Dexamethasone
- Atc Codes:A01AC02#C05AA09#D07AB19#D07XB05#D10AA03#H02AB02#R01AD03#S01BA01#S01CB01#S02BA06#S03BA01
- CAS Codes:2392-39-4#312-93-6
- PHARMGKB ID:2392-39-4#312-93-6
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Induces
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Austria: Dexabene, Dexamethason, Fortecortin, Monodex; Belgium: Aacidexam, Dexa-Sine, Maxidex; Bulgaria: Dexagel, Dexamethason KRKA, Dexamethasone, Dexapolcort, Dexavenum, Maxidex, Prednisolon F, Unidexa; Cyprus: Decadron, Dexamed, Dexamethasone, Dexsol, Maxidex, Perazone; Czech Republic: Dexamed, Dexamethasone, Fortecortin; Denmark: Maxidex; Estonia: Dexamethason KRKA, Maxidex, Oftan Dexa; Finland: Dexametason, Käärmepakkaus, Oftan Dexa, Oradexon; France: Aldyzine, Dectancyl, Dexafree, Maxidex, Rockles; Germany: Afpred-Dexa, Axidexa, Cortidexason, Dexa-Allvoran, Dexa-Cinit, Dexa-CT, Dexa-Effekton, Dexa-Ophtal, Dexa-Ratiopharm, Dexa-Sine, Dexa-Siozwo, Dexabene, Dexabeta, Dexaflam, Dexagalen, Dexagel, Dexahexal, Dexamethason, Dexapos, Dexasel, Fortecortin, Isopto-Dex, Liptotalon, Monodex, Solupen, Tuttozem; Greece: Decadron, Dexamethasone, Maxidex, Soldesanil, Suomi, Thilodexine; Hungary: Dexa-Ratiopharm, Maxidex, Oradexon; Ireland: Dexamethasone, Dexsol, Maxidex; Italy: Capital, Cortiarscolloid, Decadron, Dermadex-Teofarma, Desalfa, Desameta, Desamix, Dexamono, Eta Biocortilen, Luxazone, Megacort, Netildex, Soldesam, Visumetazone; Latvia: Dexacip, Dexamethason, Dexona, Maxidex, Oftan Dexa; Lithuania: Deksametazonas, Dexamethason, Dexamethasone, Dexona, Maxidex, Oftan Dexa; Luxembourg: Aacidexan, Decadron, Dexabene, Dexamethasone, Fortecortin, Maxidex, Oradexon; Malta: Dexamethasone, Maxidex; Netherlands: Dexa-POS, Dexamethason, Dexsol, Oradexon; Poland: Dexadent, Dexafree, Dexagel, Dexamethason, Dexapolcort, Dexaven, Dikamfen, Fortecortin; Portugal: Decadron, Dexafree, Dexaval, Oradexon, Ronic; Romania: Afacort, Dexagel, Dexamed, Dexametazona, Dexamethasone, Dexaton, Maxidex, Netildex; Slovakia: Dexa-Ratiopharm, Dexamethasone, Dexamethazon, Dexamed, Unidexa; Slovenia: Dexamethason, Maxidex; Spain: Colircusi Dexametasona, Dexafree, Fortecortin, Inzitan, Maxidex; Sweden: Dexacortal, Dexametason, Isopto-Maxidex, Maxidex, Opnol; UK: Dexamethasone, Dexsol, Maxidex, Otomize.
North America
Canada: Ak Dex, Dexamethasone, Dexasone, Dextab, Diodex, Maxidex; USA: Dexamethasone, Maxidex, Ozurdex.
Latin America
Argentina: Decadron, Dexalaf, Dexameral, Dexametasona, Dexatotal, Fadametasona, Isopto Manidex, Lormine, Nexadron Oftal, Rupedex, Sedesterol; Brazil: Cortitop, Decadron, Decadronal, Deflaren, Dexaden, Dexadermil, Dexagreen, Dexametasona, Dexametax, Dexametisona, Dexaminor, Dexason, Duo-Decadron, Maxidex, Metadex, Metaxon, Metcort, Minidex, Topidexa, Uni Dexa; Mexico: Adrecort, Azona-Keton, Beminex, Bexine, Cortidex, Cryometasona, Decadron, Decadronal, Decorex, Dexafrin, Dexagrin, Dexal, Dexametasona, Dexamilan, Dexicar, Dexona, Dibasona, Examsa, Indarzona-N, Isoftalmol Dexametasona, Lergosin, Maxidex, Pardex, Reusan, Taxyl.
Asia
Japan: Amumetazon, Aphtasolon, Bisuo-DS, Corson, Dalalone, Decadron, Dersone, DEX, Dexa A, Dexaltin, Dexa-Mamallet, Dexamethasone, D-E-X-T, Eurason D, Hifmeta, Limethason, Maxidex, Mitasone, Santeson, Stmerin, Voalla, Zalucs.
