dexamethasone
Dexamethasone is a corticosteroid that's used to treat many inflammatory conditions, including allergic reactions and certain autoimmune conditions. If you've been taking dexamethasone for a long time, you're at higher risk for side effects like weight gain and weakened bones. Dexamethasone also has many drug interactions, so make sure to tell your provider and pharmacist what medications you're taking before starting this steroid. This medication is available as oral tablets and solutions, as well as an injection that's usually given in a healthcare setting.
What is Dexamethasone?
What is Dexamethasone used for?
Hormone-related conditions
Eye conditions
Stomach conditions
Respiratory disorders
Autoimmune and rheumatic conditions
Multiple myeloma (Hemady brand only), blood cancers, and other blood-related conditions
Certain eye conditions
Nervous system and brain conditions
Kidney diseases
Shock
How Dexamethasone works
Dexamethasone is a corticosteroid that's similar to a hormone that your body naturally makes, called cortisol. It lowers swelling (inflammation) and other immune responses that can cause you pain, discomfort, or harm.
Dexamethasone is a long-acting corticosteroid, meaning its effects can linger around longer than other similar medications.
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What are the side effects of Dexamethasone?
Common Side Effects
- Difficulty sleeping
- Higher blood sugar levels
- Headache
- Mood swings
- Nausea
- Stomach pain
- Feeling more hungry
- Weight gain
Other Side Effects
- Acne
- Dry and/or thinning skin
- Thinning scalp hair
- Rash
- Loss of muscle mass
- Muscle weakness
- Depression
- Vision changes
- Abnormal fat deposits
- Swelling in feet and ankles (fluid retention)
- Slower wound healing
Serious Side Effects
- Allergic reaction: trouble breathing or swallowing, swelling (on your face, lips, mouth, or throat), peeling skin, rash, hives
Source: DailyMed
More on Dexamethasone side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Aggression
agitation
blurred vision
decrease in the amount of urine
dizziness
fast, slow, pounding, or irregular heartbeat or pulse
headache
irritability
mental depression
mood changes
nervousness
noisy, rattling breathing
numbness or tingling in the arms or legs
pounding in the ears
swelling of the fingers, hands, feet, or lower legs
trouble thinking, speaking, or walking
troubled breathing at rest
Incidence not known
Abdominal or stomach cramping and/or burning (severe) or pain
backache
bloody, black, or tarry stools
cough or hoarseness
darkening of the skin
decrease in height
decreased vision
eye tearing
facial hair growth in females
fainting
fever or chills
flushed, dry skin
fractures
fruit-like breath odor
full or round face, neck, or trunk
heartburn and/or indigestion (severe and continuous)
increased hunger
increased thirst
increased urination
loss of appetite
loss of sexual desire or ability
lower back or side pain
menstrual irregularities
muscle pain or tenderness
muscle wasting or weakness
pain in the back, ribs, arms, or legs
painful or difficult urination
skin rash
sweating
trouble healing
trouble sleeping
unexplained weight loss
unusual tiredness or weakness
vision changes
vomiting
vomiting of material that looks like coffee grounds
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Increased appetite
Incidence not known
Abnormal fat deposits on the face, neck, and trunk
dry scalp
lightening of normal skin color
red face
reddish purple lines on the arms, face, legs, trunk, or groin
swelling of the stomach area
thinning of the scalp hair
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Dexamethasone
Pros
Can treat many conditions
Works quickly to relieve symptoms and problems caused by an overactive immune system, like swelling or rash
Option to take it by mouth
Available as a liquid for children or people who can't take tablets by mouth
Cons
Can cause trouble sleeping and headaches
Long-term use can cause problems with skin, bone, eye health and put you at a higher risk for infections
Can cause withdrawal symptoms if you stop taking too suddenly
Safety during pregnancy or breastfeeding isn't clear
Pharmacist tips for Dexamethasone
Dexamethasone can irritate your stomach so it is best to take it with food.
Dexamethasone can cause you to feel anxious or have a harder time falling asleep. You will want to take it earlier in the day, if possible, so you don't have trouble sleeping at night.
If you're taking the oral solution or elixir, use the measuring device comes with the medication to measure out your doses. Don't use kitchen or measuring spoons, since these may not be accurate.
If you are prescribed a dose pack of dexamethasone, such as TaperDex 6-Day, follow the directions on the package to take your doses correctly. These dose packs contain a specific number of tablets that lasts for a specific number of days to help treat your condition. The packs also help you to lower your dose slowly until you stop the medication completely so as to prevent any side effects from stopping dexamethasone too quickly.
Dexamethasone can weaken your immune system so avoid getting any "live" vaccines (e.g. chickenpox or shingles vaccine) while taking this medication since the vaccine may not work as well.
When you take dexamethasone for a long time, your body lowers the amount of stress hormone that it produces, so you shouldn't suddenly stop taking your medication or lower your dose without talking to your doctor. If you do, you may get withdrawal symptoms including weakness, fatigue, nausea, vomiting, and diarrhea.
Frequently asked questions about Dexamethasone
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What are the risks and warnings for Dexamethasone?
