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Updated on August 3, 2023
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Dexamethasone Interactions: Potential Risks and Precautions

Dexamethasone is an effective steroid for various medical conditions, such as inflammation, allergic reactions, and cancer treatment. We discuss the possible interactions between Dexamethasone and other drugs and the precautions you must take when using this medication.

What is Dexamethasone?

Dexamethasone is a corticosteroid, anti-inflammatory drug that treats:

  • Multiple sclerosis
  • Inflammation
  • Allergies
  • Cerebral edema (swelling of the brain)
  • Shock 

Additionally, it provides relief for people struggling with the following conditions:

  • Asthma
  • Dermatitis 
  • Drug hypersensitivity reactions 

In endocrinology, Dexamethasone is a diagnostic tool for Cushing Syndrome, which occurs when your body produces too much cortisol.1

Off-Label Uses

Dexamethasone’s off-label uses include:

  • Treating chemotherapy-induced nausea and vomiting
  • Preventing and treating altitude sickness
  • Stopping spinal cord compression due to metastases in oncological cases
  • Treating severe cases of COVID-19 (those on supplemental oxygen or ventilatory support)
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What are the General Interactions of Dexamethasone?

While you can't combine some medicines, there are instances where your doctor may prescribe two different drugs that could interact. In the case of Dexamethasone, physicians don't typically use it with other drugs.

If they do, they may adjust the dosage or frequency of use for one or both medicines. Doing so will avoid potential complications, such as heartburn and indigestion.2

General Drug Interactions 

Your doctor may combine Dexamethasone with other medications to treat conditions you may have or be at risk of having.

These are medications that can interact with Dexamethasone:

  • Abametapir
  • Aceclofenac
  • Acemetacin
  • Aldesleukin
  • Alfentanil
  • Amiodarone
  • Amtolmetin Guacil
  • Apalutamide
  • Aspirin
  • Balofloxacin
  • Bemiparin
  • Benzhydrocodone
  • Besifloxacin
  • Boceprevir
  • Bromfenac
  • Bufexamac
  • Buprenorphine
  • Bupropion
  • Carbamazepine
  • Celecoxib
  • Ceritinib
  • Cholestyramine
  • Choline Salicylate
  • Ciprofloxacin
  • Clarithromycin
  • Clonixin
  • Cobicistat
  • Codeine
  • Conivaptan
  • Dabrafenib
  • Daclatasvir
  • Darunavir
  • Desogestrel
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Dienogest
  • Diflunisal
  • Dihydrocodeine
  • Dipyrone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Drospirenone
  • Droxicam
  • Efavirenz
  • Elvitegravir
  • Enoxacin
  • Enzalutamide
  • Estradiol
  • Ethinyl Estradiol
  • Ethynodiol
  • Etodolac
  • Etofenamate
  • Etonogestrel
  • Etoricoxib
  • Etravirine
  • Fedratinib
  • Felbinac
  • Fenoprofen
  • Fentanyl
  • Fepradinol
  • Feprazone
  • Fexinidazole
  • Fleroxacin
  • Floctafenine
  • Flufenamic Acid
  • Flumequine
  • Flurbiprofen
  • Fosamprenavir
  • Fosphenytoin
  • Gatifloxacin
  • Gemifloxacin
  • Gestodene
  • Hemin
  • Hydrocodone
  • Ibuprofen
  • Idelalisib
  • Indinavir
  • Indomethacin
  • Itraconazole
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lapatinib
  • Lenacapavir
  • Levofloxacin
  • Levonorgestrel
  • Lomefloxacin
  • Lopinavir
  • Lornoxicam
  • Loxoprofen
  • Lumacaftor
  • Lumateperone
  • Lumiracoxib
  • Lutetium Lu 177 Dotatate
  • Macimorelin
  • Meclofenamate
  • Medroxyprogesterone
  • Mefenamic Acid
  • Meloxicam
  • Meperidine
  • Mestranol
  • Methadone
  • Mitotane
  • Morniflumate
  • Moxifloxacin
  • Nabumetone
  • Nadifloxacin
  • Nadroparin
  • Naproxen
  • Nefazodone
  • Nelfinavir
  • Nepafenac
  • Nevirapine
  • Nifedipine
  • Niflumic Acid
  • Nilotinib
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nimodipine
  • Nirmatrelvir
  • Nomegestrol
  • Norelgestromin
  • Norethindrone
  • Norfloxacin
  • Norgestimate
  • Norgestrel
  • Ofloxacin
  • Omaveloxolone
  • Oxaprozin
  • Oxycodone
  • Oxyphenbutazone
  • Parecoxib
  • Pazufloxacin
  • Pefloxacin
  • Pentazocine
  • Phenylbutazone
  • Phenytoin
  • Piketoprofen
  • Piperaquine
  • Piroxicam
  • Posaconazole
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Prulifloxacin
  • Rifampin
  • Ritonavir
  • Rofecoxib
  • Rufloxacin
  • Salicylic Acid
  • Salsalate
  • Saquinavir
  • Sargramostim
  • Segesterone
  • Sodium Salicylate
  • Sparfloxacin
  • St John's Wort
  • Sufentanil
  • Sulindac
  • Sunitinib
  • Tacrolimus
  • Telaprevir
  • Telithromycin
  • Tenoxicam
  • Thalidomide
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Tosufloxacin
  • Tramadol
  • Ubrogepant
  • Ulipristal
  • Valdecoxib
  • Velpatasvir
  • Vincristine Sulfate Liposome
  • Voriconazole
  • Vortioxetine
  • Voxilaprevir

