Dexamethasone tablets and liquid

Dexamethasone is a type of medicine called a steroid (or corticosteroid). Steroids are copies of a hormone your body makes naturally. They're not the same as anabolic steroids.

Dexamethasone tablets and liquid are used to treat a wide range of health conditions. These include:

• severe skin conditions
• severe allergies (anaphylaxis)
• sickness (nausea and vomiting)
• croup
• swelling (inflammation) in your eye
• autoimmune conditions, such as lupus

It's used in hospitals as a treatment for severe COVID-19 and other serious infections.

It can also help reduce the side effects of cancer treatment, or some of your symptoms if you're having end of life care.

It's available on prescription only and comes as tablets, soluble tablets and as a liquid you drink. It can be given by injection but this is usually only done in hospital.

Dexamethasone also comes as eye drops and a spray to treat eye and ear infections.

Most adults and children (including babies) can take dexamethasone.

Dexamethasone is not suitable for some people. To make sure it's safe for you, tell your doctor if you have:

• ever had an allergic reaction to dexamethasone or any other medicine
• recently been in contact with someone with shingles, chickenpox or measles
• an infection or any unhealed wounds
• liver or kidney problems
• ever had mental health problems (or a close family member has)
• ever had tuberculosis (TB)
• high blood pressure, heart failure or have recently had a heart attack
• diabetes
• epilepsy
• glaucoma
• an underactive thyroid
• osteoporosis (thinning bones)
• a stomach ulcer
• myasthenia gravis, a rare condition that causes muscle weakness
• recently had vaccinations, or are due to have vaccinations
• been trying to get pregnant, or are pregnant or breastfeeding

You'll usually take between 0.5mg and 10mg of dexamethasone a day. For some conditions the dose can go up to 16mg a day.

Dosage for children

Doses are usually lower for a child. The doctor will use your child's height and weight to work out the right dose for them.

For treating croup, your child will usually have a single one-off dose.

If you're taking dexamethasone for longer than a few weeks, your dose may change.

Your doctor may reduce your dose once your symptoms start to get better. If your symptoms get worse again, they may increase your dose.

Your doctor will probably reduce your dose gradually before you stop completely. This is to reduce the risk of withdrawal symptoms.

You'll usually take dexamethasone once a day. Take it in the morning with or immediately after your breakfast. Do not take it on an empty stomach.

For soluble tablets, dissolve them in a glass of water then drink it all. For other tablets, swallow them whole with a drink of water.

If you're taking dexamethasone liquid, use the plastic syringe or spoon that comes with your medicine to measure out the right dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

Unless your doctor gives you different instructions, take your full dose in one go. For example, if your dose is 6mg, your doctor may tell you to take three 2mg tablets at the same time.

If your doctor prescribes dexamethasone 2 or 3 times a day, take your last dose before 6pm. It will be less likely to affect your sleep.

For some conditions you may not need to take dexamethasone every day. Your doctor might tell you to take it every other day instead.

How long you will take dexamethasone for depends on why you need it. Your doctor will tell you how long to take it for.

When used to treat croup in children, your doctor will give a single one-off dose.

For some conditions you may only need to take dexamethasone for a few days or weeks.

However, for other conditions you may need to take it for longer, sometimes for several months.

If you take dexamethasone once a day and you miss a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose and take the next dose at the usual time.

If you take it 2 or 3 times a day, take the missed dose as soon as you remember, unless it's almost time for your next dose. In this case, skip the missed dose and take the next dose at the usual time.

Never take 2 doses at the same time. Never have an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Taking 1 or 2 extra dexamethasone tablets once is unlikely to harm you. If you're worried, talk to your doctor or pharmacist.

If you take too much dexamethasone for more than a few days, it could harm your health.

• you take more than your prescribed dose of dexamethasone and you have new symptoms, such as stomach pain or difficulty sleeping

Go to 111 online or call 111. Call 111 if you're asking about a child under the age of 5 years.

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the dexamethasone packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Do not stop taking dexamethasone suddenly, especially if you've been on a high dose for a long time.

Your health condition may flare up again.

You may also get extra side effects including:

• severe tiredness
• weakness
• body aches
• joint pain

Your doctor will probably want to reduce your dose gradually over several weeks to prevent these side effects.

Do not stop taking dexamethasone without talking to your doctor. You'll need to reduce your dose gradually.

These common side effects of dexamethasone happen in more than 1 in 100 people. There are things you can do to help cope with them:

Try to eat a healthy balanced diet without increasing your portion sizes. Regular exercise will also help to keep your weight stable.

Take dexamethasone with a meal or snack to reduce the chances of stomach problems. It may also help to avoid rich or spicy food.

If these symptoms carry on, speak to your doctor. They may give you an extra medicine to protect your stomach.

Take dexamethasone in the morning so the levels of dexamethasone in your body are low at bedtime. If you take dexamethasone more than once a day try taking your last dose before 6pm.

