Introduction: 

     Dexamethasone, also known as “life saving drug” is a synthetic adrenocortical steroid (Glucocorticoid: steroid hormones that reduce inflammation and suppress the immune system)  and thermogenesis drug used to treat a wide range of conditions including inflammation, overactive immune response problems etc. It is also used as replacement therapy in adrenocortical deficiency states and as a diagnostic agent in tests of adrenal function. It works similar to cortisol hormone. 

Explanation: 

Glucocorticoids are naturally occurring steroids in the body (as hydrocortisone and cortisone) and are mainly absorbed from the gastrointestinal tract (GIT Tract). They cause metabolic effects and modify the body’s immune responses to external stimuli. Synthetic analogs such as dexamethasone are primarily used in anti-inflammatory disorders of many organisms. At equipotent anti-inflammatory doses, dexamethasone almost completely lacks the sodium-retaining property of hydrocortisone and closely related derivatives. 

Composition of Dexamethasone: 

     Each 2ml contains 1mg of dexamethasone. 

Uses of Dexamethasone:

 Dexamethasone is involved in treatment of 

1. Allergy
2. Rheumatic problems
3. Skin diseases 
4. Inflammations
5. Thermogenises
6. Croup
7. Brain swelling
8. Eye pain following eye surgery
9. Chronic obstructive pulmonary disease (COPD)
10. Superior vena cava syndrome (Complicated form of cancer) 

Side effects of Dexamethasone:

1. Sleep loss
2. Anxiety
3. Mood swings
4. Immuno suppressant
5. Feeling nervous
6. Water retention 
7. Weight gain
8. Stomach Ulcer
9. Adrenal Suppression 
10. Higher blood sugar levels
11. Increased appetite
12. Hormone disorders
13. Cataract
14. Glaucoma
15. Increase uterine contractions
16. Weakens the Bones 
17. Osteoporosis
18. Thermogenesis (Increases body temperature (Pyrexia))

       There may be some other side effects that not listed above and have faced by patients 

Instructions: 

• Store below 30
• Store in a cool and dry place
• Avoid freezing
• Use before expiry date.
• Keep out of the reach of children
• To be sold on the prescription of a registered pharmacist or veterinarian. 

Dosage of Dexamethasone:

Doses depend on the condition, weight, formulation and route, so they should be set by a doctor or vet.

Humans (adults unless noted)

• Anti-inflammatory/allergic: 0.5-9 mg/day orally, in 1-4 divided doses
• COVID-19 (hospitalized, on oxygen): 6 mg daily, up to 10 days
• Brain swelling: 10 mg IV load, then 4 mg every 6 h
• Chemo-related nausea: 8-20 mg, depending on the regimen
• Multiple myeloma: 40 mg daily on set days of a cycle
• Croup/asthma (children): 0.15-0.6 mg/kg once, max about 16 mg
• Bacterial meningitis (children): 0.15 mg/kg every 6 h for 2-4 days
• Dexamethasone suppression test: 1 mg overnight (low-dose) or 8 mg (high-dose)

Dogs

• Anti-inflammatory: 0.05-0.15 mg/kg once daily (oral, IV, IM, SC)
• Immunosuppressive: 0.25-0.5 mg/kg/day, tapered
• Addisonian crisis: about 0.1-0.2 mg/kg IV
• Cushing’s testing: low-dose 0.01 mg/kg IV, high-dose 0.1 mg/kg IV

Cats

• Anti-inflammatory: about 0.1-0.2 mg/kg once daily. Cats tolerate steroids somewhat better than dogs but still have diabetes and heart-failure risks.
• Cushing’s testing: low-dose 0.1 mg/kg, high-dose 1 mg/kg IV

Horses and cattle

• Horses: roughly 0.02-0.2 mg/kg, depending on the use
• Cattle: typically 5-20 mg total for inflammation. Higher doses (20-30 mg) are used to induce parturition under veterinary direction.

Precautions & Avoids:

              Dexamethasone is very sensitive to be combined with calcium, resulting in bradycardia, cardiac arrhythmia, cardiac arrest and death. Combined use with NSAIDS is prohibited. It is not recommended to be used in viral infections because it prolongs the duration of most of viral diseases(Due to its immunosuppressant property) except Corona virus. 

