dexamethasone at a glance
Medicine class
Long-acting synthetic glucocorticoid corticosteroid
Main effect
Reduces inflammation, allergic responses and immune activity
Forms covered
Standard oral tablets and an eye-drop suspension
Important precaution
Do not stop systemic treatment suddenly without prescriber advice
What is dexamethasone used for?
Uses of the selected products include:
Systemic treatment of inflammatory, allergic, immune-mediated and other glucocorticoid-responsive disorders.
Adjunctive control of cerebral oedema.
Treatment of COVID-19 in eligible hospital patients requiring supplemental oxygen.
Selected inflammation of the conjunctiva, cornea or anterior eye segment.
Inflammation after eye surgery, corneal grafting or specified corneal injuries.
How does dexamethasone work?
Dexamethasone binds to glucocorticoid receptors inside cells and changes gene activity involved in inflammation and immunity. This reduces inflammatory chemicals, swelling and immune-cell activity.
dexamethasone preparations and strengths
Tablet
Route: Oral
Strengths: 500 micrograms, 0.5 mg, 1 mg, 2 mg, 4 mg
How to take dexamethasone
Follow the prescription and product leaflet because administration differs by formulation.
Take oral dexamethasone with or just after food; swallow standard tablets with water.
Do not stop systemic treatment suddenly unless a clinician tells you to.
Shake the eye-drop suspension and avoid touching the dropper tip.
After an eye drop, gently close the eyelid or press the inner corner of the eye.
Separate other eye products and apply eye ointment last. Avoid contact lenses during active inflammation unless advised otherwise.
dexamethasone side effects
Common or expected effects
- Indigestion or stomach discomfort
- Sleep disturbance
- Mood changes, irritability or anxiety
- Increased appetite and weight gain
- Raised blood glucose
- Eye irritation, discomfort or blurred vision with eye drops
Get urgent medical advice
- Severe or masked infection
- Suicidal thoughts, mania, hallucinations or marked confusion
- Adrenal suppression or acute adrenal insufficiency
- Gastrointestinal bleeding or pancreatitis
- Severe allergic reaction
- Raised eye pressure, glaucoma, cataract, corneal damage or worsening eye infection
dexamethasone in pregnancy
Dexamethasone may be used when expected benefit justifies risk, although another corticosteroid may sometimes be preferred. Repeated or prolonged systemic exposure may prompt fetal-growth monitoring. Maxidex is not recommended unless clinically needed. Do not stop prescribed treatment without speaking to the prescriber.
dexamethasone while breastfeeding
Dexamethasone can be used cautiously while breastfeeding a healthy, full-term infant, though alternatives with more evidence may be preferred. Greater systemic exposure may require monitoring of infant feeding, growth and adrenal function. Product-specific assessment is appropriate for eye drops.
dexamethasone interactions
Tell the prescriber or pharmacist about all medicines, vaccines and supplements. Important examples include:
Ritonavir, cobicistat and other strong CYP3A inhibitors
May increase dexamethasone exposure and systemic corticosteroid effects.
Rifampicin, rifabutin and enzyme-inducing antiseizure medicines
May reduce dexamethasone’s clinical effect.
Common questions about dexamethasone
Answers are fully visible for fast scanning and source review.
Can dexamethasone be stopped suddenly?
Not without prescriber advice. Sudden withdrawal may cause the condition to flare and can cause adrenal insufficiency after significant systemic exposure.
Is a steroid card needed?
Some people need a blue steroid treatment card or red steroid emergency card. A pharmacist or prescriber should assess this.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.