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Dexamethasone is a long-acting synthetic corticosteroid, manufactured as oral tablets, solution and other products, that compounding pharmacies prepare in oral, topical and other forms.
Dexamethasone is a synthetic glucocorticoid, a lab-made version of the cortisol-type hormones the adrenal glands produce. It is used mainly for its anti-inflammatory and immune-modifying effects, and at doses with the same anti-inflammatory effect as hydrocortisone it has almost no salt-retaining activity. Manufactured dexamethasone tablets and oral solution are FDA-approved for a long list of conditions across many body systems, including severe allergic conditions, certain skin, rheumatic, blood, eye, respiratory, kidney and digestive diseases, adrenal insufficiency (where hydrocortisone is preferred), palliative management of some leukemias and lymphomas, cerebral edema, and diagnostic testing of adrenal overactivity. Prescribers may order dexamethasone compounded when they want a strength or concentration that is not manufactured, a liquid or topical form, a preparation free of dyes, sugar or another excipient, or a combination with another ingredient. Compounded dexamethasone is not FDA-approved and requires a prescription.
Manufactured oral dexamethasone carries no boxed warning. It is contraindicated in systemic fungal infections and in anyone allergic to it. Because corticosteroids suppress the body's own cortisol production, do not stop it suddenly after longer courses; your prescriber will taper it. It raises infection risk and can hide the signs of one, and live vaccines should not be given during immunosuppressive doses. Other warnings include high blood sugar, fluid retention and high blood pressure, low potassium, bone loss and growth slowing in children, stomach ulcers, and mood changes, insomnia or psychosis. It interacts with CYP3A4 inducers such as phenytoin and rifampin, inhibitors such as ketoconazole, warfarin, diabetes medicines, and potassium-depleting diuretics. Use in pregnancy only when benefit outweighs risk. LactMed states short-term use is unlikely to affect a breastfed infant. For fever, black stools, vision changes or unusual weakness, talk to your prescriber or pharmacist.
Dexamethasone is a synthetic glucocorticoid with a relative anti-inflammatory potency about 25 times that of hydrocortisone, classed as a long-duration agent, with negligible mineralocorticoid activity at equipotent doses. Glucocorticoids are readily absorbed from the gastrointestinal tract; metabolic clearance falls in cirrhosis, and dexamethasone is itself a moderate CYP3A4 inducer, so inducers and inhibitors of CYP3A4 alter its exposure. The tablet and oral solution labels list indications spanning allergic, dermatologic, endocrine, rheumatic, hematologic, neoplastic, nervous system, ophthalmic, renal, respiratory and gastrointestinal categories, plus diagnostic testing for adrenocortical hyperfunction. Prescribers have ordered compounded dexamethasone oral suspensions when a dye-free or specific-concentration liquid is needed; published stability studies describe suspensions prepared from tablets or powder in commercial suspending vehicles, and one pediatric study designed a suspension free of potentially harmful excipients. Dosing, duration and taper per prescriber. Monitoring per label: blood pressure, glucose, electrolytes including potassium, weight and edema, intraocular pressure if therapy exceeds six weeks, linear growth in children, bone health with prolonged use, coagulation with warfarin, and signs of adrenal insufficiency on withdrawal; infants exposed in utero should be observed for hypoadrenalism. Not a controlled substance.
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
For prescribers
Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
