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dexamethasone

Other Name(s):
Appearance: Available as tablets in various strengths, shapes and colours OR a clear, colourless injection that may be mixed into larger bags of fluids. 

Medication Information Sheet
dexamethasone tablets or injection (dex-a-METH-a-sone)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Generic brand(s) available, Decadron®

Appearance:

Available as tablets in various strengths, shapes and colours OR a clear, colourless injection that may be mixed into larger bags of fluids. 

What is this medication for?
  • Dexamethasone is a corticosteroid (acts like a hormone the body normally makes, called cortisol).
     
  • Dexamethasone is used to treat many conditions. This information sheet is about its use as:
     
    • cancer treatment, where it is usually given along with other anticancer medications as part of a treatment regimen, 
       
    • or to control nausea and vomiting from cancer treatment.
What should I do before I have this medication?
  • Tell your health care team if you have or had:
     
    • infections,
    • diabetes or high blood sugar,
    • osteoporosis or bone thinning,
    • cataracts, glaucoma or increased eye pressure,
    • stomach ulcers,
    • heart, kidney or liver problems,
    • depression or mood changes,
    • if you have had dexamethasone or other corticosteroids before and for how long,
    • or if you have any allergies. 
       
  • Check with your health care team before having any vaccinations, surgeries or dental work. 
     
  • This drug contains a small amount of lactose. If you cannot tolerate lactose, talk to your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.
     
  • ► Use 2 effective forms of birth control at the same time while taking this drug. Keep using birth control for at least 6 months after your last dose unless your health care team told you differently. Talk to your health care team to figure out the best method(s) for you and/or your partner.
     
  • Do not breastfeed while using this drug.
How is this medication given?
  • Take it exactly as directed by your doctor. Make sure you understand the instructions.

Tablets:

  • Swallow whole with a glass of water, with food.
  • If the tablet(s) are taken once daily, take them in the morning right after eating breakfast. This is when your body normally makes a similar corticosteroid called cortisol. 
  • Do not stop taking dexamethasone without first checking with your health care team. You may be instructed to lower your dose slowly before stopping dexamethasone to reduce the risk of side effects. 

Injection:

  • Dexamethasone may be given by intravenous (IV) injection. 
What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

For mild aches and pain or fever:

  • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
     
  • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
     
  • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of stomach problems or bleeding, especially if you are taking other anticancer drugs.  Talk to your health care team before you start or stop these medications.
     
  • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
     
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.
     
  • If you have diabetes, talk to your health care team about checking your blood sugar more often. Dexamethasone may increase blood sugar levels. 
How should I safely store this medication?
  • Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.

  • Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.

What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects are more common and may be severe with higher doses or prolonged use of dexamethasone (for weeks or months). Talk to your health care team about what side effects to expect. 

Side effects and what to do When to contact doctor?
Common Side Effects

Mild swelling in arms and legs; puffiness

To help prevent swelling :

  • Eat a low-salt diet.
  • Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

 

Contact your health care team if no improvement or if severe

Stomach irritation or pain

  • You may have nausea, pain or a burning sensation in your belly (stomach). 

Get emergency help right away if you have sudden, severe pain in your belly, vomit blood, see blood in your stool or have dark, black-coloured stool. 

Contact your health care team if no improvement or if severe

High blood sugar 

  • You may feel thirsty and pee more often.
  • Your doctor may check your blood sugar level. You may be advised to change your diet or take medication to treat high blood sugar.
  • Check your blood sugar regularly if you have diabetes.
Contact your health care team as soon as possible 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment: 

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often to prevent infection.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 

Get emergency medical help right away

Other corticosteroid effects 

  • You may have increased appetite, weight gain, increased blood pressure (if you measure this at home), difficulty sleeping, mood changes, acne or other skin changes, or wounds that do not heal well. 

     
Contact your health care team if these bother you or if severe

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • Any changes in your vision (eyesight) 
  • Severe headache, dizziness or fainting spells
  • Severe or unusual bone pain, especially in your back, hips or wrists 
  • Muscle weakness, difficulty walking
  • Extreme tiredness, loss of appetite with weight loss, darkening of your skin
  • Severe pain in your belly that extends to your back
  • Fever, itchiness, rash, swollen lips, face or tongue, chest or throat tightness
  • Seizures 


For more links on how to manage your symptoms go to https://www.cancercareontario.ca/en/symptom-management.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.