Drug Interactions With Potential Side Effects

Using certain medications with Dexamethasone also increases the risk of certain side effects. Thus, your doctor will adjust the dose or frequency of one or both medicines for safety reasons.2

These are the drugs that can interact with Dexamethasone, risking side effects:

  • Alcuronium
  • Aminoglutethimide
  • Aprepitant
  • Atracurium
  • Auranofin
  • Caspofungin
  • Fluindione
  • Fosaprepitant
  • Fosnetupitant
  • Gallamine
  • Hexafluorenium
  • Licorice
  • Metocurine
  • Netupitant
  • Ospemifene
  • Pancuronium
  • Phenobarbital
  • Rifapentine
  • Saiboku-To
  • Vecuronium
  • Warfarin

Other Interactions

Be aware of the potential interactions between specific medicines and food. Consuming alcohol or tobacco while taking certain medications can also lead to complications. 

Consult with a healthcare professional to discuss the appropriate medication use concerning food, alcohol, and tobacco.

Can I Take Dexamethasone with Tylenol?

Dexamethasone with Tylenol (acetaminophen) is generally safe, especially for minor pain.3 There have been no reported interactions between these drugs, although this doesn't guarantee their compatibility.

Tylenol and nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain, but Tylenol falls outside the category of NSAIDs. Consult with a healthcare professional before taking both medications as a precaution.4

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What Other Pain Relievers Can Be Taken with Dexamethasone?

You can take codeine, co-codamol, and paracetamol with Dexamethasone for effective pain relief. However, healthcare professionals advise against nonsteroidal anti-inflammatory painkillers (NSAIDs) to avoid stomach ulceration and bleeding.

These NSAIDs include:5

  • Naproxen
  • Ibuprofen
  • Aspirin

A clinical study recommends a low-dose combination of ibuprofen and Dexamethasone as a viable treatment method for neuropathic pain.6 This approach provides a valuable option for those having difficulty tolerating high-dose medications. 

Nonetheless, consult a healthcare professional if you're considering taking these medications together to ensure safety and effectiveness.7

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What Medications Should You Avoid with Dexamethasone?

medications you should avoid with dexamethasone 1

To ensure safety, you should avoid taking medications that can lead to adverse interactions while taking Dexamethasone. 

Aside from the abovementioned medications, here are others you should avoid taking with Dexamethasone:2

  • Artemether
  • Desmopressin
  • Praziquantel
  • Rilpivirine
  • Rotavirus Live Vaccines

Taking these drugs with Dexamethasone can lead to a dangerous decrease in the effectiveness of the medication, increased complications, and potential toxicity. Therefore, you must talk to your doctor or healthcare provider about any medications before using Dexamethasone.

How Does Dexamethasone Interact with the Body?

Dexamethasone is a strong medicine that helps the body in many ways. Particularly, it:1

  • Stops neutrophils from moving around
  • Prevents lymphocytes from making new cells
  • Strengthens the small blood vessels so less liquid can pass through them
  • Stabilizes lysosomes
  • Increases vitamin A levels in your blood
  • Blocks some proteins called cytokines
  • Grows surfactant levels
  • Improves how well your lungs work

The body breaks down Dexamethasone mainly in the liver and then gets rid of it in urine. However, the drug's effects can change when other medicines are involved.

Some drugs can interact with Dexamethasone since their combination with Dexamethasone is not necessarily harmful. Your doctor must evaluate each drug individually to determine the potential interactions.

Consulting with your doctor is an excellent way to avoid possible complications and get the most out of your medication.

How Dexamethasone Treats COVID-19

COVID-19 triggers a severe hyperinflammatory response in the body. As a result, Dexamethasone's ability to suppress inflammation is vital to its therapeutic efficacy against the virus.

