AdultPediatricDosage Forms & Strengths tablet 0.5mg (generic) 0.75mg (generic) 1mg (generic) 1.5mg (generic) 2mg (generic) 4mg (generic) 6mg (generic) 20mg (Hemady) injectable suspension 4mg/mL (generic) 10mg/mL (generic) elixir/oral solution 0.5mg/5mL (generic, Baycadron) oral concentrate 1mg/1mL (Dexamethasone Intensol) Inflammation 0.75-9 mg/day IV/IM/PO divided q6-12hr Intra-articular, intralesional, or soft tissue: 0.2-6 mg/day Multiple Sclerosis (Acute Exacerbation) 30 mg/day PO for 1 week; follow by 4-12 mg/day for 1 mo Cerebral Edema 10 mg IV, then 4 mg IM q6hr until clinical improvement is observed; may be reduced after 2-4 days and gradually discontinued over 5-7 days Shock 1-6 mg/kg IV once or 40 mg IV q2-6hr PRN Alternative: 20 mg IV, then 3 mg/kg/day by continuous IV infusion High-dose treatment not to be continued beyond 48-72 hours Allergic Conditions For control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, and serum sickness Day 1: 4-8 mg IM Days 2-3: 3 mg/day PO divided q12hr Day 4: 1.5 mg/day PO divided q12hr Days 5-6: 0.75 mg/day PO in single daily dose Day 7: No treatment Dexamethasone Suppression Test Low-dose test Screening for Cushing syndrome Overnight test: 1 mg PO between 11:00 PM and midnight; cortisol level tested between 8:00 and 9:00 AM on following morning Standard 2-day test: 0.5 mg PO q6hr (9:00 AM, 3:00 PM, 9:00 PM, 3:00 AM) for 2 days; cortisol level tested 6 hours after final dose (9:00 AM) High-dose test Confirmed Cushing syndrome in which further workup is needed to identify whether hormone excess is the result of Cushing syndrome or other causes Standard 2-day test: After determination of baseline serum cortisol or 24-hr urinary free cortisol, 2 mg PO q6hr for 2 days; urine for free cortisol is collected during test, and serum cortisol is checked 6 hours after final dose Overnight test: After determination of baseline serum cortisol, 8 mg (typically) PO between 11:00 PM and midnight; cortisol level tested between 8:00 and 9:00 AM on following morning IV test: After determination of baseline serum cortisol, 1 mg/hr by continuous IV infusion for 5-7 hours Multiple Myeloma Indicated in combination with other antimyeloma products for multiple myeloma (MM) Note: Hemady is approved only for multiple myeloma 20 or 40 mg PO qDay on specific days as per specific treatment regimen Refer to the prescribing information of the other antimyeloma products used in combination with dexamethasone for specific dosing COVID-19 Disease (Off-label) Based on preliminary evidenced from the RECOVERY trial, NIH guidelines recommends dexamethasone to reduce mortality in hospitalized patients with COVID-19 disease who are receiving either invasive mechanical ventilation or oxygen alone, but not among those receiving no respiratory support 6 mg PO/IV qDay for up to 10 days or discharge, whichever comes first; use in addition to standard of care NIH guidelines for dexamethasone use in COVID-19 Preliminary outcomes from the UK RECOVERY trial showed systemic corticosteroids reduced 28-day mortality and the systemic inflammatory response that leads to lung injury and multisystem dysfunction in hospitalized patients with COVID-19 who required supplemental oxygen Benefit was greatest in patients who required mechanical ventilation (29.3% of patients died vs 41.4% in the standard of care arm); no survival benefit observed in patients not requiring oxygen Consider dexamethasone use as follows Supplement oxygen, but not requiring oxygen delivery through high-flow device, noninvasive ventilation, invasive mechanical ventilation, or ECMO Requires oxygen delivery through high-flow device or noninvasive ventilation Requires invasive mechanical ventilation or ECMO Pregnancy: NIH recommends using dexamethasone in hospitalized pregnant women with COVID-19 who require oxygen Chemotherapy-Induced Nausea & Vomiting (Off-label) 8-12 mg PO/IV alone or in combination with other antiemetics before chemotherapy, then 8 mg PO/IV q24hr for 1-3 days after chemotherapy (days 2-4) Altitude Sickness (Off-label) Prophylaxis 2 mg PO q6hr or 4 mg PO q12hr beginning on day of ascent; may be discontinued after 2- to 3-day stay at same elevation or initiation of descent Treatment Acute mountain sickness (AMS): 4 mg PO/IV/IM q6hr High-altitude cerebral