dexamethasone injection (Baycadron, Decadron [Discontinued], Dexamethasone Intensol)

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GENERIC NAME: dexamethasone injection

BRAND NAMES: Baycadron, Decadron (Discontinued), Dexamethasone Intensol

DRUG CLASS AND MECHANISM: Dexamethasone is a synthetic (created by a chemical processes) corticosteroid hormone like prednisone, betamethasone, and triamcinolone. More specifically, dexamethasone is a glucocorticoid hormone, which means that it has anti-inflammatory effects, as well as the ability to affect blood glucose use, fat breakdown, and bone development depending on where it binds in the body. Dexamethasone reduces inflammation by preventing immune cells, such as neutrophils, from migrating to the site of action, reducing the release of inflammatory signals, as well as decreasing how well substances may pass in and out of the blood vessels. It also has anti-vomiting properties (antiemetic). The FDA approved dexamethasone in 1958.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Injection solution: 4 mg/mL and 10 mg/ml; 1 mg/ml

STORAGE: Dexamethasone should be stored as intact vials at room temperature, between 20 C to 25 C (68 F to 77 F). Protect from light and heat. Do not freeze. If diluted, use within 24 hours.

PRESCRIBED FOR: Dexamethasone injection is prescribed for vomiting, as well as for a variety of diseases where blocking the immune system is important. This includes allergies, skin conditions, endocrine, hematologic, inflammatory, neoplastic, nervous system, renal, respiratory, rheumatic, and autoimmune diseases. It is also used to manage cerebral edema and chronic swelling.

DOSING: The dose for dexamethasone is based on whether is administered intravenously or by intramuscular injection as well as the severity of the condition requiring treatment. Consult the official prescribing information for dosing regimens.

DRUG INTERACTIONS: Dexamethasone may decrease levels of drugs that are broken down by liver enzymes. Examples include abiraterone, apixaban (Elquis), aripiprazole (Abilify), boceprevir (Victrelis), dronedarone (Multaq), and quetiapine (Seroquel, Seroquel XR) . Consider increasing the dose of the drug or avoiding this combination altogether. Adverse effects, such as bone marrow suppression, are enhanced when dexamethasone is used with other immunosuppressants such as leflunomide (Arava) and tacrolimus (Prograf). Dosing schedules should be evaluated and alternative therapies should be considered. Live vaccines should also be avoided because dexamethasone reduces immune function.

PREGNANCY: Category C; animal reproduction studies show adverse events with corticosteroid use. Dexamethasone has the potential to cross the placenta to affect fetal growth. Lowest effective doses should be used for the shortest duration of time, with avoidance of dosing in the first trimester to help avoid oral clefts. Low adrenal function may also develop in newborns if corticosteroid exposure occurs while in the womb.

NURSING MOTHERS: Corticosteroids are excreted in breast milk, and, therefore should be used cautiously by nursing mothers. If dexamethasone is absolutely needed and breastfeeding cannot be stopped, a separation of 4 hours between therapy and breastfeeding is recommended to decrease exposure of the infant to the corticosteroid.

Medically Reviewed by a Doctor on 5/30/2014



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