q6h]
- Start: 1-2 mg/kg/dose IV x1; begin when neurological symptoms present; Max: 16 mg/dose; Info: taper dose gradually to D/C
altitude sickness (off-label)
- [0.15 mg/kg/dose IM/IV q6h]
- Max: 4 mg/dose
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- systemic fungal infection
- cerebral malaria
- amebiasis, active
- amebiasis, latent
- ocular HSV infection
- thrombocytopenic purpura (IM use)
- joint, unstable (intra-articular use)
- abrupt withdrawal (high-dose or long-term use)
- caution: hypersensitivity to corticosteroids
- caution: hypersensitivity to sulfites
- caution: epidural use
- caution: neonates
- caution: peds patients
- caution: adolescent patients
- caution: immunosuppressed patients
- caution: infection, active
- caution: infection risk
- caution: measles exposure (non-immune patients)
- caution: varicella exposure (non-immune patients)
- caution: HTN
- caution: pheochromocytoma risk
- caution: CHF
- caution: MI, recent
- caution: diabetes mellitus
- caution: PUD
- caution: ulcerative colitis
- caution: diverticulitis
- caution: intestinal anastomosis, recent
- caution: GI perforation risk
- caution: seizure disorder
- caution: myasthenia gravis
- caution: psychiatric disorder
- caution: thyroid disorder
- caution: osteoporosis
- caution: osteoporosis risk
- caution: tumor lysis syndrome risk, high
- caution: renal impairment
- caution: cirrhosis
Drug Interactions .
Overview
dexamethasone
corticosteroid
- CYP3A4 substrate
- 11-beta-hydroxysteroid dehydrogenase type 1 substrate
- CYP3A4 inducer, weak
- affects growth hormone diagnostic test results
- binds to anion exchange resin/polymer
- corticosteroid
- GI mucosal injury/bleeding risk
- hyperammonemia
- hyperglycemic effects
- hypernatremia
- hypertensive effects
- hypokalemia
- immunomodulatory effects
- interferes w/ ACTH analog test
- lowers seizure threshold
- thrombogenic effects
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- desmopressin
- influenza nasal vaccine, live
- iohexol
- iopamidol
- measles/mumps/rubella vaccine, live
- mifepristone
- ranolazine
- rilpivirine
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- adagrasib
- afamitresgene autoleucel
- aldesleukin
- amifampridine
- amphotericin
- apalutamide
- arsenic trioxide
- artemether/lumefantrine
- astragalus
- atazanavir
- axicabtagene ciloleucel
- betamethasone
- brexucabtagene autoleucel
- budesonide
- butalbital
- carbamazepine
- ceritinib
- chloramphenicol
- cholestyramine
- ciltacabtagene autoleucel
- cladribine oral
- clarithromycin
- cobicistat
- codeine
- cortisone
- darunavir
- deflazacort
- desogestrel (contraceptive)
- dexamethasone
- dienogest (contraceptive)
- dolutegravir
- drospirenone (contraceptive)
- elvitegravir
- encorafenib
- enzalutamide
- epinephrine inhaled
- estradiol (contraceptive)
- ethinyl estradiol (contraceptive)
- ethynodiol (contraceptive)
- etonogestrel (contraceptive)
- etravirine
- fentanyl
- fosphenytoin
- furosemide
- hydrocortisone
- idecabtagene vicleucel
- idelalisib
- itraconazole
- ivosidenib
- ketoconazole
- levoketoconazole
- levonorgestrel (contraceptive)
- levonorgestrel (post-coital contraceptive)
- lifileucel
- lisocabtagene maraleucel
- lonafarnib
- lopinavir/ritonavir
- lumacaftor/ivacaftor
- lumateperone
- lutetium Lu 177 dotatate
- macimorelin
- mavacamten
- medroxyprogesterone (contraceptive)
- meperidine
- methylprednisolone
- midodrine
- mitotane
- natalizumab
- nefazodone
- nelfinavir
- nevirapine
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norgestimate (contraceptive)
- norgestrel (contraceptive)
- obecabtagene autoleucel
- oliceridine
- oxycodone
- pentobarbital
- phenobarbital
- phenytoin
- pimecrolimus topical
- posaconazole
- prednisolone
- prednisone
- primidone
- rabies vaccine
- ribociclib
- rifabutin
- rifampin
- ritonavir
- segesterone (contraceptive)
- St. John's wort
- tipranavir
- tisagenlecleucel
- tramadol
- tranexamic acid
- tucatinib
- ulipristal (post-coital contraceptive)
