Anti-inflammatory agent, systemic corticosteroid
CCP: Adjunctive treatment for anaphylaxis, croup, and bronchospasm secondary to asthma or chronic obstructive pulmonary disease
Systemic fungal infections
Hypersensitivity to dexamethasone or other corticosteroids
All indications: 8 mg IV/IO/IM/PO
Suppresses neutrophil migration, decreasing production of inflammatory mediators, and reversing increased capillary permeability.
Following intravenous administration:
Cardiovascular: Bradycardia, cardiac arrhythmia, cardiac failure, cardiomegaly, circulatory shock, edema, embolism (fat), hypertension, hypertrophic cardiomyopathy (premature infants), myocardial rupture (post-MI), syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis
Central nervous system: Depression, emotional lability, euphoria, headache, increased intracranial pressure, insomnia, malaise, myasthenia, neuritis, neuropathy, paresthesia, personality changes, pseudotumor cerebri (usually following discontinuation), psychic disorder, seizure, vertigo
Dermatologic: Acne vulgaris, allergic dermatitis, alopecia, atrophic striae, diaphoresis, ecchymoses, erythema, facial erythema, fragile skin, hyperpigmentation, hypertrichosis, hypopigmentation, perianal skin irritation (itching, burning, tingling; following IV injection), petechiae, skin atrophy, skin rash, subcutaneous atrophy, suppression of skin test reaction, urticaria, xeroderma
Endocrine & metabolic: Adrenal suppression, carbohydrate intolerance, Cushing syndrome, decreased glucose tolerance, decreased serum potassium, diabetes mellitus, fluid retention, glycosuria, growth suppression (children), hirsutism, HPA-axis suppression, hyperglycemia, hypokalemic alkalosis, menstrual disease, moon face, negative nitrogen balance, protein catabolism, redistribution of body fat, sodium retention, weight gain
Gastrointestinal: Abdominal distention, gastrointestinal hemorrhage, gastrointestinal perforation, hiccups, increased appetite, nausea, pancreatitis, peptic ulcer, pruritus ani (following IV injection), ulcerative esophagitis
Genitourinary: Defective (increased or decreased) spermatogenesis
Hematologic & oncologic: Kaposi sarcoma, petechial, tumor lysis syndrome
Hepatic: Hepatomegaly, increased serum transaminases
Hypersensitivity: Anaphylactoid reaction, anaphylaxis, angioedema, hypersensitivity
Infection: Infection, sterile abscess
Local: Postinjection flare (intra-articular use)
Neuromuscular & skeletal: Amyotrophy, aseptic necrosis of bones (femoral and humoral heads), bone fractures, Charcot-like arthropathy, myasthenia, myopathy (particularly in conjunction with neuromuscular disease or neuromuscular-blocking agents), osteoporosis, rupture of tendon, steroid myopathy, vertebral compression fracture
Ophthalmic: Exophthalmos, glaucoma, increased intraocular pressure, subcapsular posterior cataract
Respiratory: Pulmonary edema
Miscellaneous: Wound healing impairment
Source: Dexamethasone. In: Lexicomp Online, UpToDate, Waltham, MA. (Accessed November 20, 2020.)
May cause hypercortisolism, particularly in younger children or when used for long periods of time at higher doses.
Dexamethasone should not generally be used for adrenal insufficiency, as it does not provide any mineralocorticoid activity.
Use with caution in patients with heart failure or hypertension: dexamethasone has been associated with fluid retention and electrolyte disturbance.
Corticosteroids have been associated with myocardial rupture when used in acute myocardial infarction.
Dexamethasone crosses the placenta. Some studies have found an association between corticosteroid use in the first trimester and oral clefts and decreased birth weights.
Corticosteroids may enhance the adverse or toxic effects of non-steroidal anti-inflammatory agents and salicylates (including gastrointestinal ulceration and bleeding). They may also reduce the serum concentration of salicylates.
May decrease the serum concentration of phenytoin.
May enhance the anticoagulant properties of warfarin.