Dexamethasone should be used with caution in: children, the elderly, patients with a history of or family history of mental illness including depression, mental illness that was made worse be previous steroid medicine, renal disease, liver disease, heart failure, heart attack, diabetes or family history of diabetes, glaucoma (an eye condition) or family history of glaucoma, osteoporosis (a bone condition), high blood pressure, fitting (epilepsy), muscle weakness (myasthenia gravis), migraine, muscle weakness with dexamethasone or other steroids in the past, infection with parasites, stunted growth, Cushing's syndrome, head injury, stroke, patients who have been vaccinated against measles or chickenpox, underactive thyroid gland, history of tuberculosis (TB), herpes simplex infection of the eye, fungal infection of the eye, cold sores or genital herpes, asthma.
It should not be used in: patients with an allergy to dexamethasone or to any other ingredients contained in the medicine or an allergy to other corticosteroids, infection that affects the whole body, infection of a joint, unstable joints where joints such as the knee suddenly give way, ulcers of the stomach or duodenum, infection with tropical worms, fungal, viral or other infections of the eye, users of soft contact lenses (applies to eye drops only), patients vaccinated with a live virus.
Also see list of precautions and interactions
Do not store above 25ºC. Protect from light.
What is it used for?
- Dexamethasone is used to increase the amount of corticosteroid in your body. Corticosteroids occur naturally in your body and help you to remain healthy and well. Increasing the amount of corticosteroid in your body is a way of treating a number of different conditions which cause inflammation in the body.
- It is a glucocorticoid, sometimes known as a steroid or corticosteroid.
- It is used to reduce pain, swelling and inflammation and to treat a number of different diseases of the immune system.
- In general this drug is used to treat hormonal conditions when the body does not produce enough of its own steroids, and to treat a range of immune and allergic conditions.
- Benefits of being on this drug can include relief from pain, inflammation and swelling and associated symptoms.
Listed below are the typical uses of dexamethasone.
- Severe allergic reactions (anaphylactic shock, angioedema)
- Asthma attacks
- Other lung disorders including chronic asthma, pneumonitis and chronic obstructive pulmonary disease
- Inflammation of the brain (cerebral oedema) associated with brain tumours
- Worsening of multiple sclerosis
- Eye disorders including inflammation of the eye
- The kidney condition nephrotic syndrome
- Inflammatory bowel disease (ulcerative colitis, Crohn's disease)
- Inflammatory disease of the joints and soft tissue such as rheumatoid arthritis,
- Polymyalgia rheumatica and polyarteritis nodosa (conditions associated with inflammation of the arteries)
- Blood disorders including leukaemia, myeloma, idiopathic thrombocytopenic purpura (ITP), haemolytic anaemia
- Skin disorders including pemphigis vulgaris and erythema multiforme
- Hepatitis (liver disease)
- Polymyositis (inflammation of many muscles)
- Cancers including leukaemia, malignant lymphoma and breast cancer
- Severe shock caused by surgery, accidental trauma or severe infection
- The inherited condition congenital adrenal hyperplasia
- As an immunosuppressant in patients who have undergone an organ transplant
- To prevent sickness after chemotherapy
On occasion your doctor may prescribe this medicine to treat a condition not on the above list. Such conditions are listed below.
- As a diagnostic test for diseases which may have an effect on the natural production of corticosteroids such as Cushing's syndrome
HOW TO USE/TAKE
How often do I take it?
- Take this medication in the tablet form by mouth usually daily in divided doses, with or after food. Do not crush or chew the tablets. Other dexamethasone formulations (eye drops, injection) may need to be taken or used more or less frequently, as indicated by your doctor or pharmacist. Make sure that you carefully read the patient information leaflet provided with your medicine so that you know exactly how and how often to take or use your dexamethasone medicine. If you are unsure consult your doctor or pharmacist.
- If you take dexamethasone for more than 3 weeks, you should be given a 'Steroid Treatment Card' which provides important details about your treatment. This card should be carried with you at all times and shown to any doctor or nurse treating you.
- Use this medication regularly in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
- It may take some weeks before the full benefit of this drug takes effect.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- Keep away from people who have chickenpox, shingles or measles. If you do come into contact with somebody with chickenpox or shingles, contact your doctor straightaway. Dexamethasone is unlikely to affect your ability to drive or operate machinery. However, dexamethasone eye drops may cause stinging or sensitivity to bright light. If your sight is affected in any way after using dexamethasone eye drops you should not drive or operate machinery. Consult your doctor or pharmacist for more details.
When can I stop?
