Medicort (Dexamethasone)

• Dexamethasone is a glucocorticoid that modulates inflammatory and immune pathways.
• Allergic reactions: reduces swelling, itching and airway constriction.
• Asthma exacerbations: decreases airway inflammation to improve breathing.
• Rheumatoid arthritis: alleviates joint pain and swelling by suppressing synovial inflammation.
• Dermatologic inflammatory conditions: diminishes skin redness, edema and lesions in disorders such as eczema or psoriasis.

• Dexamethasone binds to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and interacts with glucocorticoid response elements on DNA. This alters transcription of multiple genes, leading to decreased production of pro‑inflammatory cytokines, inhibition of leukocyte migration, and suppression of immune cell activation, thereby providing potent anti‑inflammatory and immunosuppressive effects.

Adverse reactions may vary in frequency and severity.

Common Side Effects

• Increased appetite and weight gain.
• Insomnia or mood changes.
• Mild hyperglycemia.
• Gastrointestinal discomfort or dyspepsia.
• Facial flushing or skin thinning.
• Muscle weakness.

Serious or Rare Side Effects

• Severe infections due to immunosuppression.
• Adrenal insufficiency on abrupt discontinuation.
• Osteoporosis and increased fracture risk.
• Cataracts or glaucoma.
• Severe hyperglycemia or diabetic ketoacidosis.
• Psychosis or severe mood disorders.

Use of dexamethasone requires careful monitoring and patient education.

• Blood glucose monitoring: assess for hyperglycemia, especially in diabetic patients.
• Infection surveillance: watch for signs of bacterial, viral or fungal infections.
• Bone health evaluation: consider calcium/vitamin D supplementation and bone density testing for long‑term use.
• Dose minimisation: employ the lowest effective dose for the shortest duration possible.
• Tapering plan: gradually reduce dose when discontinuing to avoid adrenal crisis.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Dexamethasone can alter the activity of several concomitant medicines.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase dexamethasone exposure.
• Live vaccines: risk of uncontrolled infection due to immunosuppression.
• Anticoagulants (warfarin): enhanced anticoagulant effect, requiring close INR monitoring.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampin, carbamazepine): may reduce dexamethasone efficacy.
• Antidiabetic agents: glucocorticoid‑induced hyperglycemia may necessitate dose adjustment of insulin or oral hypoglycemics.