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✔️ Side Effects

Endocrine & Metabolic: Cushing-like symptoms, hirsutism, menstrual irregularities, adrenal suppression, impaired glucose tolerance, calcium imbalance.
Fluid & Electrolyte Disturbances: Sodium retention, hypertension, hypokalemia.
Musculoskeletal: Myopathy, osteoporosis, aseptic necrosis.
Gastrointestinal: Peptic ulcers, perforation, gastrointestinal bleeding.
Dermatologic: Delayed wound healing, skin thinning, acne, bruising.
Neurological: Mood swings, insomnia, euphoria, depression, psychotic reactions.
Ophthalmic: Increased intraocular pressure, cataracts.
Immunosuppressive Effects: Higher infection risk, reduced vaccine efficacy

✔️ Dosage & Administration

Dosage varies based on the severity of the condition and patient response. If no improvement is observed within a few days, continued use is not recommended.

Oral Tablets:

• Adults: 1–10 mg per day.
• Children: 0.03–0.20 mg/kg body weight per day.
• Higher doses may be necessary initially, followed by gradual tapering.
• Dexamethasone Suppression Test: 1 mg at 11 PM; plasma cortisol is measured the next morning. If needed, extended testing involves 0.5 mg every 6 hours for 48 hours, followed by 2 mg every 6 hours for another 48 hours.

✔️ Drug Interactions

• Diuretics & Cardiac Glycosides: Risk of enhanced potassium loss, increasing toxicity in patients on cardiac glycosides.
• Antidiabetics: May impair glucose tolerance, necessitating dose adjustments.
• NSAIDs: Increased risk of gastrointestinal ulcers.
• Oral Anticoagulants: May alter their effectiveness.
• Liver Enzyme Inducers (e.g., rifampicin, barbiturates, phenytoin): May reduce dexamethasone effectiveness.
• Salicylates: Caution when reducing steroid doses to prevent salicylate toxicity.
• Antacids (e.g., magnesium trisilicate): May impair steroid absorption; spacing doses is recommended.

✔️ Contraindications

• Active gastric or duodenal ulcers.
• Systemic fungal infections.
• Active viral infections (e.g., varicella, herpes).
• Glaucoma.
• Hypersensitivity to corticosteroids.

✔️ Pregnancy & Lactation

• Category C: Use only if benefits outweigh potential fetal risks.
• Glucocorticoids pass into breast milk; high doses may require discontinuation of breastfeeding.

✔️ Precautions & Warnings

• Use the lowest effective dose.
• Taper doses gradually to prevent adrenal insufficiency.
• Caution in hypertension, heart failure, renal insufficiency, osteoporosis, peptic ulcers, and psychiatric conditions.
• Growth suppression risk in pediatric patients—use a minimal effective dose.

✔️ Storage Conditions:

• Store in a cool, dry place away from light and moisture.
• Keep all medications out of children's reach.