Decadron-Dexamethasone

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Uses For This Medication
  • Dexamethasone is used alone or in combination with other medications to treat many different types of diseases and conditions, including allergic conditions, skin diseases, ulcerative colitis, certain blood disorders or diseases, eye disorders, swelling of the brain (due to brain tumor or head injury), arthritis, asthma, and certain kidney diseases.
  • Dexamethasone is also used in the treatment of certain types of cancer, including certain types of leukemia (acute lymphoblastic leukemia), non-Hodgkins’ lymphoma, and multiple myeloma.
  • Dexamethasone is also used in combination with other medications to help prevent nausea and vomiting that can occur as a side effect of chemotherapy.
  • Dexamethasone is also used to decrease the risk of developing allergic reactions to certain chemotherapy medications, including paclitaxel (Taxol®) or docetaxel (Taxotere®).
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Dexamethasone belongs to a class of medications known as corticosteroids. It is similar to the steroid hormone that is made in the body by the adrenal glands. Dexamethasone has different effects depending on what it is being used to treat. Dexamethasone is a very strong anti-inflammatory and helps prevent the white blood cells in the body from producing an inflammatory reaction.
  • Dexamethasone is beneficial in the treatment of various diseases and conditions (including allergic conditions, skin diseases, ulcerative colitis, certain blood disorders or diseases, eye disorders, swelling of the brain, arthritis, asthma, kidney diseases). Dexamethasone helps to relieve some disease symptoms by modifying how the immune system works. The exact benefit of dexamethasone in the treatment of acute lymphoblastic leukemia, non-Hodgkins’ lymphoma, and multiple myeloma is not clear. However, dexamethasone is an important part of some of the chemotherapy treatments used for these cancers.
  • Dexamethasone, in combination with other medications, is effective in preventing nausea and vomiting from chemotherapy.
  • Dexamethasone is effective in preventing allergic reactions to certain chemotherapy medications, including paclitaxel (Taxol®) and docetaxel (Taxotere®).
  Who Should Not Take This Medication You should not take this medication if you:
  • Are allergic to dexamethasone or any of its components.
  • Have any sort of fungal infection or other type of infection, as dexamethasone can make it worse.
  Precautions to be Aware of Before Taking This Medication

Allergy related precautions

Rarely, dexamethasone may cause allergic reactions. These allergic reactions can cause difficulty breathing and a decrease in blood pressure. Your doctor or healthcare provider will watch you carefully during and after the administration of dexamethasone to make sure that you do not experience any allergic reactions. If an allergic reaction occurs it is treatable with medications.

Blood related precautions

This medication can cause high blood sugar levels. Your doctor or healthcare provider will check your blood regularly while you are on this medication to monitor for this possible problem. If you notice symptoms such as increased thirst, increased hunger, or increased urination, make sure that you tell your doctor or healthcare provider right away. In addition, if you are diabetic, the dose of your diabetes medications may need to be changed. Be sure to check with your doctor or healthcare provider.

Infection related precautions

  • Patients who are on dexamethasone are more prone to infections, including bacterial, viral or fungal infections. In addition, dexamethasone can actually worsen existing fungal infections and should not be used in patients who already have a fungal infection. The risk of developing an infection increases as the doses of dexamethasone increase. Your doctor or healthcare provider will monitor you carefully while you are on dexamethasone to make sure that you do not develop any sort of infection. If you develop a fever or any other symptoms of illness, you should contact your doctor or healthcare provider.
  • This drug modifies the way the immune system works and it can increase the likelihood of infections. In addition, the drug may make the signs of infections, such as fever, difficult to detect.
  • Patients who are on dexamethasone should stay away from individuals with either chickenpox or the measles.
  Organ related precautions
  • This medication may increase your blood pressure. Most people usually don’t feel any different when their blood pressure is raised. However, severe increases in blood pressure can cause headache, visual disturbances, confusion, or sleepiness. Contact your doctor or healthcare provider if you have these symptoms.
  • Dexamethasone can cause eye problems, including cataracts and glaucoma. Your doctor or healthcare provider will monitor you carefully to ensure that you do not develop this problem. In addition, you should let your doctor or healthcare provider know if you have any vision problems or changes.
  • This medication may cause irritation and/or bleeding of the stomach. Let your doctor or healthcare provider know if you vomit blood or pass black tarry stools. In addition, if you already have stomach problems (such as stomach ulcers or diverticulitis), you should let your doctor or healthcare provider know.
  • Dexamethasone can decrease the formation of bone and can increase the breakdown of bone. This can cause poor bone growth in children and can lead to osteoporosis in any patients who are taking this medication. If you are post-menopausal or have any pre-existing bone conditions, you should talk with your doctor before starting dexamethasone.
 

