Common brand names

• Decadron

How it is administered

Dexamethasone is most commonly administered orally in the form of tablets (available in strengths such as 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, and 6 mg). It is also available as an oral solution and as a concentrated oral solution (Intensol). For certain conditions, dexamethasone may be given by injection (intramuscular or intravenous), or as an ophthalmic (eye) drop or implant for eye conditions.

The route and dose depend on the specific disease being treated and the patient’s individual needs. Always follow your healthcare provider’s instructions for administration.

How it works

Dexamethasone is a synthetic corticosteroid, which means it mimics the effects of hormones produced naturally by your adrenal glands. It works by reducing inflammation and suppressing the immune system’s response. This can help control symptoms caused by overactive immune responses, such as swelling, pain, and allergic reactions.

In blood cancers like myelofibrosis, dexamethasone is sometimes used for its anti-inflammatory and immunosuppressive effects. It can help manage complications such as severe inflammation or immune-related symptoms. Dexamethasone also helps reduce certain side effects of chemotherapy or other cancer treatments, such as nausea and allergic reactions. By modulating the immune system and decreasing inflammation, it can improve quality of life and help control disease symptoms.

Who should take it

Dexamethasone is indicated for a wide range of conditions, including severe allergic reactions, skin diseases, certain endocrine and gastrointestinal disorders, and as part of the palliative management of leukemias and lymphomas. In the context of blood cancers, it is often used to help manage symptoms or complications related to the disease or its treatment.

For patients with myelofibrosis or other blood cancers, dexamethasone may be prescribed to help control inflammation, manage anemia, or reduce side effects from other treatments. It is also used in the management of certain emergencies, such as severe allergic reactions or swelling in the brain (cerebral edema).

Who should not take it

Dexamethasone should not be taken by individuals who have a known hypersensitivity to dexamethasone or any of its components. It is also contraindicated in patients with systemic fungal infections, as it can worsen these infections due to its immune-suppressing effects.

Caution is needed in people with active infections, certain viral diseases (like herpes simplex of the eye, varicella, or measles), or those who have recently received live vaccines. It should be used carefully in patients with a history of tuberculosis, peptic ulcers, osteoporosis, or psychiatric disorders. Always discuss your full medical history with your healthcare provider before starting dexamethasone.

Commonly used with

Dexamethasone is often used in combination with other medications, especially in the treatment of blood cancers. It may be used alongside chemotherapy drugs, anti-nausea medications, or other steroids. In some regimens, it is combined with drugs like thalidomide or lenalidomide for multiple myeloma, or with other immunosuppressive agents for certain blood disorders.

It is also commonly used with medications to prevent or treat side effects of cancer therapy, such as antiemetics for nausea or antibiotics for infection prevention.

Commonly tested with

Dexamethasone is frequently tested in combination with other chemotherapy agents, immunomodulatory drugs, and targeted therapies in clinical trials for blood cancers. For example, it is often studied with lenalidomide, bortezomib, or thalidomide in multiple myeloma. It may also be tested with other supportive care medications to evaluate its effectiveness in reducing treatment-related side effects.

In clinical practice, dexamethasone is sometimes used as part of diagnostic tests, such as the dexamethasone suppression test for Cushing’s syndrome.