In a recent clinical trial, those hospitalized with COVID-19 who received Dexamethasone experienced lower 28-day mortality rates, especially those requiring mechanical ventilation or oxygen therapy.1

Is Dexamethasone a Fever Reducer?

Yes, Dexamethasone is effective in reducing fever. A study showed that those with pneumonia treated with Dexamethasone experienced a significant decrease in body temperature.7

The suppression of pro-inflammatory and pyretic cytokines is the most likely mechanism behind the fever-reducing effect of this medication. However, you shouldn't use it to treat preschool children with fevers caused by common respiratory infections.8

Dexamethasone's strong immunosuppressive properties may increase the risk of opportunistic infections and potentially worsen any infection. 

Before prescribing corticosteroid therapy, medical professionals must weigh the potential risks and strictly avoid its use for fever of unknown origin.

How Long Does Dexamethasone Stay in Your Body?

The half-life of Dexamethasone ranges from 36 to 72 hours.8 This means it takes the body between 0.5 and 1.5 days to eliminate half of the amount taken. 

On the other hand, its mean terminal half-life lasts approximately four hours, and its oral clearance is 15.7 L/hr with just one dose.1

The following factors affect how long Dexamethasone stays in the system:1

  • Dosage
  • Age
  • Metabolism
  • Diet
  • Kidney function

Potential Side Effects and Precautions When Taking Dexamethasone with Other Medications

You can't have any immunization or vaccination while taking this drug.9 Dexamethasone may weaken your body's ability to resist infections, lowering vaccine efficacy or potentially causing infection. 

Dexamethasone increases the risk of gastrointestinal bleeding and ulceration if combined with NSAIDs.5

Before taking Dexamethasone, inform your doctor if you are:10

  • Pregnant or planning on getting pregnant
  • Taking prescription and nonprescription medicines
  • Having fungal infections
  • Experiencing or have ever had osteoporosis; heart, intestinal, kidney, or liver disease; ulcers; high blood pressure; diabetes; seizures; myasthenia gravis; herpes eye infection; mental illness; tuberculosis; or an underactive thyroid gland
  • Having surgery
  • Taking large doses of aspirin or other arthritis medication
  • With a medical history of ulcers

Monitoring Adverse Effects

Seek immediate medical help if you experience these symptoms that won't go away while taking Dexamethasone.10

  • Acne
  • Anxiety
  • Depression
  • Dizziness
  • Easy bruising
  • Headache
  • Increased hair growth
  • Insomnia
  • Irregular or absent menstrual periods
  • Restlessness
  • Stomach irritation
  • Upset stomach
  • Vomiting
dexamethasone adverse side effects 1

Call your doctor immediately if you experience any of the following adverse reactions:

  • A black or tarry stool
  • Colds or infections that last a long time
  • Muscle weakness
  • Skin rashes
  • Swollen face, lower legs, or ankles

Summary

Dexamethasone is a type of corticosteroid medication used to treat disorders related to inflammation. It helps reduce swelling, pain, itching, and allergic reactions. However, it can have serious side effects and interactions combined with other medications.

Therefore, talking to your doctor before taking Dexamethasone with other medications is essential. Your doctor will consider all your current drugs and advise on potential interactions to avoid adverse drug reactions.

Updated on August 3, 2023
10 sources cited
Updated on August 3, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Johnson et al. “Dexamethasone.” StatPearls, 2023.
  2.  Mayo Foundation for Medical Education and Research. “Dexamethasone (Oral Route).” Mayo Clinic, 2023.
  3. Dexamethasone.” BC Cancer Agency, 2007.
  4. Dexamethasone and Tylenol Interactions.” Drugs.com, 2023.
  5. Ghelani, R. “Can I take other medicines with dexamethasone?” Netdoctor, 2019.
  6. Park et al. ”Co-Administered Low Doses Of Ibuprofen And Dexamethasone Produce Synergistic Antinociceptive Effects On Neuropathic Mechanical Allodynia In Rats.” Journal of Pain Research, 2019.
  7. Vestjens et al. “Antipyretic effect of dexamethasone in community-acquired pneumonia.” European Respiratory Society, 2015.
  8. Cronin et al. “Single dose oral dexamethasone versus multi-dose prednisolone in the treatment of acute exacerbations of asthma in children who attend the emergency department: study protocol for a randomized controlled trial.” Trials, 2012.
  9. Mayo Foundation for Medical Education and Research. “Dexamethasone (Oral Route) Precautions.” Mayo Clinic, 2023.
  10. U.S. National Library of Medicine. “Dexamethasone.” MedlinePlus, 2017.
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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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