Dexamethasone can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Lowered stress hormone levels
Risk factors: Lowering dose or stopping dexamethasone too quickly especially after long-term treatment | Stress such as trauma, surgery or infection
If you've been taking corticosteroids like dexamethasone for a long time, lowering your dose or stopping it too quickly can be dangerous since your body can't respond to stress (adrenal insufficiency). Symptoms low stress hormone levels include joint or muscle pain, extreme low energy and depression. If your provider wants to lower your dose of dexamethasone, they'll work with you to do it slowly over time. Talk to your doctor before you make any changes or stop it.
Higher risk of infections
Risk factors: Taking other immunosuppressants | Long-term treatment | Not vaccinated against viral diseases | Contact with people who have viral illness | History of bacterial or viral conditions
If you take dexamethasone for a long time it can raise your risk of infections and hide some signs of infection. Be especially careful not to be in contact with anyone who has the chickenpox or measles. If you had tuberculosis (TB) in the past your doctor will need to monitor you while taking dexamethasone. You might need to take TB medications to prevent getting it or treat it if your TB comes back.
Also, talk to your doctor before getting any vaccinations. Depending on your dose of dexamethasone and how long you've been taking this medication, you might not be able to receive live vaccines since there's a higher chance you'll get sick from them. Also, your provider might ask you to wait to receive inactivated vaccines because these types of vaccines might not work as well to protect you from future infections.
High blood pressure and kidney-related problems
Risk factors: Recent heart attack
Dexamethasone can cause high blood pressure. It can also cause your body to hold on to more salt and your kidneys to lose more potassium. Talk to your doctor if you have heart failure, high blood pressure, or kidney damage because taking dexamethasone might worsen these conditions.
Stomach and intestinal problems
Risk factors: Drinking alcohol | History of stomach bleeding | Active or history of stomach ulcers | Ulcerative colitis | Taking dexamethasone with other medications that can cause stomach problems
Taking dexamethasone raise the risk of damage to the lining of your stomach and intestine. You should avoid alcoholic beverages because they can worsen stomach irritation. Tell your doctor and get medical care right away if you have stomach pain or bloody/dark stools when you go to the bathroom.
Weakened bones
Risk factors: High dose of dexamethasone | Long duration of treatment
If you take dexamethasone for a long time, this medication can weaken your bones. This can lead to osteoporosis in adults and slower growth rate in children. Ask your doctor for recommendations for how to prevent further weakening of bones. They might ask you to eat foods that are rich in calcium and vitamin D, such as leafy greens, milk, and eggs. They might also recommend you do bone-strengthening exercises, such as walking, climbing stairs, or using resistance bands.
Eye problems
Long-term use of dexamethasone leads to a higher risk of cataracts or glaucoma. You may also be more at risk for certain eye infections. Don't take dexamethasone if you have herpes simplex of the eye. Let your doctor know if you have blurry vision, eye pain or any vision changes while taking this medication.
Dexamethasone dosage forms
Typical dosing for Dexamethasone
Adults (oral): The typical starting dose ranges from 0.75 mg to 9 mg by mouth daily, depending on your medical condition.
Children (oral): Your child's provider will determine their dose based on their body weight. The typical starting dose ranges from 0.02 mg/kg to 0.3 mg/kg by mouth a day in 3 or 4 divided doses, depending on your child's medical condition.
Dexamethasone is also available as an oral solution or elixir for those who have trouble swallowing pills, and as an intravenous (IV) injection given by a healthcare provider for those requiring emergency care.
Interactions between Dexamethasone and other drugs
More on Dexamethasone interactions
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Artemether
- Desmopressin
- Praziquantel
- Rilpivirine
- Rotavirus Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Aceclofenac
- Acemetacin
- Aldesleukin
- Alfentanil
- Amiodarone
- Amtolmetin Guacil
- Apalutamide
- Balofloxacin
- Bemiparin
- Benzhydrocodone
- Besifloxacin
- Boceprevir
- Bromfenac
- Bufexamac
- Buprenorphine
- Bupropion
- Carbamazepine
- Celecoxib
- Ceritinib
- Cholestyramine
- Choline Salicylate
- Ciprofloxacin
- Clarithromycin
- Clonixin
- Cobicistat
- Codeine
- Conivaptan
- Daclatasvir
- Darunavir
- Desogestrel
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Dienogest
- Diflunisal
- Dihydrocodeine
- Dipyrone
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Dronedarone
- Drospirenone