      Moreover, It was the first drug proven to cut COVID-19 deaths. In the 2020 RECOVERY trial, it reduced mortality by about a third in ventilated patients and by about a fifth in those on oxygen. It showed no benefit, and possible harm, in patients not needing oxygen. It costs pennies and is on the WHO essential medicines list.Its plasma half-life is only ~4 hours, but its biological effect lasts 36-72 hours. It keeps acting inside cells after the blood level falls. That’s why a single dose can treat croup in a child. In veterinary, vets use it to induce labor in cattle. It triggers the fetal stress-hormone cascade that starts parturition.

Frequently Asked Questions

What is dexamethasone?

 Dexamethasone, also known as “life saving drug” is a synthetic adrenocortical steroid (Glucocorticoid: steroid hormones that reduce inflammation and suppress the immune system)  and thermogenesis drug used to treat a wide range of conditions including inflammation, overactive immune response problems etc.

What is dexamethasone used for?

Dexamethasone is used for treatment of Allergy, Rheumatic problems, Skin diseases, Inflammations, Thermogenises, Croup, Brain swelling, Eye pain following eye surgery, Chronic obstructive pulmonary disease (COPD), Superior vena cava syndrome (Complicated form of cancer) 

Is dexamethasone a steroid?

Yes, Dexamethasone is a synthetic adrenocortical steroid (Glucocorticoid: steroid hormones that reduce inflammation and suppress the immune system)  and thermogenetic drug used to treat a wide range of conditions including inflammation, overactive immune response problems etc.

How long do side effects of dexamethasone last?

The lasting duration of dexamethasone side effects depends on how long you took the medication, your dosage, and whether the effects are short acting (short term) or long acting (long term). Usually side effects fade within 24 to 48 hours (1-2 Days) after your last injected dose, while long-term or severe effects can take weeks, months, or longer to resolve (1 to 4 Weeks or longer).  

Is dexamethasone a corticosteroid​?

Yes, dexamethasone is a potent synthetic corticosteroid.

What does dexamethasone do? 

Dexamethasone is a potent synthetic corticosteroid that works by decreasing inflammation and suppressing an overactive immune system. It slows down an immune system that is attacking the body,  and stops white blood cells from traveling to swollen areas for causing inflammation. It is globally used in severe allergies that are hard to control, respiratory diseases (Asthma or chronic obstructive pulmonary disease (COPD)), rheumatoid arthritis, reduced brain swelling, Severe COVID-19, reduces cancer by killing cancerous cells. 

Is dexamethasone a strong steroid? 

Yes, dexamethasone is a very strong, highly potent corticosteroid drug. 

Why do I feel so good on dexamethasone? 

Dexamethasone can make you active, energetic, euphoric, because it is a potent corticosteroid drug that mimics cortisol and directly alters brain chemistry and neurotransmitter activity of the organism. 

What are 5 uses for dexamethasone? 

5 uses for dexamethasone are Allergy, Rheumatic problems, Skin diseases , Inflammations, Thermogenises

What are the worst side effects of dexamethasone? 

Dexamethasone can cause death when it is combined with calcium and is used, which results in calcium crystal and finally death occurs of that living organism. Other worst side effects include severe systemic, metabolic, and psychological complications, adrenal gland suppression, arthritis, osteoporosis, high blood pressure and many more. 

Is dexamethasone a high risk drug?

Dexamethasone is not formally classified as a “high-risk” medication in terms of dosing errors, but it carries significant risks and side effects—especially when used in high doses or for a long time. It should never be used with NSAIDs and Calcium (as a solution). It can cause death when it is combined with calcium which results in Calcium crystals and finally death occurs. 

Can dexamethasone make you sleepy? 

Dexamethasone does not make you sleepy directly, but it can cause tiredness or fatigue indirectly by disrupting your sleep. 

What to avoid when taking dexamethasone?

The use of NSAIDs and calcium drugs should be avoided while using dexamethasone. 

Will dexamethasone give you energy? 

Yes, dexamethasone can give you a temporary boost in energy, activeness or a feeling of stimulation. 

Who should not take dexamethasone? 

Dexamethasone should not be taken by anyone who is allergic to the medication, has an untreated infection, or is receiving a live vaccine. 

How quickly does dexamethasone start working? 

Dexamethasone typically starts working within 20 minutes to 2 hours, depending on how it is given (Intravenous or intramuscular, Intravenous acts fast as compared to intramuscular).