Dexamethasone

Dexamethasone is a corticosteroid (glucocorticoid) medicine. It is available in Bangladesh under many brand names. Below are its uses, side effects and precautions, and every brand with its current price.

• Corticosteroid-responsive inflammatory and allergic conditions.
• Severe allergic reactions as part of appropriate medical management.
• Asthma or COPD exacerbations when a systemic corticosteroid is indicated.
• Rheumatic, autoimmune, dermatologic, gastrointestinal, blood, or kidney disorders where corticosteroid therapy is prescribed.
• Cerebral edema and certain cancer-related supportive uses when directed by a specialist.
• Prevention or treatment of nausea and vomiting associated with some chemotherapy regimens, as prescribed.
• Eye inflammation responsive to steroids, such as allergic or non-infectious conjunctival, corneal, or anterior segment inflammation, after infection has been excluded.
• Ear inflammation responsive to steroids when prescribed and when the eardrum status and infection risk have been assessed.

• Indigestion, increased appetite, weight gain, mood changes, sleep disturbance, headache, or dizziness.
• Raised blood sugar, fluid retention, increased blood pressure, and low potassium, especially with systemic use.
• Increased risk of infection or masking of infection symptoms.
• Stomach ulcer or bleeding, particularly with NSAIDs or in high-risk patients.
• Long-term use may cause osteoporosis, muscle weakness, skin thinning, easy bruising, delayed wound healing, adrenal suppression, Cushingoid features, cataract, glaucoma, or growth suppression in children.
• Eye preparations may cause stinging, blurred vision, raised eye pressure, cataract, delayed corneal healing, or worsening of viral, fungal, or bacterial eye infections.
• Skin preparations may cause burning, irritation, acne-like rash, skin thinning, stretch marks, or worsening of untreated infection.
• Serious allergic reaction is rare but requires urgent medical help.

Use extra caution in people with current or recent infection, tuberculosis, diabetes, high blood pressure, heart failure, kidney or liver disease, peptic ulcer, osteoporosis, glaucoma, cataract, epilepsy, mood disorders, thyroid disease, or a history of steroid side effects. Before eye or ear use, infection and eardrum problems should be assessed by a healthcare professional. Avoid prolonged or frequent use unless clearly prescribed. Use under a registered doctor's or pharmacist's guidance.

• NSAIDs such as ibuprofen, naproxen, or aspirin may increase the risk of stomach ulcer or bleeding.
• Warfarin and other anticoagulants may have altered effect; monitoring may be needed.
• Diabetes medicines may need adjustment because dexamethasone can raise blood glucose.
• Live vaccines should generally be avoided during immunosuppressive systemic corticosteroid therapy.
• Rifampicin, carbamazepine, phenytoin, phenobarbital, and similar enzyme inducers may reduce dexamethasone effect.
• Ketoconazole, itraconazole, ritonavir, cobicistat, and some macrolide antibiotics may increase steroid exposure and side effects.
• Diuretics that lower potassium and digoxin may increase risk from low potassium.
• Other immunosuppressants can increase infection risk.

• Known hypersensitivity to dexamethasone or any component of the product.
• Untreated systemic fungal infection when systemic dexamethasone is being considered.
• Use of live vaccines in patients receiving immunosuppressive systemic corticosteroid doses.
• Topical eye use in untreated viral eye disease such as epithelial herpes simplex keratitis, fungal or mycobacterial eye infection, or untreated purulent bacterial eye infection.
• Topical skin or ear use on untreated infections unless appropriate anti-infective treatment is also prescribed.

During pregnancy, dexamethasone should be used only when the expected benefit justifies the potential risk, and the dose and duration should be kept as low as clinically appropriate. Prolonged or high-dose systemic use may affect fetal growth or neonatal adrenal function. Dexamethasone can pass into breast milk in small amounts; breastfeeding mothers should use it only on medical advice, especially with high-dose or long-term systemic therapy.

Store at room temperature, away from excessive heat, moisture, and direct light. Do not freeze liquid preparations unless the label specifically allows it.

Keep eye and ear drops tightly closed and avoid touching the dropper tip to any surface. Discard opened sterile drops according to the product label or pharmacist's advice. Keep all medicines out of reach of children.