$Unique_ID{BRK01918}
$Pretitle{}
$Title{DEXAMETHASONE (SYSTEMIC)}
$Subject{Decadron (Merck Sharp & Dohme)
Dexameth (Major)
dexamethasone (various manufacturers)
Dexone (Reid-Rowell)
Hexadrol (Organon)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


DEXAMETHASONE (SYSTEMIC)
------------------------------------------------------------------------------

BRAND NAMES (Manufacturers):
     Decadron (Merck Sharp & Dohme)
     Dexameth (Major)
     dexamethasone (various manufacturers)
     Dexone (Reid-Rowell)
     Hexadrol (Organon)
TYPE OF DRUG:
     Adrenocorticosteroid hormone
INGREDIENT:
     dexamethasone
DOSAGE FORMS:
     Tablets (0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, and 6 mg)
     Oral elixir (0.5 mg per 5-ml spoonful, with 5% alcohol)
     Oral solution (0.5 mg per 5-ml spoonful)
     Oral concentrate (0.5 mg per 0.5 ml, with 30% alcohol)
STORAGE:
     Dexamethasone should be stored at room temperature in a tightly closed
       container.

USES

     Your adrenal glands naturally produce certain cortisone-like chemicals.
These chemicals are involved in various regulatory processes in the body (such
as those involving fluid balance, temperature, and reaction to inflammation).
Dexamethasone belongs to a group of drugs known as adrenocorticosteroids (or
cortisone-like medications).  It is used to treat a variety of disorders,
including endocrine and rheumatic disorders; asthma; blood diseases; certain
cancers; eye disorders; gastrointestinal disturbances, such as ulcerative
colitis; respiratory diseases; and inflammations such as arthritis,
dermatitis, and poison ivy.  How this drug acts to relieve these disorders is
not completely understood.

TREATMENT

     In order to prevent stomach irritation, you can take dexamethasone with
food or milk.
     If you are taking only one dose of this medication each day, try to take
it before 9:00 A.M.  This will mimic the body's normal production of this type
of chemical.
     The oral elixir and solution forms of this medication should be measured
carefully with a specially designed 5-ml measuring spoon.  An ordinary kitchen
teaspoon is not accurate enough.
     The oral concentrate may be diluted in juice, other liquids, or
semi-solid foods like applesauce.
     It is important to try not to miss any doses of dexamethasone.  However,
if you do miss a dose of this medication, follow these guidelines:
     1. If you are taking this medication more than once a day, take the
missed dose as soon as possible and return to your regular schedule.  If it is
already time for the next dose of medication, double the dose.
     2. If you are taking this medication once a day, take the dose you missed
as soon as possible, unless you don't remember until the next day.  In that
case, do not take the missed dose at all, just follow your regular dosing
schedule.  Do not double the next dose.
     3. If you are taking this drug every other day, take it as soon as you
remember.  If you missed the scheduled time by a whole day, take it when you
remember, then skip a day before you take the next dose.  Do not double the
dose.
     If you miss more than one dose of dexamethasone, CONTACT YOUR DOCTOR.

SIDE EFFECTS

     Minor.

     Dizziness, false sense of well-being, fatigue, increased appetite,
increased sweating, indigestion, leg cramps, menstrual irregularities, muscle
weakness, nausea, reddening of the skin on the face, restlessness, sleep
disorders, thinning of the skin, or weight gain.  These side effects should
disappear as your body adjusts to the medication.
     To help avoid potassium loss while using this drug, you can take your
dose with a glass of fresh or frozen orange juice, or eat a banana each day.
The use of a salt substitute also helps to prevent potassium loss.  Check with
your doctor before changing your diet or using a salt substitute.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
abdominal enlargement or pain; acne or other skin problems; back or rib pain;
bloody or black, tarry stools; blurred vision; convulsions; eye pain; fever
and sore throat; growth impairment (in children); headaches; impaired healing
of wounds; increased thirst and urination; mental depression; mood changes;
muscle wasting; nightmares; peptic ulcers; rapid weight gain (three to five
pounds within a week); rash; shortness of breath; unusual bleeding or
bruising; or unusual weakness.

