Dexamethasone injection Rx
Generic Name and Formulations:
Dexamethasone phosphate (as sodium); 4mg/mL, 10mg/mL; for IV inj; contains sulfites.
Various generic manufacturers
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Indications for Dexamethasone injection:
Steroid-responsive disorders when oral therapy not feasible.
Adults and Children:
See literature. Initially usually 0.5–9mg daily IV.
Systemic fungal infection. Live vaccination. Ocular herpes simplex. Cerebral malaria.
Asthma (inj). Strongyloides infestation. Varicella. Vaccinia. Recent MI. Tuberculosis. Latent amebiasis. Hypothyroidism. Cirrhosis. If exposed to chickenpox or measles, consider prophylactic passive immune therapy. Renal insufficiency. Ulcerative colitis. Intestinal anastomoses. Diverticulitis. Peptic ulcer. CHF. Hypertension. Osteoporosis. Diabetes. Myasthenia gravis. Hypoprothrombinemia. Supplement with additional steroids in physiologic stress. Avoid abrupt cessation. Monitor weight, growth, fluid and electrolyte balance. Pregnancy (Cat.C). Nursing mothers: not recommended.
Potentiated by CYP3A4 inhibitors (eg, ketoconazole, macrolides), cyclosporine, estrogens. Antagonized by CYP3A4 inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin), ephedrine. May potentiate cyclosporine. May antagonize anticoagulants (monitor), isoniazid, other CYP3A4 substrates (eg, indinavir, erythromycin). Increased risk of arrhythmias with digitalis. May need to adjust dose of antidiabetic agents. Increased GI effects with aspirin. Monitor for hypokalemia with potassium-depleting drugs (eg, amphotericin B, diuretics). Toxic epidermal necrolysis possible with thalidomide. Concomitant indomethacin: may get false-negative on dexamethasone suppression test. May suppress reactions to skin tests.
HPA axis suppression, masks infection, increased susceptibility to infection, glaucoma, cataracts, secondary infections, hypokalemia, hypocalcemia, hypernatremia, hypertension, psychic disorders, myopathy, osteoporosis, peptic ulcer, dermal atrophy, increased intracranial pressure, carbohydrate intolerance, inj site reactions.
Formerly known under the brand names Decadron, Hexadrol.
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