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.
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