Dexamethasone

The only US label we reviewed for this page is for a 20 mg dexamethasone tablet product. It is indicated, in combination with other anti-myeloma medicines, for adults with multiple myeloma.

That label does not describe the many other situations in which dexamethasone tablets and injections are used. We therefore cannot list them here from our sources.

The National List of Essential Medicines 2022 includes dexamethasone in its sections on antiallergics, palliative care, adrenal hormones and COVID-19 management. Your doctor decides which use applies to you.

• US label reviewed: multiple myeloma in adults, together with other medicines
• Indian essential list: antiallergic, palliative care, adrenal hormone and COVID-19 management sections

The label describes dexamethasone as a corticosteroid with anti-inflammatory effects and low mineralocorticoid activity, which means little effect on salt balance.

In multiple myeloma its exact mechanism is unknown. It is said to cause programmed cell death in myeloma cells.

The US label we reviewed describes 20 mg or 40 mg by mouth once daily, on specific days set by the treatment protocol, with or without food. The doses for the combined medicines are in their own labels.

The label recommends a lower dose in older adults because of more toxicity. For other conditions the dose, number of days and tapering schedule are chosen by the prescriber, and those details are not in the label we reviewed.

Long courses are usually reduced gradually. Do not alter the dose or stop on your own. Indian pack labels may differ from the US label, and your prescriber's instruction always comes first.

• Taken with or without food, as prescribed
• Dose days follow the treatment protocol
• Do not stop suddenly after long use; ask your doctor how to taper

It must not be used in people allergic to dexamethasone or its ingredients, or with systemic fungal infections. Live or live-attenuated vaccines should be avoided during immunosuppressive doses.

The label asks for monitoring in people with diabetes, high blood pressure, heart or kidney problems, thyroid or adrenal disorders, glaucoma or cataract, bone thinning, mood disorders and ulcers or bowel conditions such as diverticulitis or ulcerative colitis.

Stopping suddenly after long use can cause adrenal insufficiency, which can be life-threatening. It can also bring a withdrawal syndrome with nausea, headache, fever and joint pain.

Corticosteroids cross the placenta, and the label reports cleft lip or palate, poor growth and low birth weight. Effective contraception is advised, and pregnancy testing is advised before use in this product. Safety in children has not been established in the label we reviewed.

• Do not use if allergic or with systemic fungal infection
• Avoid live vaccines during immunosuppressive doses
• Check blood sugar, blood pressure and potassium
• Do not stop suddenly after long use; ask your doctor or pharmacist
• Pregnancy: risk to the baby; talk to your doctor first
• Children: safety not established in this label

• Strong CYP3A4 inhibitors and inducers
• Cholestyramine
• Anticholinesterases
• Erythropoietin-type and oestrogen-containing medicines
• Diabetes medicines (dose may need review)
• Strong CYP3A4 inhibitors raise dexamethasone levels and the risk of side effects.
• Strong CYP3A4 inducers can lower its effect, and the label says to avoid both where possible.
• Cholestyramine can lower steroid exposure.
• Anticholinesterase medicines may cause severe weakness in people with myasthenia gravis.
• Erythropoietin-type medicines and oestrogen-containing medicines can raise clot risk.
• Tell your doctor and pharmacist about every medicine, including diabetes medicines, since steroids may raise blood sugar.

No match in this label text. Ask your pharmacist about any medicine you take.

The label says treatment of overdose is supportive and based on symptoms. Seek medical help right away after an overdose.

The label we reviewed says to store the tablets at 20 to 25 degrees Celsius in a tight, light-resistant, child-resistant container.

Check the pack in your hand, as Indian products may differ.

The Drugs Rules schedules we checked list dexamethasone under Schedule H, so it can be sold only on a registered doctor's prescription.

It is on the National List of Essential Medicines 2022 as tablets of 0.5 mg, 2 mg and 4 mg and as a 4 mg/mL injection (for example page 63). NPPA lists ceiling prices for scheduled formulations, shown below.

The Jan Aushadhi list we checked includes dexamethasone tablets IP 0.5 mg and dexamethasone injection IP 4 mg per mL. The banned-combination list we checked mentions dexamethasone in 1 entry.

• Schedule H: prescription only
• NLEM 2022: listed
• NPPA price ceiling: listed
• Jan Aushadhi: listed

The NPPA list we checked (as on March 2026) shows a ceiling of Rs 0.22 per 0.5 mg tablet and Rs 4.73 per 4 mg tablet. For the 4 mg/mL injection, the ceiling per mL depends on pack size, from Rs 5.21 for a 2 mL pack to Rs 0.93 for a 30 mL pack.

An older NPPA list (as on 30.09.2020) shows different values, so check the date. The Jan Aushadhi list includes the 0.5 mg tablet and the 4 mg/mL injection. Check the pack and seller; we do not show a brand price.