Class: Adrenal Corticosteroid
Dosage Forms.Tablet: 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, 6 mg; Solution: 0.5 mg/5 mL; Elixir: 0.5 mg/5 mL
Common FDA Label Indication, Dosing, and Titration.
Dosing for indications listed below: Adults: 0.75-9 mg/d po; Children: 0.02-0.3 mg/kg/d in 3-4 divided doses; for all patients, adjust dose according to patient response
1. Allergic states (eg, asthma, etc)
2. Dermatologic diseases (eg, exfoliative erythroderma, etc)
3. Endocrine disorders (eg, adrenocortical insufficiency, etc)
4. Gastrointestinal diseases (eg, regional enteritis, ulcerative colitis, etc)
5. Hematologic disorders (eg, acquired hemolytic anemia, etc)
6. Neoplastic diseases (eg, palliative management of leukemias and lymphomas, etc)
7. Nervous system (eg, multiple sclerosis, cerebral edema, etc)
8. Renal diseases (eg, idiopathic nephrotic syndrome, systemic lupus erythematosus, etc)
9. Respiratory diseases (eg, idiopathic eosinophilic pneumonia, etc)
10. Rheumatic disorders (eg, rheumatoid arthritis, etc)
1. Chemotherapy-induced nausea and vomiting: 20 mg IV before chemotherapy, 8 mg IV or po bid × 3 d after chemotherapy
MOA. Glucocorticosteriods are naturally occurring and synthetic adrenocortical steroids cause varied metabolic effects, modify the body’s immune responses to diverse stimuli, and are used primarily for their anti-inflammatory effects in disorders of many organ systems.
Drug Characteristics: Dexamethasone Oral
Medication Safety Issues: Dexamethasone Oral
Drug Interactions: Dexamethasone Oral
Adverse Reactions: Dexamethasone Oral
Efficacy Monitoring Parameters. Improvement or resolution of clinical signs and symptoms; monitor for decrease in ESR, or improvement of PFT.
Toxicity Monitoring Parameters. Monitor for signs of hyperglycemia, osteoporosis, and adrenocortical insufficiency and infection; frequency and severity of adverse effects are dependent on the length of treatment and dose.
Key Patient Counseling Points. For short-term treatment, inform patients to take doses with meals to prevent GI upset. For high dose or longer-term treatment, inform patients to monitor for signs of hyperglycemia, osteoporosis, adrenocortical insufficiency and infection.
Clinical Pearls. Available in a wide variety of dosage forms for various indications, including injectable, topical, otic, and ophthalmic preparations. Use lowest effective and discontinue as soon as possible to avoid serious long-term adverse effects.