Dexamethasone

Generic Details

Generic Name

Dexamethasone

Other Names

  • Decadron
  • DexPak

Drug Class

  • Corticosteroid

Chemical Formula

C22H29FO5

Molecular Weight

392.461 g/mol

Mechanism of Action

  • Dexamethasone acts as a potent anti-inflammatory and immunosuppressant drug by binding to specific cytoplasmic receptors. It then enters the cell nucleus and modifies gene transcription, resulting in the synthesis of anti-inflammatory proteins and suppression of inflammatory mediators.

Indications

  • Inflammatory conditions such as arthritis, allergic disorders, asthma, skin conditions, certain cancers, autoimmune diseases, and various other conditions where suppression of the immune system is necessary.

Common Dosage Forms

  • Tablet
  • Injection
  • Eye/Ear Drops
  • Topical Cream/Ointment

Typical Dosage

  • 0.5-9 mg daily, depending on the condition being treated

Pediatric Dosage

  • Dosage varies based on weight and condition, should be determined by a healthcare provider

Geriatric Dosage

  • Lower doses may be required in elderly patients

Side Effects

  • Common: insomnia, increased appetite, indigestion, mood changes. Rare but serious: high blood sugar, osteoporosis, glaucoma, adrenal suppression.

Contraindications

  • Systemic fungal infections, live vaccines, hypersensitivity to dexamethasone or other corticosteroids.

Pregnancy Category

  • Category C - risks cannot be ruled out but may be acceptable if benefits outweigh risks.

Lactation Safety

  • Considered compatible with breastfeeding in small doses, monitor for infant growth and development.

Drug Interactions

  • Interacts with a wide range of medications including anticoagulants, antidiabetic drugs, certain antibiotics, and anticonvulsants. Consult a healthcare provider for specific interactions.

Overdose Symptoms

  • Severe headache, swelling, rapid weight gain, shortness of breath, vision problems, seizures.

Antidote for Overdose

  • No specific antidote, treatment is symptomatic and supportive.

Storage Conditions

  • Store at room temperature away from moisture and heat.

Pharmacokinetics

  • Absorption: Rapid and complete when administered orally or intramuscularly.
  • Distribution: Widely distributed in the body, crosses the blood-brain barrier, and enters breast milk.
  • Metabolism: Primarily hepatic metabolism.
  • Excretion: Mainly via urine as metabolites.

Precautions

  • Monitor for signs of infection, hyperglycemia, osteoporosis, and mental status changes. Avoid sudden discontinuation of the medication.

Warnings

  • Long-term use can lead to serious side effects. Do not stop abruptly without medical advice. May mask signs of infection.

Others

  • Dexamethasone is also sometimes used in emergency settings for its anti-inflammatory properties, such as in the management of severe COVID-19 cases.