This page shows what was measured, who it was measured in, and what that does not settle.
What Dexamethasone does in the body
Severe inflammation and swelling — including brain swelling, croup, some cancers, and COVID-19 severe enough to need oxygen
Dexamethasone is cortisol with two chemical changes: a fluorine atom that makes it bind its receptor far more tightly, and a methyl group that stops the body breaking it down quickly. Those changes also strip out the part of cortisol’s effect that makes you retain salt and water, which is why it can be used to bring swelling down rather than add to it. Inside a cell it frees a receptor that moves into the nucleus and shuts off the genes that make inflammatory signals. It crosses into the brain and across the placenta as easily as into anywhere else, which is both why it works on brain swelling and fetal lungs and why nothing about its effects is local.
What happened in people
Neonatal death 19.6% against 23.5% with antenatal dexamethasone in 2,852 women across five countries, RR 0.84, P=0.03
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
That the pooled RECOVERY mortality figure applies to all hospitalised COVID-19 patients — it reverses direction in the stratum not receiving oxygen
Where it acts
Cytoplasm and nucleus of nucleated cells throughout the body. It crosses the blood-brain and placental barriers freely, which is what makes it the steroid used for cerebral oedema and for fetal lung maturation.
Kind of result
Living longer, or avoiding a major event
Supervision
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
What the registries record it as
Its recorded molecular formula is C22H29FO5, weighing 392.47 g/mol.
US prescribing information · 7514e6b8-c33f-4fbf-8810-ef520e1eb4bd · read 2026-08-30
Where each sentence above came from
No recorded sentence describes the change this makes in a way that stands on its own. The page opens with what it is taken for instead, and the recorded explanation follows below.
Shown as the opening line on this page.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 162 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
Receptor
A receptor is a part of a cell that a signal fits into.
A picture of it, and where the picture fails
A receptor is like a lock waiting for one key.
Where that stops being true. A lock either opens or does not. A receptor can be half-triggered, or worn out.
What people get wrong. Fitting a receptor is read as causing a benefit. It causes a step, and nothing more.
A protein that binds a specific ligand and converts that binding into a cellular response.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 40 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Recovery
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Recovery
time to marrow recovery
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
∅ Nothing in the sources checked
No registered study lists a life outcome for this goal.
— Not recorded
Harms were not a registered measure for this goal.
… Waiting for a reviewer
Who was studied is listed further down the page.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
All-cause mortality within 28 days of randomisation
✓ The study showed what it set out to show
Who was studied
RECOVERY dexamethasone arm (NCT04381936, ISRCTN50189673)
22.9% against 25.7%; age-adjusted rate ratio 0.83 (95% CI 0.75 to 0.93), P<0.001
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The overall figure conceals a reversal: rate ratio 0.64 on invasive ventilation, 0.82 on oxygen alone, 1.19 on no respiratory support. Quoting the pooled number without the stratum is the commonest misreading of this trial. The trial was open-label, so all non-mortality outcomes are subject to expectation effects.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Neonatal death 19.6% against 23.5%, RR 0.84 (95% CI 0.72 to 0.97), P=0.03; stillbirth or neonatal death 25.7% against 29.2%, RR 0.88 (0.78 to 0.99), P=0.04
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Stopped early for benefit at the second interim analysis, which tends to overstate effect size. It was conducted in hospitals with reliable gestational-age assessment; the ACT trial shows what the same drug does without that.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Cluster-randomised implementation trial across six countries
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
225 against 232 deaths per 1,000 live births, RR 0.96 (95% CI 0.87 to 1.06), P=0.65; whole-population mortality 27.4 against 23.9 per 1,000, RR 1.12 (1.02 to 1.22), P=0.0127
Repeated elsewhere
Unreplicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Suspected maternal infection rose (OR 1.45, 95% CI 1.33 to 1.58, P<0.0001). The authors calculated an excess of 3.5 neonatal deaths per 1,000 women exposed to the strategy.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Unfavourable outcome on the Glasgow Outcome Scale at 8 weeks
✓ The study showed what it set out to show
Who was studied
European Dexamethasone in Adulthood Bacterial Meningitis study (de Gans 2002)
How many people
301