- vaccinia immune globulin
- vamorolone
- voriconazole
- zuranolone
Monitor/Modify Tx
- abemaciclib
- abiraterone acetate
- abrocitinib
- acarbose
- acebutolol
- acetazolamide
- afatinib
- aficamten
- aflibercept
- albuterol
- albuterol inhaled
- alendronate
- aliskiren
- almotriptan
- aloe
- alogliptin
- amiloride
- aminocaproic acid
- amlodipine
- amphetamine
- angiotensin II
- anthrax immune globulin
- anthrax vaccine
- anti-inhibitor coagulant complex
- antihemophilic factor (factor VIII)/von Willebrand factor complex
- aprepitant
- aprocitentan
- arformoterol inhaled
- armodafinil
- asciminib
- asparaginase
- aspirin
- atenolol
- atidarsagene autotemcel
- atogepant
- atomoxetine
- atropine ophthalmic
- avatrombopag
- axitinib
- azilsartan medoxomil
- baricitinib
- bazedoxifene
- bempedoic acid
- benazepril
- benzphetamine
- betaxolol
- bevacizumab
- bexagliflozin
- binimetinib
- bismuth subsalicylate
- bisoprolol
- botulism immune globulin
- brentuximab vedotin
- brigatinib
- brolucizumab
- bromocriptine
- bumetanide
- buprenorphine
- bupropion
- C1 esterase inhibitor
- cabazitaxel
- cabozantinib
- caffeine
- caffeine citrate
- calaspargase
- canagliflozin
- candesartan cilexetil
- cannabis
- captopril
- carfilzomib
- carglumic acid
- carvedilol
- caspofungin
- celecoxib
- cetuximab
- chikungunya vaccine
- chlorothiazide
- chlorthalidone
- chorionic gonadotropin
- cinacalcet
- cisplatin
- clevidipine
- clonidine
- clozapine
- coagulation factor IX
- coagulation factor VIIa
- coagulation factor XIII A-subunit
- cocaine
- colesevelam
- colestipol
- concizumab
- copanlisib
- corticotropin
- cosyntropin
- COVID-19 vaccine
- crizotinib
- cyclophosphamide
- cyclosporine
- cysteamine
- cytomegalovirus immune globulin
- danazol
- dapagliflozin
- darbepoetin alfa
- decitabine
- deferasirox
- desvenlafaxine
- deuruxolitinib
- dexmethylphenidate
- dextroamphetamine
- dichlorphenamide
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- digoxin
- dihydroergotamine
- diltiazem
- dimethyl fumarate
- dinutuximab
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- diroximel fumarate
- disopyramide
- dobutamine
- donepezil
- dopamine
- doxapram
- doxazosin
- dronabinol
- drospirenone (hormone replacement)
- droxidopa
- dulaglutide
- ebola vaccine, live
- eletriptan
- eltrombopag
- emapalumab
- empagliflozin
- enalapril
- enalaprilat
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- epirubicin
- eplerenone
- epoetin alfa
- eptinezumab
- erenumab
- ergotamine
- erlotinib
- ertugliflozin
- esketamine
- esmolol
- estetrol (contraceptive)
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- etelcalcetide
- ethacrynic acid
- ethanol (alcoholic beverage)
- ethinyl estradiol (hormone replacement)
- etodolac
- etrasimod
- everolimus
- exenatide
- factor XIII concentrate
- faricimab
- fedratinib
- felodipine
- fenfluramine
- fenofibrate
- fenofibric acid
- fenoldopam
- fenoprofen
- fibrinogen (human)
- fingolimod
- fitusiran
- fludrocortisone
- flurbiprofen
- follitropin
- formoterol inhaled
- fosaprepitant
- foscarnet
- fosfomycin injection
- fosinopril
- fostamatinib
- fremanezumab
- frovatriptan
- fruquintinib
- galantamine
- galcanezumab
- gefitinib
- glimepiride
- glipizide
- glyburide
- glycerol phenylbutyrate
- guanfacine
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B immune globulin
- hepatitis B vaccine
- hoodia
- human papillomavirus vaccine
- hydralazine
- hydrochlorothiazide
- hydroxocobalamin IV
- ibandronate
- ibrutinib
- ibuprofen
- ibuprofen lysine
- ifosfamide
- imatinib
- immune globulin
- indapamide
- indomethacin
- influenza H5N1 vaccine
- influenza vaccine
- insulin
- iodixanol
- iomeprol
- iopromide
- iothalamate meglumine
- ioversol
- irbesartan
- isoproterenol
- isradipine
- Japanese encephalitis vaccine
- ketamine
- ketoprofen
- ketorolac
- labetalol
- lanreotide
- lanthanum
- lazertinib
- leflunomide
- lenalidomide
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- levonorgestrel (hormone replacement)
