API

Dexamethasone (4mg)

Drug classification

Corticosteroids (glucocorticoid).

Dosage form

Tablet

API strength per dosage

4 mg

Dose

Adults: 0.5–10 mg daily in divided doses, adjusted per indication and response. Pediatrics: 0.02–0.3 mg/kg/day in divided doses, maximum 16 mg/day. Adjust dose in hepatic impairment; use lowest effective dose for shortest duration. Taper gradually after prolonged use.

Mechanism of action

Binds to cytosolic glucocorticoid receptors (NR3C1), translocates to the nucleus, modulates gene transcription by binding glucocorticoid response elements, suppresses pro-inflammatory cytokine expression (e.g., IL-1, TNF-α), inhibits phospholipase A2 via increased lipocortin-1, and reduces COX-2 expression, resulting in potent anti-inflammatory and immunosuppressive effects.

Indications

Treatment of Inflammatory conditionsTreatment of Autoimmune conditions

Side effects

Cardiovascular complications Metabolic disorder Infection Hiccup Decreased sperm count Cushing syndrome

Pregnancy category

Precautions

Use with caution in infections, diabetes, hypertension, osteoporosis, peptic ulcer, psychiatric disorders, glaucoma, renal or hepatic impairment, pregnancy, breastfeeding, recent vaccination, myasthenia gravis, heart failure, and in elderly patients; avoid abrupt withdrawal; monitor for adrenal suppression and immunosuppression.

Contraindications

Systemic fungal infections, hypersensitivity to dexamethasone or corticosteroids, administration of live or attenuated vaccines in immunosuppressed patients, active untreated infections, peptic ulcer, severe psychosis.