Study design
Randomised, double-blind, placebo-controlled
Compared against
A dummy treatment
Kind of result
A number that stands in for health
What was found
Unfavourable outcome 15% against 25%, RR 0.59 (95% CI 0.37 to 0.94), P=0.03; death 7% against 15%, RR 0.48 (0.24 to 0.96), P=0.04
Repeated elsewhere
Failed to Replicate
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The population was European, largely HIV-negative, with a high proportion of pneumococcal disease. Neither the Malawi nor the Vietnam replication reproduced the overall result.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Odds ratio 1.14 (95% CI 0.79 to 1.64) by intention to treat; 1.10 (0.68 to 1.77) restricted to proven pneumococcal meningitis
Repeated elsewhere
Failed to Replicate
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Ninety percent of participants were HIV-positive. The trial did not show harm, but it removed the basis for assuming the European result applies in this setting.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Between-group difference 4.8 days (95% CI 2.57 to 7.03), P<0.0001; 60-day mortality 21% against 36%, difference -15.3% (-25.9 to -4.9), P=0.0047
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Stopped by the data monitoring board for a low enrolment rate after 88% of the planned sample, over a recruitment period of nearly six years. Open-label with an unblinded control arm and no placebo.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
Interval reported. 95% CI 2
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 6 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
■Living longer, or avoiding a major eventEvidence recorded. Death, a heart attack, a stroke, a hospital stay.17 registered measures of this kind. 1 written-up study measured this and did not show a benefit.
□What a body can do day to dayNo evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
□Measured performanceNo evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
□Symptoms and quality of lifeNo evidence recorded. Pain, tiredness, mood, sleep, as the person rated it.No registered study measures this.
□A number that stands in for healthNo evidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.No registered study measures this.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in C. elegans (roundworm), Mouse, Rat, Dog. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Where a source records it acting
Immune and lymphatic system: Glucocorticoids modify the body’s immune responses to diverse stimuli; synthetic analogs including dexamethasone are primarily used for their anti-inflammatory effects
US prescribing information · 01cfaa3e-5e30-18fa-e063-6394a90a084e · read 2026-08-27
Start
Dexamethasone
What a person takes: Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant.
The measurement behind this step
Well absorbed orally and rapidly distributed, including across the blood-brain barrier and the placenta. Because it is a poor substrate for placental 11-beta-hydroxysteroid dehydrogenase type 2, an intramuscular dose given to a mother reaches the fetus largely intact, which is what makes fetal lung maturation possible. The intravitreal implant exists to place the same molecule inside the eye for months without systemic exposure.
Getting in
Given by almost any route, and it reaches almost everywhere
Tablet, injection, eye drop or implant — dexamethasone is absorbed well and distributes widely, including into the brain and across the placenta into an unborn baby.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Oral bioavailability is high and the water-soluble sodium phosphate ester allows intravenous, intramuscular, intra-articular and intraocular use. Unlike cortisol, it is a poor substrate for placental 11-beta-hydroxysteroid dehydrogenase type 2, so it is not inactivated on the way to the fetus — the pharmacological basis of the antenatal indication.
The fluorine makes it stick, the methyl makes it last
Two small chemical changes to cortisol do all the work: one makes the molecule grip its receptor far more tightly, the other stops enzymes from taking it apart quickly.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The 9-alpha fluorine is electron-withdrawing and increases the acidity of the adjacent 11-beta hydroxyl, strengthening the hydrogen bond to the receptor. The 16-alpha methyl group sterically blocks the metabolic route that would otherwise clear the molecule and, separately, abolishes mineralocorticoid receptor activity. Together they give roughly 25 to 30 times cortisol’s glucocorticoid potency and a 36 to 72 hour biological half-life.
The receptor is released and moves into the nucleus
The receptor waiting in the cell is bound up in a complex of helper proteins. Dexamethasone binding releases it and it travels to where the DNA is.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Identical to the general glucocorticoid pathway: dissociation of the HSP90-HSP70-p23-immunophilin complex, FKBP51 to FKBP52 exchange, dynein-mediated transport, nuclear import through two localisation signals in NR3C1.