Avoid having a big meal, smoking, or drinking alcohol, tea or coffee in the evening. Try not to watch television or use your mobile phone before going to bed. Instead, try to relax for an hour before bedtime.

Dexamethasone can affect your mood in different ways. Talk to your doctor if you're finding it hard to cope.

Talk to your doctor or a pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects are more likely with higher doses (6mg a day or more) or if you take dexamethasone for more than a month.

Speak to a doctor if you get "moon face" (a puffy, rounded face) and weight gain in your upper back or belly. This happens gradually and can be a sign of Cushing's syndrome.

Call a doctor or call 111 now if you get:

• a high temperature, chills, a very sore throat, ear or sinus pain, a cough, coughing up more mucus (phlegm) or a change in colour of your mucus, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
• a very upset stomach or you're being sick (vomiting), very bad dizziness or passing out, muscle weakness, very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
• sleepy or confused, very thirsty or hungry, a need to pee more often than usual, flushing, breathing quickly or breath that smells like fruit – these can be signs of high blood sugar (hyperglycaemia)
• muscle pain, weakness or cramps, or your heartbeats suddenly become more noticeable (heart palpitations) – these can be signs of low potassium levels
• severe stomach pain, severe back pain, severe upset stomach or you're being sick (vomiting) – these can be signs of pancreas problems
• breathlessness
• swelling in your arms or legs
• changes in your eyesight
• any bruising or bleeding that is not normal
• red or black poo

• you have black or dark brown vomit or you're vomiting blood

Find your nearest A&E

Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.

Bring all the medicines you take with you.

You may notice mood changes and mental health problems while taking dexamethasone.

Talk to your doctor or call 111 if:

• you're feeling high, or have moods that go up and down
• you're feeling depressed
• you're feeling anxious
• you have problems sleeping
• you have difficulty in thinking, or are feeling confused and forgetting things
• you're feeling, seeing or hearing things that do not exist (hallucinations)
• you notice changes in the way you usually behave

The higher the dose, the more intense the mood changes can be.

• you have thoughts about harming yourself or ending your life

Find your nearest A&E

Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.

Bring all the medicines you take with you.

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to dexamethasone.

Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

If you take dexamethasone for several months it can make your bones weaker and more likely to break (osteoporosis) and you can get eyesight problems.

If you have diabetes, dexamethasone can affect blood sugar control. Your doctor may need to adjust your diabetes treatment while you take this medicine and again after you stop.

Long-term side effects in children and teenagers

Dexamethasone can cause slower growth in children and teenagers if they take it for a long time.

Your child's doctor will monitor their height and weight carefully for as long as they're taking dexamethasone. This will help them spot any slowing down of your child's growth and change their treatment if needed.

Even if your child's growth slows down, it does not seem to have much effect on their eventual adult height.

Talk to your doctor if you're worried. They'll be able to explain the benefits and risks of giving your child dexamethasone.

These are not all the side effects of dexamethasone. For a full list see the leaflet inside your medicines packet.

Steroids are commonly used during pregnancy and most doctors will recommend continuing to take them.

Dexamethasone can be taken in pregnancy, but talk to your doctor or specialist. They may want to switch you to a different type of steroid that's less likely to get to your baby, such as prednisolone.

Do not stop taking dexamethasone before you've spoken to your doctor.

If you're taking dexamethasone, you may be offered extra scans in later pregnancy to check that your baby is growing well.

If your doctor or health visitor says that your baby is healthy, it's usually OK to take dexamethasone while you're breastfeeding.

It's not known how much dexamethasone passes into breast milk, but it's likely to be a very low amount.

If you're only taking dexamethasone for a short time, your baby is unlikely to get any side effects. Your baby may need extra monitoring if you're taking higher doses or if you need to take it for a long time.

It has been used to treat babies for many years.

If you notice your baby is not feeding as well as usual, is not putting on weight as you would expect, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

There's no evidence that taking dexamethasone affects fertility in either men or women.

Speak to a pharmacist or your doctor if you're trying to get pregnant.

Tell your doctor if you're:

• trying to get pregnant
• pregnant
• breastfeeding

Some medicines can affect how dexamethasone works and can increase the risk of side effects.

Tell your doctor or pharmacist before starting to take dexamethasone if you:

• take medicine for heart or blood conditions, such as warfarin
• take high blood pressure medicine such as tablets that make you pee more (diuretics)
• take antibiotics such as rifampicin or rifabutin
• take antifungal medicine
• take medicine for epilepsy, such as phenytoin, carbamazepine, phenobarbitone or primidone
• take antacids or other medicine for stomach problems
• take non-steroidal anti-inflammatory drugs (NSAIDs), such as high-dose aspirin for pain relief, ibuprofen or diclofenac
• take medicine for HIV
• have recently had a vaccination, or are due to have one

There's not enough information to say that complementary medicines and herbal remedies are safe to take with dexamethasone. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.