Drug combinations
Dexamethasone and Chloramphenicol
Dexamethasone and Chlorpheniramine
Dexamethasone and Ciprofloxacin
Dexamethasone and Cyproheptadine
Dexamethasone and Dimethyl Sulfoxide
Dexamethasone and Framycetin
Dexamethasone and Gentamicin
Dexamethasone and Lenalidomide
Dexamethasone and Lidocaine
Dexamethasone and Loratadine
Dexamethasone and Moxifloxacin
Dexamethasone and Naphazoline
Dexamethasone and Neomycin
Dexamethasone and Oxytetracycline
Dexamethasone and Polymyxin B
Dexamethasone and Sodium Phosphate
Dexamethasone and Theophylline
Dexamethasone and Tobramycin
Dexamethasone and Tramazoline
Dexamethasone, Acetaminophen, and Chlorzoxazone
Dexamethasone, Butane-1,3–diol, and Dibucaine
Dexamethasone, Carisoprodol, and Piroxicam
Dexamethasone, Chloramphenicol, and Phenylephrine
Dexamethasone, Chloramphenicol, and Tetracaine
Dexamethasone, Chlorhexidine, and Nystatin
Dexamethasone, Chlorpheniramine, and Ephedrine
Dexamethasone, Clotrimazole, and Marbofloxacin
Dexamethasone, Gentamicin, and Tetrahydrozoline
Dexamethasone, Hyaluronic Acid, and Tobramycin
Dexamethasone, Hydroquinone, and Tretinoin
Dexamethasone, Metronidazole, and Nystatin
Dexamethasone, Naphazoline, and Neomycin
Dexamethasone, Naphazoline, and Tobramycin
Dexamethasone, Neomycin, and Nystatin
Dexamethasone, Neomycin, and Polymyxin B
Dexamethasone, Niacinamide, and Pyridoxine (Vitamin B~6~)
Dexamethasone, Polymyxin B, and Trimethoprim
Dexamethasone, Chlorpheniramine, Naphazoline, and Neomycin
Dexamethasone, Gentamicin, Hydrocortisone, and Ketoconazole
Dexamethasone, Lidocaine, Neomycin, and Polymyxin B
Dexamethasone, Carisoprodol, Hydroxocobalamin (Vitamin B~12a~), Piroxicam, and Pyridoxine (Vitamin B~6~)
Dexamethasone, Lidocaine, Metronidazole, Neomycin, and Nystatin
Other Dexamethasone combinations: Cyanocobalamin (Vitamin B~12~), Niacin (Vitamin B~3~); Pyridoxine (Vitamin B~6~), Thiamine (Vitamin B~1~)
Chemistry
Dexamethasone Sodium Phosphate: C~22~H~28~FNa~2~O~8~P. Mw: 516.40. (1) Pregna-1,4-diene-3,20-dione, 9-fluoro-11,17-dihydroxy-16-methyl-21-(phosphonooxy)-, disodium salt, (11β,16α)-; (2) 9-Fluoro-11β,17,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione 21-(dihydrogen phosphate) disodium salt. CAS-2392-39-4; CAS-312-93-6 (dexamethasone 21-(dihydrogen phosphate)).
Pharmacologic Category
Hormones and Synthetic Substitutes; Adrenals. EENT Preparations; Anti-inflammatory Agents; Corticosteroids. Antiemetic. (ATC-Code: A01AC02; C05AA09; D07AB19; D07XB05; D10AA03; H02AB02; H02AB02; R01AD03; S01BA01; S01CB01; S02BA06; S03BA01).
Mechanism of action
Decreases inflammation by suppression of neutrophil migration, decreased production of inflammatory mediators, and reversal of increased capillary permeability. Suppresses normal immune response. The mechanism of the antiemetic activity of dexamethasone is unknown.
Therapeutic use
Anti-inflammatory or immunosuppressant agent of allergic, dermatologic, endocrine, hematologic, inflammatory, neoplastic, nervous system, renal, respiratory, rheumatic, and autoimmune origin. Management of cerebral edema, septic shock, chronic swelling. Diagnosis of Cushing’s syndrome. Antiemetic. Treatment of palpebral and bulbar conjunctivitis, corneal injury from chemical, radiation, thermal burns, or foreign body penetration. Also used for the treatment of inflammation of external auditory meatus, and of edema associated with infective otitis externa.
Pregnancy and lactiation implications
Crosses the placenta and is partially metabolized to an inactive metabolite. Used in premature labor (24-34 weeks gestation) to stimulate fetal lung maturation. Adverse events in the fetus/neonate reported following large doses of systemic corticosteroids during pregnancy. Caution during lactation.
Unlabeled use
Treatment of a variety of oral diseases of allergic, inflammatory or autoimmune origin. General indicator consistent with depression and/or suicide. Accelerate fetal lung maturation in preterm labor.
Contraindications
Hypersensitivity to dexamethasone or any component of the formulation. Systemic fungal infections, cerebral malaria. Ophthalmic use in viral, fungal, or tuberculosis diseases of the eye.
Warnings and precautions
May cause hypercorticism or suppression of HPA axis (particularly in younger children or in patients receiving high doses for prolonged periods), which may lead to adrenal crisis. Use caution upon withdrawal and discontinuation of the drug and transference from systemic corticosteroids to inhaled products. Aerosol steroids do not provide the systemic steroid needed to treat patients having trauma, surgery, or infections. May increase the incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines. Exposure to chickenpox should be avoided. Not for treatment of ocular herpes simplex, cerebral malaria or viral hepatitis. Restrict use in active tuberculosis (only in conjunction with antituberculosis treatment). Possible development of Kaposi’s sarcoma (with long treatment). Acute myopathy reported with high doses. May cause psychiatric disturbances (depression, euphoria, insomnia, mood swings, and personality changes). Does not provide adequate mineralocorticoid activity in adrenal insufficiency. The lowest possible dose should be used during treatment, and discontinuation and/or dose reductions should be gradual. Caution in heart failure (risk of fluid retention and hypertension with prolonged use), diabetes mellitus (may produce hyperglycemia), GI disease (perforation risk), hepatic or renal impairment (fluid retention), myasthenia gravis (exacerbation of symptoms, especially during initial treatment), following acute MI (risk of myocardial rupture), osteoporosis (risk of increased bone loss and osteoporotic fractures), history of seizure disorder (seizures with adrenal crisis reported), cataracts and/or glaucoma. Metabolic clearance of corticosteroids increases in hyperthyroidism and decreases in hypothyroidism. May affect growth velocity in pediatric patients. Should be used cautiously in the elderly.