- licorice
- linagliptin
- liraglutide
- lisdexamfetamine
- lisinopril
- lixisenatide
- lorlatinib
- losartan
- luspatercept
- lusutrombopag
- magnesium citrate
- magnesium salicylate
- mannitol
- meclofenamate
- medroxyprogesterone (hormone replacement)
- mefenamic acid
- megestrol
- meloxicam
- meningococcal vaccine
- menotropins
- metformin
- methamphetamine
- methazolamide
- methotrexate
- methoxy polyethylene glycol-epoetin beta
- methyldopa
- methylergonovine
- methylphenidate
- methyltestosterone
- metoclopramide
- metolazone
- metoprolol
- metyrapone
- miglitol
- milnacipran
- minoxidil
- mirabegron
- mitapivat
- mitomycin
- modafinil
- moexipril
- momelotinib
- monomethyl fumarate
- motixafortide
- mycophenolate mofetil
- mycophenolic acid
- nabumetone
- nadolol
- naproxen
- naratriptan
- nateglinide
- naxitamab
- nebivolol
- necitumumab
- neostigmine
- netupitant
- nicardipine
- nifedipine
- nilotinib
- nimodipine
- nintedanib
- niraparib
- nisoldipine
- norepinephrine
- norethindrone (hormone replacement)
- obinutuzumab
- olaparib
- olmesartan medoxomil
- olodaterol inhaled
- osilodrostat
- ospemifene
- oxaprozin
- oxymetazoline nasal
- oxytocin
- ozanimod
- pacritinib
- pamidronate
- panitumumab
- pazopanib
- pegaspargase
- perindopril
- pexidartinib
- phendimetrazine
- phenoxybenzamine
- phentermine
- phentolamine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pindolol
- pioglitazone
- piroxicam
- pneumococcal vaccine
- poliovirus vaccine
- polyethylene glycol
- polyethylene glycol/electrolytes
- pomalidomide
- ponatinib
- ponesimod
- porfimer
- pralsetinib
- pramlintide
- prazosin
- progesterone (hormone replacement)
- progesterone vaginal (hormone replacement)
- propranolol
- prothrombin complex concentrate (human)
- pseudoephedrine
- pyridostigmine
- quetiapine
- quinapril
- quinidine (antiarrhythmic)
- raloxifene
- ramipril
- ramucirumab
- ranibizumab
- regorafenib
- repaglinide
- respiratory syncytial virus vaccine
- Rho(D) immune globulin
- rimegepant
- ripretinib
- risedronate
- ritlecitinib
- rivastigmine
- rizatriptan
- romiplostim
- ropinirole
- rosiglitazone
- rotigotine transdermal
- ruxolitinib
- ruxolitinib topical
- sacituzumab govitecan
- salmeterol inhaled
- salsalate
- saxagliptin
- selinexor
- selpercatinib
- semaglutide
- siponimod
- sipuleucel-T
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- smallpox/mpox vaccine, live
- sodium acid phosphate
- sodium benzoate
- sodium phenylacetate
- sodium phenylbutyrate
- sodium polystyrene sulfonate
- sodium tetradecyl sulfate
- sodium thiosulfate
- solriamfetol
- somapacitan
- somatrogon
- somatropin
- sorafenib
- sotatercept
- spironolactone
- sulfate bowel prep
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tafasitamab
- tagraxofusp
- tamoxifen
- telmisartan
- temsirolimus
- terazosin
- terbutaline
- teriflunomide
- tesamorelin
- testosterone
- thalidomide
- tiagabine
- tick-borne encephalitis vaccine
- timolol
- tirzepatide
- tivozanib
- tocilizumab
- tofacitinib
- tolmetin
- topiramate
- toremifene
- torsemide
- trametinib
- trandolapril
- tretinoin
- triamcinolone
- triamterene
- typhoid vaccine
- ubrogepant
- upadacitinib
- vadadustat
- valoctocogene roxaparvovec
- valsartan
- vandetanib
- varicella zoster immune globulin
- vasopressin
- venlafaxine
- verapamil
- vilanterol inhaled
- viloxazine
- voclosporin
- von Willebrand factor
- vorinostat
- warfarin
- willow bark
- yohimbe
- zavegepant
- ziv-aflibercept
- zolmitriptan
- zonisamide
- zopapogene imadenovec
Caution Advised
- abatacept
- acalabrutinib
- adalimumab
- albendazole
- alemtuzumab
- alfentanil
- alprazolam
- amiodarone
- anakinra
- anifrolumab
- anti-thymocyte globulin
- atorvastatin
- avacopan
- avapritinib
- azacitidine
- azathioprine
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- belinostat
- bendamustine
- berotralstat
- bictegravir
- bimekizumab
- blinatumomab
- bortezomib
- bosentan
- bosutinib
- brivaracetam
- brodalumab