- It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop. If you are on long term dexamethasone treatment, the importance of not suddenly stopping treatment is explained in more detail in your steroid treatment card.
DEXAMETHASONE SIDE EFFECTS
- Stomach problems which may cause perforation of bleeding
- Increased appetite
- Feeling or being sick
- Severe pain in the back or tummy (this may be a symptom of an inflamed pancreas)
- Water retention
- High blood pressure
- Blood clots
- Thinning of the bones (osteoporosis)
- Recurring infections that get worse each time such as thrush or chicken pox
- Skin problems
- Eye problems
- Irregular or missing periods
- Stunted growth in children and teenagers
- Swelling of the face (moon face)
- Worsening of diabetes
- Increased body hair
- Weight gain
- Worsening of epilepsy (fitting)
- Unusual headaches with eyesight problems
- Difficulty sleeping
- Mood swings
- Feeling depressed
If any of these persist or you consider them severe then inform your doctor as soon as possible. Further information about other side effects can be found in the patient information leaflet.
Tell your doctor immediately if you develop any of the following symptoms:
- Mental health problems such as feeling depressed (including thinking about suicide), feeling high (mania) or moods that go up and down, feeling anxious, difficulty sleeping, difficulty thinking, feeling confused and losing your memory, feeling, seeing or hearing things which do not exist, having strange or frightening thoughts, changing how you act or having feelings of being alone.
- Any kind of skin rash, itching of the skin or difficulty breathing (this may be a sign of an allergic reaction)
- Narrowing of your field of vision, cloudy vision, or worsening of viral or fungal infections after applying dexamethasone eye drops
- Stinging or burning of the eye after applying dexamethasone eye drops
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.
Before taking dexamethasone, tell your doctor or pharmacist if you are allergic to it; or to other steroids (corticosteroids or glucocorticoids); or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of: an allergy to dexamethasone or to any other ingredients contained in the medicine or an allergy to other corticosteroids, an infection that affects the whole body, infection of a joint, unstable joints where joints such as the knee suddenly give way, ulcers of the stomach or duodenum, infection with tropical worms, fungal, viral or other infections of the eye, you use soft contact lenses (applies to eye drops only), have been vaccinated with a live virus.
Whilst taking prednisolone, keep away from people who have chicken-pox or shingles, if you have never had them, as they could affect you severely. If you do come into contact with someone with chicken pox or shingles then see your doctor immediately.
Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following: a history of or family history of mental illness including depression, mental illness that was made worse be previous steroid medicine, renal disease, liver disease, heart failure, heart attack, diabetes or family history of diabetes, glaucoma (an eye condition) or family history of glaucoma, osteoporosis (a bone condition), high blood pressure, fitting (epilepsy), muscle weakness (myasthenia gravis), migraine, muscle weakness with dexamethasone or other steroids in the past, infection with parasites, stunted growth, Cushing's syndrome, head injury, stroke, previous vaccination against measles or chickenpox, underactive thyroid gland, history of tuberculosis (TB), herpes simplex infection of the eye, fungal infection of the eye, cold sores or genital herpes, asthma.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- Alcohol intake is not known to affect dexamethasone.
The elderly: dexamethasone should be used with caution in the elderly as it may be associated with more serious side effects than in younger people.
Pregnancy and breastfeeding - please ensure you read the detailed information below
Dexamethasone should only be taken in pregnancy if considered necessary by your doctor.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Dexamethasone may pass into breast milk. It should only be used in breastfeeding if considered necessary by your doctor.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- Medicines that thin the blood such as warfarin
- Medicines for diabetes including insulin
- Medicines for high blood pressure
- Medicines for epilepsy (fitting)
- Medicines for fungal infections such as amphotericin
- Medicines for viral infections
- Medicines to lower potassium levels in the blood
- Cardiac glycosides such as digoxin
- Calcium salts
- Water tablets (diuretics)
- Medicines containing oestrogen or progestogens (including the oral contraceptive pill)
- Muscle relaxants
- Sodium benzoate
- Sodium phenylbutyrate
- Non-steroidal anti-inflammatory drugs (NSAIDs)
This information does not contain all possible interactions. Therefore, before using dexamethasone, tell your doctor or pharmacist of all the products you use.
An overdose of dexamethasone may cause swelling of the throat, skin reaction and difficulty breathing. Tell your doctor straightaway if you think you have taken too much dexamethasone.
If you apply too many dexamethasone eye drops to your eye, it can be washed out of your eye with warm water. If dexamethasone eye drops are accidentally swallowed this is unlikely to cause any serious problems
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of dexamethasone or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.