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Dexamethasone
Dexamethasone (Decadron)
Dexamethasone
(dex-ah-METH-ah-zohn) Oral: Decadron Dexameth Dexamethasone Intensol Dexasone Dexone Hexadrol (Rx). Topical: Aeroseb-Dex Decaderm (Rx). Ophthalmic: Maxidex Ophthalmic (Rx)

Classification: Glucocorticoid, synthetic

See Also: See also Corticosteroids.

Action/Kinetics: Long-acting. Low degree of sodium and water retention. Diuresis may ensue when transferred from other corticosteroids to dexamethasone. t1/2: 110-210 min.

Additional Uses In acute allergic disorders, PO dexamethasone may be combined with dexamethasone sodium phosphate injection and used for 6 days. To test for adrenal cortical hyperfunction. Cerebral edema due to brain tumor, craniotomy, or head injury. Investigational: Diagnosis of depression. Antiemetic in cisplatin-induced vomiting. Prophylaxis or treatment of acute mountain sickness. Decrease hearing loss in bacterial meningitis. Bronchopulmonary dysplasia in preterm infants. Hirsutism.

Contraindications: Use for replacement therapy in adrenal cortical insufficiency.

Special Concerns: Use during pregnancy only if benefits outweigh risks.

Additional Drug Interactions: Ephedrine effect of dexamethasone R/T liver breakdown.

How Supplied: Concentrate: 1 mg/mL; Elixir: 0.5 mg/5 mL; Ophthalmic suspension: 0.1%; Tablet: 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, 6 mg

Dosage
•Oral Concentrate Tablets, Elixir Most uses.
Initial: 0.75-9 mg/day; maintenance: gradually reduce to minimum effective dose (0.5-3 mg/day).
Suppression test for Cushing's syndrome.
0.5 mg q 6 hr for 2 days for 24-hr urine collection (or 1 mg at 11 p.m. with blood withdrawn at 8 a.m. for blood cortisol determination).
Suppression test to determine cause of pituitary ACTH excess.
2 mg q 6 hr for 2 days (for 24-hr urine collection).
Acute allergic disorders or acute worsening of chronic allergic disorders.
Day 1: Dexamethasone sodium phosphate injection, 4-8 mg IM. Days 2 and 3: Two 0.75-mg dexamethasone tablets b.i.d. Day 4: One 0.75-mg dexamethasone tablet b.i.d. Days 5 and 6: One 0.75-mg dexamethasone tablet. Day 7: No treatment. Day 8: Follow-up visit to physician.
•Topical Aerosol, Cream
Apply sparingly as a light film to affected area b.i.d.-t.i.d.
•Ophthalmic Suspension
1-2 gtt in the conjunctival sac q hr during day and q 2 hr during night until a satisfactory response obtained; then, 1 gtt q 4 hr and finally 1 gtt q 6-8 hr.