Dexona-tablet

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Dexona 0.5 mg is een orale tablet die bevat dexamethasone, a synthetic long-acting glucocorticoid. Dexamethasone is on the WHO Essential Medicines List and is one of the most widely used corticosteroids in clinical practice, with applications ranging from cerebral oedema and anti-emetic cover during chemotherapy to allergic reactions, autoimmune disease, and (notably, since 2020) severe COVID-19.

Compared with hydrocortisone and prednisolone, dexamethasone has three distinguishing pharmacological features:

• Very high glucocorticoid potency — 25–30× hydrocortisone
• No mineralocorticoid activity — does not cause fluid retention, does not help in adrenal crisis
• Long biological half-life (36–54 hours) — allows once-daily dosing

What Is Dexona Tablet Used For?

• Cerebral oedema from primary or metastatic brain tumours
• Anti-emetic cover during chemotherapy (highly effective, often combined with 5-HT3 antagonists)
• Severe COVID-19 requiring oxygen (RECOVERY trial 2020; 6 mg daily for up to 10 days)
• Severe acute allergic reactions
• Autoimmune flares — SLE, rheumatoid arthritis, vasculitis, inflammatory bowel disease
• Acute severe asthma and severe COPD exacerbation (single 8–12 mg dose is effective in ED)
• Croup in children — a single 0.15–0.6 mg/kg oral dose
• Antenatal use for fetal lung maturation (specialist obstetric use at risk of preterm delivery)
• Haematological malignancy — part of chemotherapy protocols (ALL, multiple myeloma)
• Bacterial meningitis — adjunct for reducing neurological sequelae
• Dexamethasone suppression test — diagnostic use for Cushing syndrome

How Does Dexamethasone Work?

Dexamethasone binds to intracellular glucocorticoid receptors with high affinity. The activated receptor translocates to the nucleus and modulates gene transcription, producing broad anti-inflammatory, immunosuppressive, and metabolic effects. At therapeutic doses, dexamethasone suppresses cytokine production, reduces leukocyte trafficking to tissue, stabilises vascular permeability, and attenuates the inflammatory cascade.

Dexona Tablet Dosing

• Mild inflammatory conditions: 0.75–3 mg/day (1.5–6 tablets of 0.5 mg)
• Moderate conditions: 4–6 mg/day
• Severe conditions, cerebral oedema, chemotherapy anti-emetic: 4–16 mg/day (4 mg and 8 mg tablets — Decmax — are more practical at these doses)
• Croup (children): single oral dose of 0.15 mg/kg (up to 0.6 mg/kg)
• — verbetert de verdraagzaamheid van metformine. to reduce gastric irritation
• Ochtenddosis (before 9 a.m.) mimics natural cortisol rhythm and reduces HPA-axis suppression

Corticosteroid Potency and Equivalence

Different corticosteroids differ mainly in potency, duration of action, and mineralocorticoid (salt-retaining) activity. The table below gives the clinically useful equivalence — it lets you translate a dose of one steroid into the equivalent dose of another.

Who Should Not Take Dexona?

• Systemic fungal infection (other than as replacement therapy in adrenal insufficiency)
• Live vaccines during immunosuppressive doses (see specialist before BCG, MMR, yellow fever, varicella, oral typhoid)
• Active untreated bacterial infection (start antibiotics first)
• Active tuberculosis without anti-TB cover
• Known hypersensitivity to the active molecule or any excipient
• Use with caution in: diabetes mellitus, congestive heart failure, hypertension, osteoporosis, peptic ulcer, psychiatric disorders, glaucoma, herpes simplex ophthalmicus
• Pregnancy: use only if clearly needed — prednisolone and hydrocortisone cross the placenta less than dexamethasone/betamethasone, which are preferred when a fetal effect is intended (e.g. lung maturation)

Side Effects of Corticosteroids

Corticosteroid side effects are dose- and duration-dependent. Short courses (< 2 weeks) at moderate doses are usually well tolerated. Longer or higher-dose therapy produces the classic “Cushingoid” profile.

