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ALIMENTARY TRACT AND METABOLISM › STOMATOLOGICAL PREPARATIONS › STOMATOLOGICAL PREPARATIONS › Corticosteroids for local oral treatment
dexamethasone
A01AC02
Forms & Strengths
- Oral tablet: 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, 6 mg
- Oral solution: 0.5 mg/5 mL, 1 mg/mL
- Injection solution: 4 mg/mL, 10 mg/mL
- Ophthalmic suspension: 0.1%
Adult Dosing
- Inflammatory conditions: 0.75 mg to 9 mg daily orally in divided doses
- Cerebral edema: 10 mg IV load, then 4 mg IV every 6 hours
- COVID-19: 6 mg orally or IV once daily for up to 10 days
- Croup: 0.6 mg/kg orally or IM as a single dose (max 16 mg)
Pediatric Dosing
- Airway edema / Croup: 0.6 mg/kg orally or IM as a single dose (max 16 mg)
- Anti-inflammatory / Immunosuppression: 0.02 to 0.3 mg/kg/day orally or IV divided every 6 to 12 hours
Indications
- Severe inflammation and allergic conditions
- Cerebral edema associated with brain tumors
- COVID-19 in hospitalized patients requiring oxygen therapy
- Diagnostic testing for Cushing syndrome
- Nausea and vomiting associated with chemotherapy
Mechanism of Action
- Potent synthetic glucocorticoid with minimal mineralocorticoid activity
- Binds to intracellular glucocorticoid receptors, modulating gene transcription
- Suppresses neutrophil migration, decreases leukocyte production of inflammatory cytokines, and reverses capillary permeability
Contraindications
- Systemic fungal infections
- Known hypersensitivity to dexamethasone or components
- Administration of live or live-attenuated vaccines while receiving immunosuppressive doses
Adverse Reactions
- Hyperglycemia and secondary diabetes
- Fluid retention, hypertension, and weight gain
- Insomnia, mood changes, and psychosis
- Increased susceptibility to severe infections
- Gastrointestinal ulceration and dyspepsia
- Long-term: osteoporosis, adrenal suppression, and skin thinning
Drug Interactions
- Strong CYP3A4 inducers (e.g., phenytoin, rifampin, phenobarbital) decrease dexamethasone plasma concentrations
- CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) increase dexamethasone exposure
- NSAIDs or anticoagulants increase the risk of gastrointestinal bleeding
- Diuretics (e.g., furosemide, thiazides) increase the risk of severe hypokalemia
Curated Content: Needs Vetting Before Put to Clinical Use