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- buspirone
- busulfan
- canakinumab
- cannabidiol
- capivasertib
- capmatinib
- carboplatin
- carmustine
- cat's claw
- cenobamate
- certolizumab pegol
- chlorambucil
- ciprofloxacin
- cladribine injection
- clobazam
- clobetasol ophthalmic
- clofarabine
- clofazimine
- clomipramine
- clonazepam
- clorazepate
- cobimetinib
- coccidioides immitis skin test antigen
- conivaptan
- crovalimab
- cytarabine
- dabrafenib
- dactinomycin
- danicopan
- daratumumab
- daridorexant
- dasatinib
- daunorubicin
- defactinib
- delgocitinib topical
- deucravacitinib
- dexamethasone ophthalmic
- diazepam
- difluprednate ophthalmic
- docetaxel
- doravirine
- dordaviprone
- doxorubicin
- dronedarone
- dupilumab
- duvelisib
- echinacea
- eculizumab
- efavirenz
- efgartigimod alfa
- elacestrant
- elbasvir
- eleuthero
- elexacaftor/tezacaftor/ivacaftor
- eliglustat
- elivaldogene autotemcel
- elotuzumab
- elranatamab
- entrectinib
- epcoritamab
- erdafitinib
- eribulin
- erythromycin
- eslicarbazepine acetate
- etanercept
- ethosuximide
- etoposide
- etuvetidigene autotemcel
- felbamate
- fexinidazole
- finerenone
- floxuridine
- fluconazole
- fludarabine
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- fosamprenavir
- gabapentin
- ganaxolone
- gemtuzumab ozogamicin
- gepirone
- gilteritinib
- ginseng, Asian
- glasdegib
- glecaprevir
- glofitamab
- golimumab
- grapefruit
- grazoprevir
- guselkumab
- haloperidol
- hydrocortisone ophthalmic
- hydroxychloroquine
- hydroxyurea
- ibritumomab tiuxetan
- icotrokinra
- idarubicin
- inebilizumab
- infliximab
- inotuzumab ozogamicin
- iptacopan
- irinotecan
- isatuximab
- isavuconazonium
- isoniazid
- isotretinoin
- istradefylline
- ivacaftor
- ixabepilone
- ixekizumab
- lacosamide
- lamotrigine
- lapatinib
- larotrectinib
- lebrikizumab
- lefamulin
- lenacapavir
- leniolisib
- letermovir
- levetiracetam
- levofloxacin
- levonorgestrel intrauterine device (contraceptive)
- linvoseltamab
- lomustine
- loncastuximab tesirine
- lorazepam
- loteprednol ophthalmic
- lurasidone
- lymphocyte immune globulin, anti-thymocyte globulin
- macitentan
- maraviroc
- melphalan
- mercaptopurine
- methacholine inhaled
- methadone
- methsuximide
- midazolam
- midostaurin
- mirikizumab
- mitoxantrone
- mobocertinib
- mogamulizumab
- mometasone implant
- mometasone inhaled
- mometasone nasal
- mosunetuzumab
- moxifloxacin
- nadofaragene firadenovec intravesical
- nafarelin nasal
- nafcillin
- naldemedine
- naloxegol
- narsoplimab
- nelarabine
- neratinib
- nipocalimab
- nirmatrelvir
- nirogacestat
- ocrelizumab
- ofatumumab
- ofloxacin
- olutasidenib
- oxaliplatin
- oxcarbazepine
- paclitaxel
- palbociclib
- pegcetacoplan
- pemigatinib
- pentostatin
- perampanel
- pimavanserin
- pirtobrutinib
- polatuzumab vedotin
- pozelimab
- praziquantel
- prednisolone ophthalmic
- pregabalin
- pretomanid
- procarbazine
- promethazine
- quinine
- quizartinib
- ravulizumab
- repotrectinib
- rifapentine
- rilonacept
- rilzabrutinib
- risankizumab
- rituximab
- roflumilast
- romidepsin
- ropeginterferon alfa-2b
- rozanolixizumab
- rufinamide
- samidorphan
- sarilumab
- satralizumab
- sebetralstat
- secukinumab
- selumetinib
- sibeprenlimab
- siltuximab
- simvastatin
- sodium picosulfate
- sonidegib
- sotorasib
- spesolimab
- stiripentol
- sulfasalazine
- sutimlimab
- suzetrigine
- tadalafil
- taletrectinib
- talquetamab
- tarlatamab
- tasimelteon
- tazemetostat
- teclistamab
- temozolomide
- teplizumab
- teriparatide
- tezacaftor/ivacaftor
- tezepelumab
- thioguanine
- thiotepa
- ticagrelor
- tildrakizumab
- tolvaptan
- topotecan
- trabectedin
- tralokinumab
- treosulfan
- tuberculin purified protein derivative
- ublituximab
- ustekinumab
- valproic acid
- vanzacaftor/tezacaftor/deutivacaftor
- vedolizumab
- velpatasvir
- venetoclax
- vigabatrin
- vilobelimab
- vinblastine
- vincristine
- vinorelbine
- vonoprazan
- voxilaprevir
- zanubrutinib
- ziftomenib
- zilucoplan
Adverse Reactions .
