Dexamethasone
Brand: Decadron (discontinued), Hemady
No boxed warning on the current FDA label.
- Caution
- Adrenal suppression with prolonged use; raises blood sugar and infection risk, and masks signs of infection.
Common side effects
- High blood sugar
- Insomnia and mood change
- Increased appetite
- Fluid retention
Key interactions
- Raises blood sugar: diabetes medicines may need adjusting
- Additive ulcer risk with NSAIDs
- Strong CYP3A4 inducers lower its level
- Live vaccines are avoided during high-dose therapy
Counseling points
- Take in the morning to reduce insomnia
- Take with food
- Do not stop abruptly after long courses: the adrenal glands need time to recover
- Report signs of infection; steroids blunt them
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