Last update: May 30, 2020

Дексаметазон

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Dexamethasone is a corticosteroid with mainly glucocorticoid activity.
Oral, parenteral, topical cutaneous, intra-articular and ophthalmic administration.

Since the last update we have not found published data on its excretion in breast milk.

Its high volume of distribution makes it difficult to excrete it in breast milk.

Other steroids (Betamethasone) that are administered prior to delivery can produce a delay of Lactogenesis phase II (milk's coming in) and a decrease of milk production within the first postpartum week (Henderson 2008)..

Intra-articular injected large doses of other steroids (Triamcinolone, Methylprednisolone) may transiently affect milk production (Smuin 2016, Babwah 2013, McGuire 2012)..

A decrease of prolactin release after administration of dexamethasone has been observed (Hubina 2002, Risch 1987), that may decrease milk production mostly in the first post-partum weeks.

Corticoids are frequently prescribed in Pediatrics with no side effects on the infant when indicated for short-term or sporadical use.

On nursing mothers a timely use or not long-term treatment is compatible with breastfeeding along with the assessment of milk production.
Expert authors consider the use of this medication to be probably compatible during breastfeeding (Hale 2019, Briggs 2017, Reece 2017, Bordini 2016, Chen 2010).
WHO Model List of Essential Drugs 2002: Compatible with breastfeeding in single dose. No data is available on long-term use (WHO 2002).

TOPICAL USE:
Because of a low absorption through skin significant excretion into breast milk is unlikely. Additionally, a high protein binding makes excretion even more unlikely.
Whenever a treatment for nipple eczema or dermatitis is required the lowest potency steroid compound should be used. It should be applied right after the feed to make sure it has disappeared before the next nursing occurs. Otherwise, wipe cream out with a clean gauze. Do not continuously use for longer than a week. Reportedly, a case of mineral-steroid toxicity has occurred due to continuous use of cream on the nipple.
Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant (De Stefano 1983).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Groups

Дексаметазон belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Дексаметазон in its composition:

  • Ak-Dex
  • Alin (Mexico)
  • Cresophene (Spain)™. Contains other elements than Дексаметазон in its composition
  • Dalalone
  • Decadran
  • Decadron
  • Decadronal
  • Dexaval
  • Dexmethsone
  • Fortecortin
  • Gano Dexacort Plus™. Contains other elements than Дексаметазон in its composition
  • Inzitan™. Contains other elements than Дексаметазон in its composition
  • Maxidex
  • Otobacid N™. Contains other elements than Дексаметазон in its composition
  • Paraflex Plus™. Contains other elements than Дексаметазон in its composition
  • Rino Dexa™. Contains other elements than Дексаметазон in its composition
  • Sofradex™. Contains other elements than Дексаметазон in its composition
  • Una A™. Contains other elements than Дексаметазон in its composition
  • Vagicort™. Contains other elements than Дексаметазон in its composition

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 70 - 78 %
Molecular weight 392 daltons
Protein Binding 77 %
VD 0,7 - 1,3 l/Kg
pKa 12,4 -
Tmax 1 - 2 hours
T1/2 3,3 - 6 hours

References

  1. Hale TW. Hale's Medications & Mothers' Milk. Springer Publishing Company. 2019
  2. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. 11th edition (acces on line) 2017
  3. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  4. Smuin DM, Seidenberg PH, Sirlin EA, Phillips SF, Silvis ML. Rare Adverse Events Associated with Corticosteroid Injections: A Case Series and Literature Review. Curr Sports Med Rep. 2016 May-Jun;15(3):171-6. Abstract
  5. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016 Abstract Full text (link to original source) Full text (in our servers)
  6. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Abstract
  7. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Abstract
  8. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  9. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008 Abstract Full text (link to original source) Full text (in our servers)
  10. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  11. Hubina E, Nagy GM, Tóth BE, Iván G, Görömbey Z, Szabolcs I, Kovács L, Góth MI. Dexamethasone and adrenocorticotropin suppress prolactin secretion in humans. Endocrine. 2002 Abstract
  12. Risch SC, Janowsky DS, Judd LL, Gillin JC, Mott MA, Rausch JL, Huey L. Measurement of ACTH and prolactin in the dexamethasone suppression test. Acta Psychiatr Scand. 1987 Nov;76(5):535-40. Abstract
  13. De Stefano P, Bongo IG, Borgna-Pignatti C, Severi F. Factitious hypertension with mineralocorticoid excess in an infant. Helv Paediatr Acta. 1983 Abstract

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