Dexamethasone is a corticosteroid used to treat inflammations. The anti-inflammatory and immunosuppressant drug works by reducing your body’s immune response. It primarily fights the symptoms of inflammation (redness, heat, tenderness, and swelling) and is also used for the management of certain autoimmune disorders.
Dexamethasone in India is available as a generic medicine and can be ordered for manufacturing from Therawin Formulations.
The drug was first synthesized in 1957 by Philip Showalter Hench and was approved for general medical usage in 1958. It is also on the World Health Organization’s list of Essential Medicines (1).
Clinical studies have shown that it is nearly six times more potent than Prednisone and is better tolerated in the treatment of many inflammatory conditions (2). The generic drug was also used in the management of critically ill Covid-19 patients.
Is Dexamethasone a steroid?
The drug belongs to the class of steroids known as glucocorticoids. It is a derivative of cortisol (hydrocortisone).
The inactive ingredients in Dexamethasone tablets may contain calcium phosphate, magnesium stearate, and lactose.
It is available as –
- Dexamethasone 0.5 mg/ 4mg/ 8mg
- Dexamethasone sodium phosphate 0.5 mg
How does it work?
Corticosteroids are naturally produced by the adrenal glands and are responsible for influencing the functioning of the heart, muscles, bones, immune system, endocrine system, and nervous system of your body.
When your immune system is compromised, this drug can be administered to mimic the effect of corticosteroids. It prevents the infection-fighting white blood cells from traveling to the site of infection, swelling, or redness and thereby reduces the symptoms of inflammation.
Corticosteroids may also work by causing programmed cell death (or apoptosis) of certain cells in patients with blood disorders.
What is Dexamethasone usually prescribed for?
Dexamethasone tablets uses are listed below:
- Dermatologic conditions like dry skin, itching, and allergic skin conditions
- Asthma
- Certain autoimmune diseases like rheumatoid arthritis or lupus
- Breathing problems
- Inflammation of the eye
- Ear infections
- Used as a test for Cushing’s syndrome
- As a single one-off dose to treat Croup in children
- Alleviate the symptoms of certain types of cancer such as leukemia, lymphoma, and multiple myeloma. It also helps to stimulate appetite in cancer patients with severe appetite issues.
- Adrenal insufficiency
What is the use of Dexamethasone for Covid?
The drug was approved for the management of severe Covid-19 symptoms. It can be administered in patients who are 12 years or older and who require supplemental oxygen therapy or are on mechanical ventilators.
It could regulate the progress of inflammation-mediated lung injury in Covid-19 patients and thus helps in reducing the chances of respiratory failure and death (3).
Can it be administered to pets?
In veterinary usage, Dexamethasone can treat ear infections, especially in dogs, and swelling of distal limbs in horses.
Availability of Dexamethasone in India
Therawin Formulations is a premium-grade supplier and manufacturer of Dexamethasone. Classified as a generic drug, Dexamethasone tablets are available as:
 Description: Round/Oval, White, Uncoated Tablets Pack: 10X100 |  Description: Round, Green/Black, Film-coated Tablets Pack: 1000 |
Apart from this Dexamethasone Tablets are available in India for contract or third-party manufacturing as:
Description: Round/Oval, Uncoated/Film Coated Tablets
Pack: Blister / Strip / Alu-Alu / Jars
Medication management
The medicine can be administered orally or given intravenously. The dexamethasone dose and the length of the treatment will depend upon the medical condition and the patient’s response to the treatment.
Peak effects of the drug are usually seen within 30 minutes of administration; however, it may take a few days for complete control of the inflammation. Dexamethasone dose is usually prescribed as –
- For Adults: 0.5mg to 9 mg per day. It can be given intravenously, intramuscularly, or orally divided every 6 to 12 hours.
- For Children: A lower dosage of 0.08g to 0.3 mg/kg/day can be administered intramuscularly, intravenously, or orally every 6 to 12 hours.
- For Multiple Sclerosis (Acute exacerbation): 30mg/day orally for a week, followed by a lower dose of Dexamethasone 4mg to 12 mg/day for a month.
- For Cerebral Edema: Dexamethasone 1mg/kg to 6 mg/kg can be given intravenously once or a Dexamethasone injection of 40 mg after 2 to 6 hours or as needed (high dose treatment should not be continued beyond 48 to 72 hours).
- For Allergic Conditions: 4 to 8 mg intramuscularly on Day 1, 3 mg orally on Days 2 & 3, 1.5 mg orally on Day 4, and 0.75 mg orally on Day 5.
The drug is preferably prescribed as a morning dose so that it does not affect the patient’s sleep pattern.
Intravenous administration is usually given for severe allergic reactions, excess fluid retention and swelling, gastrointestinal problems, and arthritis. The dosage may be reviewed depending on the illness, stress, surgery, or medical emergency.
It is important to note that the course of the treatment should be gradually reduced to minimize the side effects.
Drug interactions and toxicity
The efficiency of the corticosteroid can be reduced upon interaction with other drugs like barbiturates, phenytoin, and rifampicin. These tablets can also interact with warfarin, rifampicin, phenytoin, carbamazepine, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac, and others.
Overdose of the medicine is usually not expected to cause any life-threatening effect. In rare cases, it may be possible to develop anaphylaxis or serious allergic reactions to the drug.
What are the side effects of Dexamethasone?
Dexamethasone side effects include:
- Dry and thinning skin
- Weight gain
- Stomach pain
- Bloating
- Nausea
- Sleep problems
- Muscle weakness
- Indigestion
- Mild mood changes
Sometimes, there may be more serious side effects with this drug such as:
- High body temperature of 100.4° F (or 38° C) and above
- Chills
- Ear or sinus pain
- Mouth sores
- Dizziness
- Tightness in the chest or throat
- Loss of appetite and weight loss
- Quick breathing
- Heart palpitations,
- Unexplained bruising or bleeding.
Precautions
The drug is not recommended for patients having any fungal infection. Before prescribing, past medical conditions or infections such as shingles, tuberculosis, stomach ulcers, diabetes, glaucoma, underactive thyroid, myasthenia gravis, high blood pressure, stomach ulcer, and liver or kidney problems should be taken into consideration.
The administration of this medicine too often can make it harder to fight future infections.
Pregnant women should not be given this drug, especially in their first 12 weeks (or first trimester) of pregnancy as it can affect the baby’s growth. However, it can be recommended to women who are breastfeeding with some precautions.
How to store Dexamethasone?
Always store the medicine at room temperature and away from heat and moisture. Keep it out of reach of children and pets.
The information on this page is meant for only educational purposes and is not a substitute for medical advice. For bulk ordering or contact manufacturing of Dexamethasone in India, get in touch using the form.
References:
- WHO EML 22nd List (2021): https://apps.who.int › rest › bitstreams › retrieve
- Allan E. Shefrin, MD FRCPC, and Ran D. Goldman, MD, Use of dexamethasone and prednisone in acute asthma exacerbations in pediatric patients. Can Fam Physician. 2009 Jul; 55(7): 704–706. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2718595/
- The RECOVERY Collaborative Group. N Engl J Med 2021; 384:693-704. Dexamethasone in Hospitalized Patients with Covid-19. February 25, 2021. DOI: 10.1056/NEJMoa2021436