Dexamethasone Injection (Baycadron, Dexamethasone Intensol)

What is dexamethasone, and how does it work (mechanism of action)?

Dexamethasone is a synthetic (created by a chemical processes) corticosteroid hormone like prednisone, betamethasone, and triamcinolone. More specifically, dexamethasone is a glucocorticoid hormone, which means that it has anti-inflammatory effects, as well as the ability to affect blood glucose use, fat breakdown, and bone development depending on where it binds in the body. Dexamethasone reduces inflammation by preventing immune cells, such as neutrophils, from migrating to the site of action, reducing the release of inflammatory signals, as well as decreasing how well substances may pass in and out of the blood vessels. It also has anti-vomiting properties (antiemetic). The FDA approved dexamethasone in 1958.

What brand names are available for dexamethasone?

Baycadron, Decadron (Discontinued), Dexamethasone Intensol

Is dexamethasone available as a generic drug?

Yes

Do I need a prescription for dexamethasone?

Yes

What are the side effects of dexamethasone?

Glucocorticoids are associated with a variety of side effects based on dose and duration of therapy. Dexamethasone may commonly cause an increase in blood sugar, appetite, insomnia, acne, and nervousness or emotional instability (depression or euphoria). It may also cause impaired wound healing, high blood pressure, raised pressure in the eye, and cataracts. Serious side effects include risk of cardiomyopathy, induced diabetes mellitus, pancreatitis, osteoporosis (bone loss), and conjunctival hemorrhage.

What is the dosage for dexamethasone?

The dose for dexamethasone is based on whether is administered intravenously or by intramuscular injection as well as the severity of the condition requiring treatment. Consult the official prescribing information for dosing regimens.

Which drugs or supplements interact with dexamethasone?

Dexamethasone may decrease levels of drugs that are broken down by liver enzymes. Examples include abiraterone, apixaban (Elquis), aripiprazole (Abilify), boceprevir (Victrelis), dronedarone (Multaq), and quetiapine (Seroquel, Seroquel XR) . Consider increasing the dose of the drug or avoiding this combination altogether. Adverse effects, such as bone marrow suppression, are enhanced when dexamethasone is used with other immunosuppressants such as leflunomide (Arava) and tacrolimus (Prograf). Dosing schedules should be evaluated and alternative therapies should be considered. Live vaccines should also be avoided because dexamethasone reduces immune function.

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Is dexamethasone safe to take if I’m pregnant or breastfeeding?

Category C; animal reproduction studies show adverse events with corticosteroid use. Dexamethasone has the potential to cross the placenta to affect fetal growth. Lowest effective doses should be used for the shortest duration of time, with avoidance of dosing in the first trimester to help avoid oral clefts. Low adrenal function may also develop in newborns if corticosteroid exposure occurs while in the womb.

Corticosteroids are excreted in breast milk, and, therefore should be used cautiously by nursing mothers. If dexamethasone is absolutely needed and breastfeeding cannot be stopped, a separation of 4 hours between therapy and breastfeeding is recommended to decrease exposure of the infant to the corticosteroid.

What else should I know about dexamethasone?

What preparations of dexamethasone-injectable are available?

Injection solution: 4 mg/mL and 10 mg/ml; 1 mg/ml

How should I keep dexamethasone-injectable stored?

Dexamethasone should be stored as intact vials at room temperature, between 20 C to 25 C (68 F to 77 F). Protect from light and heat. Do not freeze. If diluted, use within 24 hours.