Serious Reactions
- anaphylaxis
- adrenal insufficiency
- steroid psychosis
- steroid myopathy
- Cushing syndrome
- infection
- diabetes mellitus
- pseudotumor cerebri
- ICP incr.
- seizures
- tumor lysis syndrome
- hypokalemic alkalosis
- HTN
- CHF
- pancreatitis
- GI perforation
- PUD
- exophthalmos
- osteonecrosis
- tendon rupture
- osteoporosis (long-term use)
- glaucoma (long-term use)
- cataracts (long-term use)
- immunosuppression (long-term use)
- Kaposi sarcoma (long-term use)
- withdrawal symptoms if abrupt D/C (high-dose or long-term use)
- growth suppression (long-term use in peds patients)
Common Reactions
- Cushingoid appearance
- hirsutism
- weight gain
- erythema
- abdominal discomfort
- appetite changes
- emotional lability
- urticaria
- rash
- nausea
- vomiting
- sodium retention
- fluid retention
- hypokalemia
- BP elevated
- edema
- diaphoresis
- muscle atrophy
- impaired wound healing (long-term use)
- skin atrophy (long-term use)
- petechiae
- ecchymosis
- skin pigmentation abnormality
- acne
- headache
- dizziness
- vertigo
- insomnia
- depression
- anxiety
- glucose intolerance
- Cushing syndrome (long-term use)
- menstrual irregularities
- IOP incr.
- post-injection flare (intra-articular use)
Safety/Monitoring .
Monitoring Parameters
electrolytes; BP; weight; TB, HBV screening at baseline if prolonged tx; 2h postprandial glucose, height (peds), chest x-ray if prolonged tx; ophthalmic exam if tx >6wk; BMD if prolonged tx or in patients 65 yo and older; consider upper GI x-ray if PUD history or significant dyspepsia
Look/Sound-Alike Drug Names
dexamethasone confused with: betamethasone; dexmedetomidine; doxazosin; methadone; methylPREDNISolone
Pregnancy/Lactation .
Pregnancy
Clinical Summary
Fetal Lung Maturation Use: may use during pregnancy; possible risk of orofacial cleft based on conflicting human data and animal data; possible risk of low birth wt and preterm birth based on limited human data; possible risk of fetal adrenal suppression based on drug's mechanism of action
All Other Uses: weigh risk/benefit during pregnancy, especially in 1st trimester or with long-term use; possible risk of orofacial cleft based on conflicting human data and animal data; possible risk of low birth wt and preterm birth based on limited human data; possible risk of fetal adrenal suppression based on drug's mechanism of action
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available, though possible risk of suppressed infant growth and endogenous steroid production based on drug's mechanism of action; no human data available, though possible transient decr. milk production based on limited human data with high-dose depot steroid injection
Pharmacology .
Metabolism: for dexamethasone: liver; CYP450: 3A4 substrate
Excretion: for dexamethasone: urine primarily; Half-life: 1.9-2.3h
Subclass: Antiemetics, Corticosteroids ; Corticosteroids, Localized ; Corticosteroids, Systemic ; Osteoarthritis, Local Agents
Mechanism of Action
for dexamethasone: exact mechanism of anti-inflammatory action unknown; inhibits multiple inflammatory cytokines; produces multiple glucocorticoid and mineralocorticoid effects
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: generic
DEA/FDA: Rx
Retail Price
Estimated prices only. For current pricing, visit GoodRx.
injectable solution:
- 10 mg/mL (1 vial, 10 mL): $10.00
injectable solution:
- 4 mg/mL (1 vial, 1 mL): $5.00
- 10 mg/mL (1 vial, 1 mL): $5.00
injectable solution:
- 4 mg/mL (6 vial, 5 mL): $12.00
injectable solution:
- 4 mg/mL (1 vial, 30 mL): $12.00
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