Miscellaneous precautions

  • This medication can cause your body to retain sodium (which may require salt restriction) resulting in swelling of the ankles and legs, and to lose potassium (which may require potassium supplementation). If you have a history of heart failure, high blood pressure or kidney problems, you should let your doctor or healthcare provider know so that he or she can monitor you carefully while you are on dexamethasone.
  • Dexamethasone can cause your blood sugar level to increase. If you have diabetes, dexamethasone can make it worse. Your doctor or healthcare provider with check you blood from time to time to make sure your blood sugar level is normal. Tell your doctor or healthcare provider if you feel very thirsty, are urinating frequently, or are loosing weight unexpectedly.
  • If you take dexamethasone for a long period of time, do not stop this medication suddenly. Doing so can cause a decrease in the natural steroid hormones that your body makes. This is called adrenocortical insufficiency. Symptoms of this are nausea, loss of appetite, tiredness, dizziness, difficulty breathing, joint pain, muscle pain, depression, low blood sugar, and low blood pressure. These symptoms can last for several months after stopping dexamethasone. The risk of developing adrenocortical insufficiency can be minimized by decreasing the dose of dexamethasone slowly.
  • Dexamethasone can cause difficulty sleeping, mood swings, euphoria, personality changes and severe depression. Also, dexamethasone can worsen existing emotional instability or psychotic tendencies.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
 

Patient specific precautions

  • This medication appears to be safe and effective in children and side effects reported in children are similar to those reported in adults. Children taking corticosteroids may experience slowed growth rate.
  Pregnancy and Breastfeeding Precautions When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant since this medication may cause fetal harm. This medication is found in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided. Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future. Medication and Food Interactions Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with dexamethasone and the following foods or medications:
  • Amiodarone (Cordarone®)
  • Aminoglutethimide (Cytadren®)
  • Amphotericin B
  • Anticholinesterase agents
  • Aprepitant (Emend®)
  • Aspirin
  • Atazanavir (Reyataz®)
  • Carbamazepine
  • Caspofungin
  • Clarithromycin (Biaxin®)
  • Cholestyramine
  • Cyclosporine
  • Digoxin (Lanoxin®)
  • Diuretics (medications that get rid of excess fluid in the body and can also be used to control high blood pressure)
  • Ephedrine
  • Erythromycin
  • Estrogens, including oral contraceptives
  • Fluoroquinolones antibiotic (e.g. ciprofloxacin, levofloxacin, Lomefloxacin, gemifloxacin)
  • Fluconazole (Diflucan®)
  • Grapefruit or grapefruit juice
  • Imatinib mesylate (Gleevec®)
  • Indinavir (Crixivan®)
  • Irinotecan
  • Isoniazid
  • Itraconazole (Sporanox®)
  • Diabetes medications
  • Nefazodone (Serzone®)
  • Nelfinavir (Viracept®)
  • NSAIDS such as ibuprofen (Advil®), naproxen (Aleve®), sulindac (Clinoril®), ketoprofen (Oruvail®)
  • Phenytoin (Dilantin®)
  • Phenobarbital
  • Rifampin (Rifadin®)
  • Rifabutin (Mycobutin®)
  • Ritonavir (Norvir®)
  • Saquinavir
  • St.John’s wort
  • Sunitinib
  • Thalidomide (Thalomid®)
  • Vaccines
  • Voriconazole (Vfend®)
  NOTE: This list may not include all medications that can have interactions with dexamethasone.

Side Effects

  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when dexamethasone is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with dexamethasone alone.
 

More common side effects

  • Increased appetite, stomach irritation
  • Euphoria, difficulty sleeping, mood changes, depression (see Precautions)
  • Flushing
  • Increased blood sugar, decreased blood potassium (symptoms are loss of appetite, muscle twitching, increased thirst, increased urination)
  • Weight gain
  • Increased blood pressure (see Precautions To Be Aware Of Before Taking This Medication)
  • Increased risk of infection
  • Bruising of the skin, delayed wound healing
 

Less common side effects

  • Fungal infections (white patches in the mouth or in the vagina) (see Precautions To Be Aware Of Before Taking This Medication)
  • Sweating
  • Diarrhea, nausea
  • Headache
  • Increased heart rate
  • Loss of calcium from bones (see Precautions)
  • Increased anxiety
 

Rare side effects

This is not a complete list of the rare side effects reported with dexamethasone. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Cataracts (see Precautions To Be Aware Of Before Taking This Medication)
  • Congestive heart failure
  • Sodium and fluid retention with swelling of ankles (see Precautions To Be Aware Of Before Taking This Medication)
  • Blurred vision
  • Stomach ulcer which may bleed(see Precautions To Be Aware Of Before Taking This Medication)
  • Acne, roundness of the face
  • Convulsions
  • Psychiatric disturbances
  • Blood clots
  • Menstrual irregularities
  How To Take This Medication
  • This medication is either taken by mouth (orally) or given by injection into a vein (IV) by a healthcare professional. This medication can be given in different doses depending on your weight, whether you are receiving IV or oral dexamethasone and your type of condition. If you are taking this medication orally, be sure to take it with food or milk and follow any other instructions provided by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you.
  • In the unlikely event of an overdose of this medication contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
 

Proper Storage

  • If you are receiving the IV form of dexamethasone, it is unlikely that you will need to store this medication. However, in the event that you do, the unopened containers should be stored at room temperature and keep in its original container.
  • If you are taking the oral form of dexamethasone, the tablets should be stored at room temperature.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.