edema (HACE): 8 mg once followed by 4 mg PO/IV/IM q6hr until symptoms resolve Spinal Cord Compression (Off-label) 10-100 mg IV, then 4-24 mg IV q6hr during radiation therapy, then taperedDosage Forms & Strengths tablet 0.5mg (generic) 0.75mg (generic) 1mg (generic) 1.5mg (generic) 2mg (generic) 4mg (generic) 6mg (generic) 20mg (Hemady) injectable suspension 4mg/mL (generic) 10mg/mL (generic) elixir/oral solution 0.5mg/5mL (generic, Baycadron) oral concentrate 1mg/1mL (Dexamethasone Intensol) Airway Edema 0.5-2 mg/kg/day PO/IV/IM divided q6hr, starting 24 hours before extubation and continued for 4-6 doses afterward Croup 0.6 mg/kg PO/IV/IM once; not to exceed 16 mg Inflammation 0.08-0.3 mg/kg/day IV/PO/IM divided q6hr or q12hr Meningitis >6 weeks: 0.6 mg/kg/day IV divided q6hr for first 2-4 days of antibiotic therapy, starting 10-20 minutes before or simultaneously with first antibiotic dose Cerebral Edema Associated With Brain Tumor 1-2 mg/kg IV/IM once; maintenance: 1-1.5 mg/kg/day IV/IM divided q4-6hr; not to exceed 16 mg/day Spinal Cord Compression 2 mg/kg/day IV divided q6hr Adrenal Cortical Hyperfunction Test After determination of baseline cortisol level, 1 mg PO at bedtime Plasma cortisol level then determined at 8:00 AM on following morning; level will be decreased in normal individuals but at baseline level in Cushing syndrome Respiratory Distress Syndrome in Premature Infants (Off-label) Prophylaxis 4 mg IM q8hr administered to mother for 2 days before deliveryInteraction CheckerEnter a drug name and dexamethasoneNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (19)apixabandexamethasone will decrease the level or effect of apixaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Reduces anticoagulant effect by decreasing apixaban systemic exposure artemether/lumefantrinedexamethasone will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacycariprazinedexamethasone will decrease the level or effect of cariprazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. CYP3A4 is responsible for the formation and elimination of cariprazine's active metabolites. The effect of CYP3A4 inducers on cariprazine exposure has not been evaluated and the net effect is unclear.cobimetinibdexamethasone will decrease the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Avoid coadministration. Strong or moderate CYP3A inducers may decrease cobimetinib systemic exposure by >80% and reduce its efficacy.dienogest/estradiol valeratedexamethasone will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Women should not choose estradiol valerate/dienogest as their contraceptive while using strong CYP3A4 inducers due to potential decrease in contraceptive efficacy. Estradiol valerate/dienogest should not be used for at least 28 days after discontinuation of the inducer due to possibility of decreased contraceptive efficacy. elbasvir/grazoprevirdexamethasone will decrease the level or effect of elbasvir/grazoprevir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. The therapeutic effect of elbasvir/grazoprevir may be reduced if coadministered with strong CYP3A inducers and is therefore contraindicated.elvitegravir/cobicistat/emtricitabine/tenofovir DFdexamethasone decreases levels of elvitegravir/cobicistat/emtricitabine/tenofovir DF by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May lead to loss of virologic response and possible resistance.lumacaftor/ivacaftordexamethasone will decrease the level or effect of lumacaftor/ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A inducers have minimal effect on lumacaftor exposure, but decreased ivacaftor exposure (AUC) by 57%. This may reduce the effectiveness of lumacaftor/ivacaftor. Therefore, coadministration is not recommended.lumefantrinedexamethasone will decrease the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacylurasidonedexamethasone decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated; decreases lurasidone Cmax by ~85%.mifepristonemifepristone, dexamethasone. Mechanism: unknown. Contraindicated. Mfr. states that mifepristone is contraindicated in pts. on long term corticosteroid Tx.naloxegoldexamethasone will decrease the level or effect of naloxegol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Use of naloxegol with strong CYP3A4 inducers is not recommendedombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)dexamethasone will decrease the level or effect of ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 inducers may reduce partiaprevir and ritonavir levels, and therefore decreased efficacy of Viekira Pakpanobinostatdexamethasone decreases levels of panobinostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 inducers can reduce panobinostat levels by ~70% and lead to treatment failure.praziquanteldexamethasone decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.regorafenibdexamethasone, regorafenib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP3A4 inducers decrease regorafenib levels and increase exposure of the active metabolite M-5.rilpivirinedexamethasone decreases levels of rilpivirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated. Rilpivirine should not be co-administered with strong CYP 3A4 inducers. Potential for loss of virologic response and possible resistance to rilpivirine or to the NNRTI class.roflumilastdexamethasone will decrease the level or effect of roflumilast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration not recommended; strong cytochrome P450 enzyme inducers decrease systemic exposure to roflumilast and may reduce the therapeutic effectivenessvandetanibdexamethasone decreases levels of vandetanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Avoid coadministration with potent CYP3A4 inducers; these drugs reduce exposure to vandetanib by up to 40%.Serious - Use Alternative (132)abametapirabametapir will increase the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.abemaciclibdexamethasone will decrease the level or effect of abemaciclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of abemaciclib with strong CYP3A4 inducers reduces plasma concentration of abemaciclib and its metabolites.acalabrutinibdexamethasone will decrease the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of acalabrutinib with strong CYP3A inducers. If a strong CYP3A inducer must be used, increase acalabrutinib dose to 200 mg twice daily.adenovirus types 4 and 7 live, oraldexamethasone decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Corticosteroids may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of corticosteroid therapy.aldesleukindexamethasone decreases effects of aldesleukin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid combination because corticosteroids can potentially diminish the antineoplastic effects of aldesleukin.anthrax vaccinedexamethasone decreases effects of anthrax vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.apalutamideapalutamide will decrease the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.apremilastdexamethasone will decrease the level or effect of apremilast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration with strong CYP inducers results in a significant decrease of systemic exposure of apremilast, which may result in loss of efficacyaxicabtagene ciloleuceldexamethasone, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Consider the use of prophylactic corticosteroid in patients after weighing the potential benefits and risks. Corticosteroids may, however, be required for treatment of cytokine release syndrome or neurologic toxicity.axicabtagene ciloleucel, dexamethasone. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid prophylactic use of systemic corticosteroids as premedication before CAR-T cell therapy. Corticosteroids may, however, be required for treatment of cytokine release syndrome or neurologic toxicity.axitinibdexamethasone decreases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Selection of concomitant medication with no or minimal CYP3A4 induction potential is recommended.BCG vaccine livedexamethasone decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.bedaquilinedexamethasone will decrease the level or effect of bedaquiline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of bedaquiline with strong CYP3A4 inducers due to potential for decreased therapeutic effectbosutinibdexamethasone decreases levels of bosutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inducers decreased bosutinib plasma concentration by ~85% .brexucabtagene autoleuceldexamethasone, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.