Dexamethasone (Decadron®)

How to Take Dexamethasone

Dexamethasone comes as a tablet or liquid to be taken by mouth. Dexamethasone can also be given intravenously (IV, into a vein) or injected into a muscle (IM).

Oral tablet form dexamethasone is best taken with food, as it can bother your stomach. Oral dexamethasone liquid should be mixed with other liquids like water, juices, or soda, or semi-solid food like applesauce or pudding. Your provider will probably tell you to take your dose(s) of dexamethasone at certain time(s) of the day every day. Your dose will depend on what the medication is being used for. Serious side effects can occur if you stop dexamethasone abruptly. Do not stop taking this medication or change your dose without direction from your healthcare team.

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.

Certain medications can interfere with oral and liquid dexamethasone, so make sure your provider is aware of all the medications, vitamins, and supplements you are taking.

You, or anyone you live with, should avoid having live or live-attenuated vaccines while receiving this medication on a long-term basis. These include herpes zoster (Zostavax) for shingles prevention, oral polio, measles, nasal flu vaccine (FluMist®), rotavirus, and yellow fever vaccines.

Dexamethasone is also available as an eye drop. This is often used to prevent eye conditions in patients with leukemia or lymphoma receiving chemotherapy. This type of dexamethasone does not cause the same side effects as the oral or liquid forms of this medication.

Storage and Handling

Store this medication at room temperature in the original container. If you prefer to use a pillbox, discuss this with your oncology pharmacist. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash. Keep containers out of reach of children and pets.

Where do I get this medication?

Dexamethasone is available through retail/mail-order pharmacy. Your oncology team will work with your prescription drug plan to identify an in-network retail/mail-order pharmacy for medication distribution.

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, are also available. Your care team can help you find these resources if they are available.

Possible Side Effects of Dexamethasone

There are a number of things you can do to manage the side effects of dexamethasone. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Increase in Appetite

Dexamethasone can cause people to be more hungry or thirsty than usual. Drink plenty of fluids and try to make your snacks healthy ones, since there may be quite a few of them! This generally resolves once the medication has been stopped.

Increase in Energy

Dexamethasone can give people an increase in energy. They may also develop insomnia, or difficulty sleeping. Taking the medication in the morning may help to prevent this.

Irritability or Change in Mood

Some people report feeling irritable or noticing a change in their mood while taking this medication. If this becomes difficult to handle or if you have a desire to hurt yourself, notify a healthcare provider right away.

High Blood Sugar

This medication can cause elevated blood sugar levels in patients with and without diabetes. Your oncology care team will monitor your blood sugar. If you develop increased thirst, urination or hunger, blurry vision, headaches or your breath smells like fruit, notify your healthcare team. Diabetics should monitor their blood sugar closely and report elevations to the healthcare team.

Swelling

Patients may notice swelling in their hands and/or feet. Elevating the feet may help to lessen swelling in the feet and ankles. Avoid restrictive or tight clothing that may make it harder for the fluid to drain from the hands, feet, and ankles.

Nausea and Heartburn

Taking dexamethasone with food or milk is generally enough to prevent nausea and heartburn. If possible, take the medication when you can be upright (not lying down) for a few hours after the dose. Avoid things that worsen the symptoms, and try antacids (milk of magnesia and calcium tablets, like Tums), saltines, or ginger ale to lessen symptoms.

Weakening of the Bones (Osteoporosis)

Long-term use of dexamethasone can lead to early osteoporosis. Your doctor may check your bone health. This is done with a bone density scan (dexa scan).

Other Side Effects

Dexamethasone can cause delayed wound healing, headaches, muscle weakness, and cataracts (after long-term use). Notify your care team if you are having any of these side effects.

If you are taking dexamethasone for an extended period of time, you may be more susceptible to developing an infection. If you have any new or worrisome symptoms such as fever, redness, fatigue, rapid heartbeat, or breathing, notify your provider right away.

Patients receiving dexamethasone eye drops may experience stinging or burning. Prolonged use of dexamethasone eye drops can increase your risk of glaucoma, visual changes, cataracts, and secondary eye infection. Report vision changes experienced while using dexamethasone eye drops to your healthcare team immediately.

Reproductive Concerns

Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.