Zema-Pak

Generic name: Dexamethasone
Drug class: Glucocorticoids

Usage of Zema-Pak

Dexamethasone provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, kidney problems, skin conditions, and flare-ups of multiple sclerosis. Dexamethasone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.

Dexamethasone tablets are also used in combination with other anti-myeloma products for the treatment of adults with multiple myeloma.

This medicine is available only with your doctor's prescription.

Zema-Pak side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Aggression

agitation

anxiety

blurred vision

decrease in the amount of urine

dizziness

fast, slow, pounding, or irregular heartbeat or pulse

headache

irritability

mental depression

mood changes

nervousness

noisy, rattling breathing

numbness or tingling in the arms or legs

pounding in the ears

swelling of the fingers, hands, feet, or lower legs

trouble thinking, speaking, or walking

troubled breathing at rest

weight gain

Incidence not known

Abdominal or stomach cramping and/or burning (severe) or pain

backache

bloody, black, or tarry stools

cough or hoarseness

darkening of the skin

decrease in height

decreased vision

diarrhea

dry mouth

eye pain

eye tearing

facial hair growth in females

fainting

fatigue

fever or chills

flushed, dry skin

fractures

fruit-like breath odor

full or round face, neck, or trunk

heartburn and/or indigestion (severe and continuous)

increased hunger

increased thirst

increased urination

loss of appetite

loss of sexual desire or ability

lower back or side pain

menstrual irregularities

muscle pain or tenderness

muscle wasting or weakness

nausea

pain in the back, ribs, arms, or legs

painful or difficult urination

skin rash

sleeplessness

sweating

trouble healing

trouble sleeping

unexplained weight loss

unusual tiredness or weakness

vision changes

vomiting

vomiting of material that looks like coffee grounds

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Increased appetite

Incidence not known

Abnormal fat deposits on the face, neck, and trunk

acne

dry scalp

lightening of normal skin color

red face

reddish purple lines on the arms, face, legs, trunk, or groin

swelling of the stomach area

thinning of the scalp hair

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Zema-Pak

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Hemady™ in the pediatric population. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of dexamethasone in children. However, pediatric patients are more likely to have slower growth and bone problems if dexamethasone is used for a long time. Recommended doses should not be exceeded, and the patient should be carefully monitored during therapy.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of dexamethasone in the elderly. However, elderly patients are more likely to have osteoporosis (weak bones) and age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for elderly patients receiving dexamethasone.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Artemether

Desmopressin

Praziquantel

Rilpivirine

Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abametapir

Aceclofenac

Acemetacin

Aldesleukin

Alfentanil

Amiodarone

Amtolmetin Guacil

Apalutamide

Aspirin

Atazanavir

Atogepant

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

Estetrol

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

Lurasidone

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

Phenobarbital

Phenylbutazone

Phenytoin

Piketoprofen

Piperaquine

Piroxicam

Posaconazole

Pranoprofen

Primidone

Proglumetacin

Propyphenazone

Proquazone

Prulifloxacin

Rifampin

Ritonavir

Rofecoxib

Rufloxacin

Salicylic Acid

Salsalate

Saquinavir

Sargramostim

Segesterone

Sodium Salicylate

Somatrogon-ghla

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

Voxilaprevir

Zolpidem

Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alcuronium

Aminoglutethimide

Aprepitant

Atracurium

Auranofin

Caspofungin

Fluindione

Fosaprepitant

Fosnetupitant

Gallamine

Hexafluorenium

Licorice

Metocurine

Netupitant

Ospemifene

Pancuronium

Rifapentine

Saiboku-To

Vecuronium

Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Relate drugs

How to use Zema-Pak

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for unwanted effects.

Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

The Dexamethasone Intensol™ solution is a concentrated liquid. Measure the concentrated liquid with the special oral dropper that comes with the package. The liquid should be added to water, juice, soda or a soda-like beverage, applesauce, or pudding. Stir the mixture well and drink or eat it right away. Do not store the mixture for future use.

You may take Hemady™ with or without food.

If you use this medicine for a long time, do not suddenly stop using it without checking first with your doctor. You may need to slowly decrease your dose before stopping it completely.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (solution, tablets):

Dose depends on medical condition:

Adults—At first, 0.75 to 9 milligrams (mg) per day. Your doctor may adjust your dose as needed.

Children—Dose is based on body weight and must be determined by your doctor. At first, 0.02 to 0.3 mg per kilogram (kg) of body weight per day, divided and taken 3 or 4 times a day. Your doctor may adjust your dose as needed.

For multiple myeloma:

Adults—20 or 40 milligrams (mg) once a day.

Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Throw away any unused Dexamethasone Intensol™ solution 90 days after the bottle is opened for the first time.

Warnings

If you will be taking this medicine for a long time, it is very important that your doctor check you at regular visits for any unwanted effects that may be caused by this medicine. Blood or urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment and for 1 month after your last dose. If you think you have become pregnant while using this medicine, tell your doctor right away.

If you are using this medicine for a long time, tell your doctor about any extra stress or anxiety in your life, including other health concerns and emotional stress. Your dose of this medicine might need to be changed for a short time while you have extra stress.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor right away if you have more than one of these symptoms while you are using this medicine: blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.

Using this medicine may increase your risk of cancer, including Kaposi's sarcoma. Talk to your doctor if you have concerns about this risk.

While you are being treated with dexamethasone, do not have any immunizations (vaccines) without your doctor's approval. Dexamethasone may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Check with your doctor right away if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine might cause thinning of the bones (osteoporosis) or slow growth in children if used for a long time. Tell your doctor if you have any bone pain or if you have an increased risk for osteoporosis. If your child is using this medicine, tell the doctor if you think your child is not growing properly.

This medicine may cause myopathy. Tell your doctor right away if you have new or worsening unexplained muscle pain, tenderness, or weakness.

This medicine may cause changes in mood or behavior for some patients. Tell your doctor right away if you have depression, mood swings, a false or unusual sense of well-being, trouble sleeping, or personality changes while taking this medicine.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain skin tests.

Talk with your doctor before using this medicine if you plan to have children. Some men who use Hemady™ have become infertile (unable to have children).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Disclaimer

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