Common use

Decadron (dexamethasone) is a potent corticosteroid medication with powerful anti-inflammatory and immunosuppressive properties. This versatile steroid medication is used to treat a wide range of conditions, including arthritis, blood disorders, hormone deficiencies, immune system disorders, allergic reactions, certain skin and eye conditions, and breathing problems. Decadron is also prescribed for certain bowel disorders where inflammation plays a central role.

In oncology, dexamethasone is an important component in the treatment of cancers of the white blood cells (leukemias) and lymph gland cancers (lymphomas), where it helps reduce tumor-related inflammation and swelling. Decadron is also used in the management of cerebral edema — swelling of the brain caused by tumors, surgery, or injury — providing critical relief from dangerous intracranial pressure. Additionally, dexamethasone serves as replacement therapy in patients whose adrenal glands are unable to produce sufficient amounts of natural corticosteroids, a condition known as adrenal insufficiency.



Dosage and direction

Take Decadron by mouth as directed by your doctor. The initial oral dose of dexamethasone ranges from 0.75 to 9 mg daily depending on the disease being treated, its severity, and the patient's response. The initial dose should be adjusted based on your response to therapy and clinical assessment.

Take this corticosteroid with food, milk, or a full glass of water to prevent stomach upset. If you take Decadron once daily, take it in the morning before 9 AM to mimic the body's natural cortisol rhythm and minimize sleep disturbances. Use this medication regularly in order to get the most benefit from it, and take it at the same time(s) each day.

It is important to continue taking this steroid medication even if you feel well, as abrupt discontinuation can cause serious withdrawal symptoms, including adrenal crisis. Follow the dosing schedule carefully, and take dexamethasone exactly as prescribed. Do not stop taking this medication without consulting your doctor — your dose may need to be gradually tapered over time. Inform your doctor if your condition does not improve or worsens.



Precautions

Do not have immunizations, vaccinations, or skin tests unless specifically directed by your doctor, as dexamethasone suppresses the immune system and may reduce vaccine effectiveness or increase the risk of infection from live vaccines.

Before taking Decadron, tell your doctor or pharmacist if you have any allergies. Provide a complete medical history, including: active fungal infections, kidney or liver disease, mental/mood conditions (depression, psychosis), low blood minerals (potassium, calcium), thyroid disease, stomach/intestinal problems (ulcers, diverticulitis), high blood pressure, heart problems, diabetes, eye diseases (glaucoma, cataracts), brittle bones (osteoporosis), history of blood clots, or recent exposure to infectious diseases.

If you have been taking Decadron for a long time, your body may not produce enough natural corticosteroids while you are under physical stress (illness, surgery, injury). Your dose may need to be adjusted during these periods. If you have stopped taking this drug within the past 12 months, you may need to restart it temporarily if your body is under physical stress. Before having surgery, tell your doctor or dentist that you are using this corticosteroid or have taken it within the last 12 months.

If you have a history of ulcers or take large doses of aspirin or other arthritis medication, limit alcoholic beverages while taking Decadron to decrease the risk of stomach and intestinal bleeding. If you have diabetes, this steroid medication may make it harder to control your blood sugar levels — monitor your blood sugar regularly and inform your doctor of the results.

During pregnancy, dexamethasone should be used only when clearly needed. Discuss the risks and benefits with your doctor. This drug may pass into breast milk and could have undesirable effects on a nursing infant, so breastfeeding is not recommended while using this medication.

Avoid contact with people who have recently received oral polio vaccine or nasal flu vaccine, and avoid people with chickenpox or measles unless you have previously had these diseases. If you are exposed to one of these infections and have not previously had it, seek immediate medical attention, as your suppressed immune system makes you vulnerable to serious complications.



Contraindications

Do NOT use Decadron if you are allergic to any ingredient in dexamethasone, you have a systemic fungal infection, or you are taking mifepristone. Contact your doctor or health care provider immediately if any of these apply to you. Patients with active untreated infections should not begin corticosteroid therapy unless the infection is being appropriately managed with antimicrobial treatment.



Possible side effects

Side effects of Decadron depend on the dose, the duration, and the frequency of administration. Short courses of dexamethasone usually are well tolerated with few and mild side effects. Long-term, high-dose corticosteroid use usually will produce predictable and potentially serious side effects. Whenever possible, the lowest effective dose of dexamethasone should be used for the shortest possible length of time to minimize side effects. Alternate day dosing also can help reduce side effects in some cases.

Side effects of this anti-inflammatory steroid may include: fluid retention, weight gain, high blood pressure, loss of potassium, headache, muscle weakness, puffiness of the face (moon face) and hair growth on the face, thinning and easy bruising of the skin, glaucoma, cataracts, peptic ulceration, worsening of diabetes, irregular menses, growth retardation in children, convulsions, stomach upset, dizziness, menstrual changes, trouble sleeping, increased appetite, depression, euphoria, insomnia, mood swings, personality changes, and even psychotic behavior in rare cases.

A very serious allergic reaction to this drug is rare but requires immediate medical attention. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Report any signs of infection (fever, persistent sore throat), bone pain, vision changes, or unusual fatigue to your healthcare provider.



Drug interactions

Drugs such as phenobarbital, ephedrine, phenytoin (Dilantin), and rifampin (Rifadin, Rimactane) may increase the breakdown of corticosteroids by the liver, resulting in lower blood levels and reduced therapeutic effects. Therefore, the dose of dexamethasone may need to be increased if treatment with any of these agents is begun or currently in use.

Additional drug interactions to be aware of include: anticoagulants (warfarin — dexamethasone may alter anticoagulant requirements), NSAIDs (increased risk of gastrointestinal bleeding), diabetes medications (corticosteroids raise blood sugar), live vaccines (contraindicated during immunosuppressive therapy), and certain antifungal medications (ketoconazole may increase dexamethasone levels). Always inform your doctor of all medications, supplements, and herbal products you are taking.



Missed dose

If you are taking Decadron daily and on a regular schedule, and 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. Consistent daily dosing is important for maintaining the therapeutic effects of your corticosteroid treatment.



Overdose

Seek emergency medical attention if you think you have used too much of this medicine. While acute dexamethasone overdose is rarely life-threatening, chronic overuse can lead to Cushing's syndrome and serious metabolic complications. Contact your local poison control center for guidance.



Storage

Decadron should be stored at 68-77 degrees F (20-25 degrees C) and not frozen. Keep this corticosteroid medication in its original container, away from moisture and direct light. Keep all medicines away from children and pets. Properly dispose of expired dexamethasone according to local guidelines.



Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.