Dexamethasone, a potent steroid used for conditions like lupus, asthma, and arthritis, has multiple side effects and crucial drug warnings dentists must know:
Generic Name: Dexamethasone
Brand Name(s): Hemady, TaperDex
Pronunciation: dex a METH a sone
About this drug:
Dexamethasone is a steroid used to treat inflammation caused by many different conditions including blood disorders, lupus, asthma, eye and skin conditions, adrenal and kidney problems, rheumatoid arthritis, and multiple sclerosis.
It is sometimes used with chemotherapy.
Dentistry-related tidbits:
Dentists should prescribe the lowest dose possible for the shortest duration needed to manage the condition. High-dose and long-term therapy must be tapered gradually to discontinue.
Do not prescribe this medication if the patient has a systemic fungal infection. Follow patients closely if they have a dental infection, had dental surgery, and are taking this medication.
Side effects for Dexamethasone include an increased risk for infection, worsening of an infection, and delayed wound healing. A patient on long-term Dexamethasone therapy may have decreased immunity and should not be around people who are sick or have infections.
Combining steroids, blood thinners, Alcohol, Aspirin, Aspirin-containing products, or other NSAIDs before prescribing this medication with Dexamethasone may increase the risk of GI ulceration, perforation, and serious bleeding. If needed for pain control, select an Acetaminophen-based pain medication.
The quinolone antibiotics such as Levofloxacin, Moxifloxacin, Ofloxacin, and Ciprofloxacin in combination with Dexamethasone may increase the risk of a tendon rupture. Prescribe an alternative antibiotic.
Using Pregabalin, Gabapentin, Carbamazepine, narcotics or benzodiazepines in combination with Dexamethasone may decrease seizure threshold.
The macrolide antibiotics (Erythromycin and Clarithromycin) or antifungals (Itraconazole, Ketoconazole, and Fluconazole) in combination with Dexamethasone may increase Dexamethasone levels and the risk of systemic corticosteroid side effects and serious infection. Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.
Fun facts:
Dexamethasone is a potent corticosteroid that is similar to the body’s endogenous cortisol.
Any grapefruit products may increase Dexamethasone levels which will increase the risk of systemic corticosteroid side effects and serious infection.
Combining Caffeine with Dexamethasone may increase the risk of hypertension.
Patients taking Dexamethasone in combination with birth control should use a backup non-hormonal contraceptive as this combination may decrease the levels and efficacy of hormonal contraceptives and may increase the risk of thrombosis.
During the 2020 SARS-CoV-2 pandemic, Dexamethasone was one of the first drugs used on critically ill patients with COVID-19 to reduce death rates.
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