dexamethasone

Nonsteroidal Anti-Inflammatory Agents (NSAIDS): Concomitant use of aspirin (or other nonsteroidal ant i nflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia.

Mechanism: Both of these drugs can irritate the lining of your stomach and digestive tract. Taking them together makes it more likely that you will develop stomach pain, ulcers, or bleeding.

What to do: Use caution when taking these together and watch for signs of stomach upset or dark stools. Your doctor may suggest a different pain reliever or a medicine to protect your stomach.

Drugs which inhibit CYP 3A4 (e.g., ketoconazole, macrolide antibiotics such as erythromycin) have the potential to result in increased plasma concentrations of corticosteroids. Ketoconazole: Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60%, leading to increased risk of corticosteroid side effects. In addition, ketoconazole alone can inhibit adrenal corticosteroid synthesis and may cause adrenal insufficiency during corticosteroid withdrawal.

Mechanism: Ketoconazole slows down how your body breaks down the steroid, which can cause the medicine to build up to high levels. This increases your risk of having serious side effects from the steroid.

What to do: Your doctor may need to lower your steroid dose or watch you closely for side effects while you are taking both medicines.

Corticosteroids primarily metabolized by CYP3A betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, mometasone, triamcinolone ↑ corticosteroid Co-administration with corticosteroids (all routes of administration) of which exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing’s syndrome and adrenal suppression.

Mechanism: Ritonavir blocks the enzyme that breaks down dexamethasone, which can cause the steroid to build up to high levels in your body.

What to do: Your doctor may need to adjust your steroid dose or monitor you closely for signs of hormone problems like Cushing’s syndrome.

Anticoagulants, Oral: Co-administration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports.

Mechanism: Dexamethasone can interfere with how warfarin works, often making it less effective. This could make your blood more likely to clot.

What to do: Your doctor should check your blood clotting tests more often and may need to change your warfarin dose.

Cyclosporine: Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently.

Mechanism: These two drugs can make each other more powerful when taken at the same time. This increases the chance of having side effects from both medicines.

What to do: Your doctor should watch you closely for side effects and may need to adjust your dosages.

Labeling: Incorrect or Missing Lot and/or Expiration date: Individual vials of Dexonto 0.4%, are labeled correctly with the BUD of 12/25/2024, however, the outer box on some of the Dexonto 0.4% are labeled incorrectly with a BUD of 12/25/2025.

Nubratori, Inc

Failed Impurities/Degradation Specifications: impurity sulfonic acid adduct of dexamethasone phosphate results were above spec.

Eugia US LLC

Lack of Assurance of Sterility: FDA inspection findings resulted in concerns regarding quality control processes

Lowlite Investments, Inc. D/B/A Olympia Pharmacy