Short-term (first 1–2 weeks):

• Insomnia, anxiety, euphoria, irritability — particularly at doses > 20 mg prednisolone-equivalent
• Increased appetite, weight gain
• Raised blood glucose (especially in diabetes)
• Fluid retention, mild ankle swelling
• Heartburn, dyspepsia
• Hypertension — especially with higher mineralocorticoid activity (hydrocortisone, fludrocortisone)

Longer-term (weeks to months):

• Osteoporosis and vertebral fractures
• Muscle wasting and proximal myopathy
• Skin thinning, easy bruising, striae, impaired wound healing
• Cushingoid appearance — moon face, central obesity, buffalo hump
• Cataracts, glaucoma
• Infection susceptibility (bacterial, viral, fungal, parasitic)
• Avascular necrosis of the femoral head
• HPA-axis suppression — risk of adrenal crisis on abrupt withdrawal
• Psychiatric effects — depression, mania, psychosis
• Peptic ulcer, especially when combined with NSAIDs

Zeldzaam maar ernstig: steroid psychosis, pancreatitis, posterior subcapsular cataract, severe osteonecrosis.

Bestellen & Levering

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Veelgestelde vragen

What is Dexona Tablet used for?

Dexona (dexamethasone 0.5 mg) is used for inflammatory, allergic, autoimmune, and malignant conditions — cerebral oedema, chemotherapy anti-emetic cover, severe COVID-19, severe allergic reactions, autoimmune flares, croup, and specific haematological malignancies.

How is dexamethasone different from prednisolone or hydrocortisone?

Dexamethasone is ~25–30 times more potent than hydrocortisone per milligram, has no salt-retaining (mineralocorticoid) activity, and has a much longer half-life. It is preferred when potent anti-inflammatory effect is needed without fluid retention (cerebral oedema, antenatal lung maturation, chemotherapy), but is not preferred for adrenal crisis, where salt-retaining action is needed.

How long does Dexona take to work?

Oral dexamethasone reaches peak plasma level in 1–2 hours. Anti-inflammatory effect begins within 1–2 hours and is maximal within 6–12 hours. Because of the long half-life, effects persist for 36–54 hours after a single dose.

Should I take Dexona in the morning?

Yes — take with breakfast where possible. Morning dosing mimics the natural diurnal cortisol cycle and causes less HPA-axis suppression than evening dosing.

Can I stop Dexona abruptly?

Short courses (under 2 weeks) can usually be stopped without a taper. Longer courses need a formal taper to prevent adrenal crisis — consult your doctor before stopping anything longer than 3 weeks of therapy.

Will Dexona cause weight gain?

Short courses rarely cause meaningful weight change. Prolonged or high-dose therapy causes fluid retention, increased appetite, and Cushingoid fat redistribution.

Is Dexona safe in pregnancy?

Dexamethasone crosses the placenta more readily than prednisolone or hydrocortisone. It is deliberately used antenatally for fetal lung maturation. For maternal disease, prednisolone is usually preferred during pregnancy unless dexamethasone is specifically indicated.

Is Dexona the same as Decdan?

Both contain dexamethasone 0.5 mg and are clinically equivalent. Decdan is a Cadila/Wockhardt brand; Dexona is a Zydus Cadila brand.

Is Dexona the same as Decmax?

Same molecule (dexamethasone). Dexona is 0.5 mg; Decmax is 4 mg — used when higher single doses are needed.

Can Dexona be used in diabetes?

Yes, but with close blood-glucose monitoring. Dexamethasone raises blood sugar and diabetic patients may need insulin or oral hypoglycaemic adjustment during treatment.

Can Dexona be used in children?

Yes — particularly for croup and for specific chemotherapy regimens. Dosing is weight-based and should be supervised by a paediatrician.

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