INTERACTIONS

     This drug interacts with several other types of drugs:
     1. Alcohol, aspirin, and anti-inflammatory medications (such as
diclofenac, diflunisal, fenoprofen, flurbiprofen, ibuprofen, indomethacin,
ketoprofen, mefenamic acid, meclofenamate, naproxen, piroxicam, sulindac, and
tolmetin) aggravate the stomach problems that may occur with use of this
medication.
     2. The dosage of oral anticoagulants (blood thinners, such as warfarin),
oral antidiabetic drugs, or insulin may need to be altered when this
medication is started or stopped.
     3. The loss of potassium caused by this medication can lead to serious
side effects in individuals taking digoxin.
     4. Thiazide diuretics (water pills) can increase the potassium loss
caused by dexamethasone.
     5. Phenobarbital, phenytoin, rifampin, and ephedrine can increase the
elimination of dexamethasone from the body, thereby decreasing its
effectiveness.
     6. Oral contraceptives (birth control pills) and estrogen-containing
drugs may decrease the elimination of this drug from the body, which can lead
to an increase in side effects.
     7. Dexamethasone can increase the elimination of aspirin and isoniazid
from the body, thereby decreasing the effectiveness of these two medications.
     8. Cholestyramine and colestipol can chemically bind this medication in
the stomach and gastrointestinal tract, preventing its absorption.
     BE SURE TO TELL YOUR DOCTOR about any medications you are
currently taking, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to dexamethasone or other adrenocorticosteroids
(such as alcometasone, amcinonide, betamethasone, clobetasol, clocortolone,
cortisone, desonide, desoximetasone, diflorasone, flumethasone, fluocinolone,
fluocinonide, fluorometholone, flurandrenolide, halcinonide, hydrocortisone,
methylprednisolone, paramethasone, prednisolone, prednisone, and
triamcinolone).
     * Tell your doctor if you now have or if you have ever had bone disease,
diabetes mellitus, emotional instability, glaucoma, fungal infections, heart
disease, high blood pressure, high cholesterol levels, myasthenia gravis,
peptic ulcers, osteoporosis, thyroid disease, tuberculosis, ulcerative
colitis, kidney disease, or liver disease.
     * If you are using this medication for longer than a week, you may need
to receive higher doses if you are subjected to stress, such as serious
infections, injury, or surgery.  Discuss this with your doctor.
     * If you have been taking this drug for more than one or two weeks, do
not stop taking it suddenly.  If it is stopped abruptly, you may experience
abdominal or back pain, dizziness, extreme weakness, fainting, fever, muscle
or joint pain, nausea, vomiting, or shortness of breath.  Your doctor may,
therefore, want to reduce the dosage gradually.  Never increase the dosage or
take the drug for longer than the prescribed time, unless you first consult
your doctor.
     * While you are taking this drug, you should not be vaccinated or
immunized.  This medication decreases the effectiveness of vaccines and can
lead to infection if a live-virus vaccine is administered.
     * Before having surgery or other medical or dental treatment, tell your
doctor or dentist you are taking this drug.
     * Because this drug can cause glaucoma and cataracts with long-term use,
your doctor may want to have your eyes examined by an ophthalmologist
periodically during treatment.
     * If you are taking this medication for prolonged periods, you should
wear or carry an identification card or notice stating that you are taking an
adrenocorticosteroid.
     * This drug can raise blood sugar levels in diabetic patients.  Blood
sugar should, therefore, be monitored carefully with blood or urine tests when
this drug is being taken.
     * Be sure to tell your doctor if you are pregnant.  This drug crosses the
placenta and may cause adverse effects in the fetus.  Birth defects have been
observed in the offspring of animals that were given large doses of this type
of drug during pregnancy.  Also, tell your doctor if you are breast-feeding an
infant.  Small amounts of this drug pass into breast milk and may cause growth
suppression or a decrease in natural adrenocorticosteroid production in the
nursing infant.

----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