- Droxicam
- Efavirenz
- Elvitegravir
- Enoxacin
- Enzalutamide
- Estradiol
- Ethinyl Estradiol
- Ethynodiol
- Etodolac
- Etofenamate
- Etonogestrel
- Etoricoxib
- Etravirine
- Felbinac
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Fleroxacin
- Floctafenine
- Flufenamic Acid
- Flumequine
- Flurbiprofen
- Fosamprenavir
- Fosphenytoin
- Gatifloxacin
- Gemifloxacin
- Gestodene
- Hemin
- Hydrocodone
- Ibuprofen
- Idelalisib
- Indinavir
- Indomethacin
- Itraconazole
- Ixabepilone
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lapatinib
- Levofloxacin
- Levonorgestrel
- Lomefloxacin
- Lopinavir
- Lornoxicam
- Loxoprofen
- Lumacaftor
- Lumateperone
- Lumiracoxib
- Lutetium Lu 177 Dotatate
- Macimorelin
- Meclofenamate
- Medroxyprogesterone
- Mefenamic Acid
- Meloxicam
- Meperidine
- Mestranol
- Methadone
- Mitotane
- Morniflumate
- Moxifloxacin
- Nabumetone
- Nadifloxacin
- Nadroparin
- Naproxen
- Nefazodone
- Nelfinavir
- Nepafenac
- Nevirapine
- Nifedipine
- Niflumic Acid
- Nilotinib
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nimodipine
- Nomegestrol
- Norelgestromin
- Norethindrone
- Norfloxacin
- Norgestimate
- Norgestrel
- Ofloxacin
- Oxaprozin
- Oxycodone
- Oxyphenbutazone
- Parecoxib
- Pazufloxacin
- Pefloxacin
- Pentazocine
- Phenylbutazone
- Phenytoin
- Piketoprofen
- Piperaquine
- Piroxicam
- Posaconazole
- Pranoprofen
- Proglumetacin
- Propyphenazone
- Proquazone
- Prulifloxacin
- Rifampin
- Ritonavir
- Rofecoxib
- Rufloxacin
- Salicylic Acid
- Salsalate
- Saquinavir
- Sargramostim
- Segesterone
- Sodium Salicylate
- Sparfloxacin
- St John's Wort
- Sufentanil
- Sulindac
- Sunitinib
- Tacrolimus
- Telaprevir
- Telithromycin
- Tenoxicam
- Thalidomide
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Tosufloxacin
- Tramadol
- Ubrogepant
- Ulipristal
- Valdecoxib
- Velpatasvir
- Vincristine Sulfate Liposome
- Voriconazole
- Vortioxetine
- Voxilaprevir
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alcuronium
- Aminoglutethimide
- Aprepitant
- Aspirin
- Atracurium
- Auranofin
- Caspofungin
- Fluindione
- Fosaprepitant
- Fosnetupitant
- Gallamine
- Hexafluorenium
- Licorice
- Metocurine
- Netupitant
- Ospemifene
- Pancuronium
- Phenobarbital
- Rifapentine
- Saiboku-To
- Vecuronium
- Warfarin
How much does Dexamethasone cost?
Dexamethasone contraindications
Fungal infection that has spread throughout the body
What are alternatives to Dexamethasone?
Hormone-related conditions
Eye conditions
Stomach conditions
Respiratory disorders
Autoimmune and rheumatic conditions
Multiple myeloma (Hemady brand only), blood cancers, and other blood-related conditions
Certain eye conditions
Nervous system and brain conditions
Kidney diseases
Shock
Allergies or allergic reactions
Conditions affecting certain hormones (e.g., low adrenal hormones)
Eye conditions
Lung conditions
Gut conditions (e.g., ulcerative colitis)
Conditions related to blood cells
Certain cancers (e.g., leukemia
Nervous system conditions (e.g., multiple sclerosis)
Joint conditions (e.g., rheumatoid arthritis)
Conditions affecting certain hormones (e.g., low adrenal hormones)
Joint conditions (e.g., rheumatoid arthritis)
Skin conditions (e.g., Stevens-Johnson syndrome)
Allergic reactions
Eye inflammation
Lung problems
Conditions related to blood cells
Cancer of blood cells (e.g., leukemia)
Gut conditions (e.g., ulcerative colitis)
What is the latest news about Dexamethasone?
Dexamethasone images
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References
Best studies we foundCenters for Disease Control and Prevention. (2020). Spoons are for soup, milliliters are for medicine.
Chartwell RX, LLC. (2023). Dexamethasone elixir [package insert]. DailyMed.
Chen Cardenas, S. M., et al. (2023). Perioperative evaluation and management of patients on glucocorticoids. Journal of the Endocrine Society.
Dobrovoljac, M., et al. (2012). How fast does oral dexamethasone work in mild to moderately severe croup? A randomized double-blinded clinical trial. Emergency Medicine Australasia.
Edenbridge Pharmaceuticals LLC. (2023). Hemady- dexamethasone tablet [package insert]. DailyMed.
Fresenius Kabi USA, LLC. (2021). Dexamethasone sodium phosphate- dexamethasone sodium phosphate injection, solution [package insert]. DailyMed.
Hikma Pharmaceuticals USA, Inc. (2020). Dexamethasone tablet; dexamethasone intensol solution, concentrate; dexamethasone solution [package insert]. DailyMed.
Johnson, D. B., et al. (2023). Dexamethasone. StatPearls.
Liu, D., et al. (2013). A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy, Asthma & Clinical Immunology.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison's disease.
Thau, L., et al. (2023). Physiology, cortisol. StatPearls.
Xspire Pharma, Llc. (2022). Taperdex 6-day- dexamethasone tablet [package insert]. DailyMed.
Yasir, M., et al. (2023). Corticosteroid adverse effects. StatPearls.
Zoorob, R. J., et al. (1998). A different look at corticosteroids. American Family Physician.
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