Posted on April 28th, 2009 by
Generic Name: Dexamethasone (DECKS-uh-METH-uh-zone), dexamethasone sodium phosphate, dexamethasone acetate
Trade Name: Decadron, Dexasone, Diodex, Hexadrol, Maxidex
For which conditions is this drug approved? Dexamethasone is used in combination with other agents for the treatment of myeloma and lymphomas. Dexamethasone may also be used to help prevent or reduce nausea and vomiting, to reduce swelling and related pressure, or as an anti-inflammatory agent. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Dexamethasone is referred to as a glucocorticoid or corticosteroid. Dexamethasone may produce anti-cancer effects through several speculated mechanisms. One such mechanism may be the inhibition of inflammatory agents in the body, which have been implicated in the development or growth of some cancers.
How is dexamethasone typically given (administered)? Dexamethasone may be administered in several different ways: orally as an elixir or tablets, intravenously (into a vein), intramuscularly (into a muscle), intralesionly (into a lesion), into soft tissue, intraarticularly (into the cavity of a joint), as eye drops, or as a lotion. The dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient.
How are patients typically monitored? Patients will usually have scheduled check-ups with their healthcare provider while they are being treated with dexamethasone. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may undergo physical examinations, scans or other measures to assess side effects and response to therapy. Patients may also have their blood sugar levels monitored.
What are the common (occur in 30% or more of patients) side effects of treatment with dexamethasone?
• Increase in appetite
• Impaired or delayed wound healing
• Increased risk of infection
• Swelling of feet or ankles
• Fluid retention, weight gain
• Weakness of muscles
• Increased levels of sugar in the blood
• Irritability, nervousness
What are the less common (occur in 10% to 29% of patients) side effects of treatment with dexamethasone?
• Mood swings
• (long-term use) – cataracts, reduction in bone density
What are the possible late side effects of treatment with dexamethasone? Patients may be an increased risk of developing cataracts or a reduction in bone density if they are treated with dexamethasone for a long period of time.
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Patients receiving dexamethasone eyedrops may wish to wear sunglasses to protect from the sun, as eyes may become more sensitive to sunlight. Patients should discuss the use of contact lenses with their healthcare provider
• Dexamethasone may leave patients more susceptible to infection. Therefore, patients should wash their hands often, avoid large crowds of people and avoid other people who are not feeling well to reduce their risk of infection.
• Patients receiving dexamethasone as a topical ointment should not apply the ointment to any open skin, unless directed by their physician
• Patients receiving dexamethasone orally may wish to take their dose with food to reduce the risk of an upset stomach
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Do not discontinue treatment with dexamethasone abruptly, as serious side effects may occur. Follow the instructions of your healthcare provider for the schedule of administration.
• Dexamethasone may cause high blood sugar levels – patients with diabetes may be required to check their blood sugar levels frequently
• Keep capsules out of reach of children and return to the pharmacy for safe disposal if treatment is terminated.
• If a dose is missed, do not take two doses at once.
When should patients notify their physician?
• Fever, chills, persistent cough, sore throat, signs of infection
• Shortness of breath
• Chest or jaw pain, difficulty breathing, a noticeable change in heart rate or rhythm?
• Extreme or prolonged fatigue
• Unexplained bleeding or bruising (bloody nose, blood in the urine, black tarry stools)
• Persistent or severe nausea or vomiting
• Severe or persistent headache
• Extreme thirst and frequent urination (signs of high blood sugar)
• Changes in vision
• Discharge from eye
• Eye pain
• Changes in pupil size
• Rash or skin abnormalities
• Wound that will not heal
• Sudden weight gain
• Swelling of feet or ankles
• Swelling, redness, tenderness or pain in one extremity and not the other
• Joint pain
• Muscle weakness, cramps, or pain
• Extreme mood swings or depression
• Confusion or hallucinations
• Abdominal pain, stomach pain or burning
• Increased in body hair or facial hair
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. Click here to view the package insert
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