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This document outlines important safety information and warnings for the use of dexamethasone. It is essential to understand these risks and precautions to ensure safe usage of the medication. Discuss any concerns with your healthcare provider before making any changes to your treatment.

• Adrenal Insufficiency: Abruptly stopping or reducing the dose of dexamethasone, especially after long-term use, can lead to adrenal insufficiency. Symptoms may include joint or muscle pain, severe fatigue, and depression. Work with your healthcare provider to gradually adjust your dosage.

• Increased Infection Risk: Long-term use of dexamethasone can heighten the risk of infections and mask their symptoms. Avoid contact with individuals who have chickenpox or measles. If you have a history of tuberculosis (TB), you may require monitoring or preventive TB medication.

• Cardiovascular and Renal Concerns: Dexamethasone may increase blood pressure and cause fluid retention while depleting potassium levels, potentially exacerbating heart failure, hypertension, or kidney issues. Consult your doctor if you have a recent history of heart attack or related conditions.

• Gastrointestinal Issues: The risk of gastrointestinal damage is elevated with dexamethasone use. Alcohol can worsen stomach irritation, so it should be avoided. Seek immediate medical attention for stomach pain or bloody stools. Be cautious if you have a history of stomach ulcers or are taking other medications that affect the stomach.

• Bone Health: Prolonged use of dexamethasone can weaken bones, leading to osteoporosis in adults and slower growth in children. Ensure adequate intake of calcium and vitamin D, and engage in exercises that strengthen bones.

• Vision Problems: Extended dexamethasone use can increase the risk of cataracts, glaucoma, and certain eye infections. Avoid use if you have herpes simplex of the eye. Report any vision changes to your healthcare provider promptly.

Contraindications

• Dexamethasone should not be used if you have a systemic fungal infection, as it poses significant health risks. Consult your healthcare provider if this condition applies to you.

Common side effects:

• difficulty sleeping
• headache
• nausea
• stomach upset
• increased appetite
• weight gain
• mood swings
• higher blood sugar levels

Less common but important to monitor:

• acne
• dry or thinning skin
• thinning scalp hair
• rash
• loss of muscle mass
• muscle weakness
• depression
• vision changes
• abnormal fat deposits
• swelling in the feet and ankles
• slower wound healing

Serious side effects:

• signs of infection (persistent sore throat or fever)
• bone or joint pain
• fast or irregular heartbeat
• severe eye pain
• unusual weight gain
• symptoms of stomach bleeding (black stools or vomit resembling coffee grounds)
• mental health changes
• menstrual irregularities
• severe muscle pain
• allergic reaction (rash, severe dizziness, difficulty breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• Artemether
• Desmopressin
• Praziquantel
• Rilpivirine
• Rotavirus Vaccine, Live

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Aldesleukin
• Celecoxib
• Ibuprofen
• Lapatinib
• Sunitinib
• Dasatinib
• St John's Wort

Interactions with low risk that usually do not require a change in therapy:

• Aspirin
• Warfarin
• Other blood thinners
• Low-dose aspirin for heart attack or stroke prevention