General anti-inflammatory dosing - Pediatric: 0.08 to 0.3 mg/kg/day in divided doses every 6 to 12 hours

Asthma exacerbation: Infants, Children, and Adolescents:  0.6 mg/kg once daily as a single dose or once daily for 2 days; maximum dose: 16 mg/dose; single dose regimens as low as 0.3 mg/kg/dose and as high as 1.7 mg/kg/dose have also been reported. Note:  Duration >2 days is not recommended.

Dexamethasone belongs to the group of medications known as corticosteroids. It is similar to prednisone in it's actions.  Dexamethasone has strong anti-inflammatory effects and can be used to treat many different conditions (such as asthma) where inflammation is involved.

Along with its needed effects, dexamethasone may cause some unwanted or undesirable effects. The frequency and severity of these effects is dependant on many factors including dose, duration of therapy and individual response. Your pharmacist will be able to tell you which ones will be more likely to occur with your particular treatment plan. Possible unwanted effects include:

• nausea
• upset stomach
• vomiting
• increased appetite
• weight gain
• bloating
• sleep disturbances

Uncommon:

• fluid retention
• higher blood sugar levels
• increased risk of infection
• impaired wound healing
• peptic ulcers

Rare:

• growth retardation in children (prolonged treatment at anti-inflammatory doses)
• Cushing's Syndrome (long-term use): Appearance of "moonface"(facial rounding); enlargement of some fat pad areas; obesity in the midsection; diabetes; osteoporosis; acne; excessive body hair growth; muscle weakness
• withdrawal effect, if therapy is discontinued abruptly (nausea, fatigue, lowered blood pressure, joint and muscle aches, fever, dizziness, fainting)
• muscle weakness
• glaucoma
• cataracts
• mental disturbances

High dose or long term therapy must be withdrawn gradually (tapered).
While taking dexamethasone, signs of infection can be masked and new infections may appear.
Diabetics may need to increase their dose of insulin or oral diabetes medications.
Dexamethasone can cause mental or mood disturbances (e.g. depression).

Drug Interactions: It is important to tell your doctor and pharmacist of any over-the-counter or prescription medications you are taking. The dose of one or both medications may need to be altered or a new medication may need to be prescribed. The following drugs and drug classes have been known to interact with dexamethasone:

• barbiturates (e.g. phenobarbital)
• phenytoin (e.g. Dilantin®)
• rifampin (e.g. Rifadin®)
• vaccines
• ketoconazole
• nonsteroidal anti-inflammatory drugs (e.g. Aspirin®)
• warfarin (e.g. Coumadin®)
• antidiabetic agents (e.g. insulin)
• cyclosporine (e.g. Neoral®)
• digoxin
• isoniazid

Your pharmacist will be able to answer any questions you may have regarding the seriousness or the mechanism of the interaction

Use is not recommended in the following situations:

• allergy to dexamethasone or any component of the preparation
• fungal infections
• tuberculosis

Caution is recommended in the following situations:

• high blood pressure
• diverticulitis (inflammation of the sacs or pouches that are formed at weak points in the wall of the colon causing abdominal pain with diarrhea or constipation)
• peptic ulcers
• herpes simplex in the eye
• kidney disease
• liver disease
• psychiatric conditions
• myasthenia gravis
• osteoporosis
• hypothyroidism
• ulcerative colitis (inflammation of the colon causing symptoms like diarrhea with or without blood and mucus, and lower abdominal pain)

Use in pregnancy: Dexamethasone may pose a small risk to the developing fetus.  Consult your doctor or pharmacist if you suspect that you may be pregnant.
Use while breastfeeding: Short-term use is considered safe.  Limit dose and duration of therapy, when possible.