Inflammatory genes are shut off and vessel walls tighten
In the nucleus it silences the genes that produce inflammatory signals, and it also makes the smallest blood vessels less leaky. That second effect is why it works on swelling.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Transrepression of NF-kappaB and AP-1 suppresses IL-1, IL-6, TNF-alpha, COX-2 and inducible nitric oxide synthase. Transactivation induces ANXA1, DUSP1, TSC22D3 and NFKBIA. In vasogenic oedema the additional effect is on endothelial tight-junction proteins and on VEGF-driven permeability in the capillaries of a tumour or abscess — the reason it works on tumour oedema and not on the cytotoxic oedema of stroke.
Where the immune response is the disease, this is a survival benefit
In severe COVID-19 the damage comes largely from the body’s own inflammatory response to the virus. Blunting it kept people alive — but only once they were sick enough to need oxygen.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
RECOVERY measured a 28-day mortality rate ratio of 0.64 (95% CI 0.51 to 0.81) in patients on invasive mechanical ventilation and 0.82 (0.72 to 0.94) in those on oxygen alone. The gradient tracks the shift from viral replication to immunopathology as the dominant driver of injury.
And where it is not, the same suppression is a liability
In patients not yet needing oxygen, the immune response was still doing its job. In that group the trial found no benefit and slightly more deaths on the drug.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
17.8% against 14.0% mortality with a rate ratio of 1.19 (95% CI 0.92 to 1.55) in the no-respiratory-support stratum of RECOVERY. The same principle appears in the Vietnam meningitis trial, where multivariate analysis associated dexamethasone with increased one-month death in probable rather than confirmed bacterial meningitis, an observation the authors attributed to unrecognised tuberculous meningitis.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
No registered study measured anything of this kind.
Measured
Things only a test, a scale or a device shows.
No registered study measured anything of this kind.
Meaningful
Things that change how a life goes, not only a number.
overall survival
survival
duration of remission
event free survival
complete remission at the end of consolidation therapy
survival following consolidation
event free survival following consolidation
progression free survival
event free survival after first randomization
disease free survival after second and third randomization
and 7 more.
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (23)
complete response
response
response rate
time to progression
dying or residual disease during induction therapy
time to marrow recovery
frequency of toxicities including infectious complications
marrow status
blasts
toxicity
occurrence of anticipated failures
objective response rate
time to treatment failure
feasibility in terms of accrual
efficacy at 3 months
toxicity at 3 months
complete response rate
objective response
time to tumor progression
maximum tolerated dose
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
People with cerebral oedema from a brain tumour, children with croup, women at risk of very preterm birth, patients with bacterial meningitis, patients with myeloma, and patients hospitalised with COVID-19 who need oxygen.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “The safety and effectiveness of DEXTENZA for the treatment of ocular inflammation and pain following ophthalmic surgery have been established in pediatric patients.”
US prescribing information · 7514e6b8-c33f-4fbf-8810-ef520e1eb4bd · read 2026-08-30
On older people, the label states: “No overall differences in safety or effectiveness have been observed between elderly and younger patients.”
US prescribing information · 7514e6b8-c33f-4fbf-8810-ef520e1eb4bd · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary There are no adequate or well-controlled studies with DEXTENZA in pregnant women to inform a drug-associated risk for major birth defects and miscarriage.”
US prescribing information · 7514e6b8-c33f-4fbf-8810-ef520e1eb4bd · read 2026-08-30
On people who are breastfeeding, the label states: “Systemically administered corticosteroids appear in human milk and could suppress growth and interfere with endogenous corticosteroid production; however the systemic concentration of dexamethasone following administration of DEXTENZA is low [see Clinical Pharmacology ( 12.3 )] .”
US prescribing information · 7514e6b8-c33f-4fbf-8810-ef520e1eb4bd · read 2026-08-30
Where the result stopped carrying
The no-respiratory-support stratum of RECOVERY: 17.8% against 14.0% mortality, rate ratio 1.19, favouring harm
The ACT implementation trial raised whole-population neonatal mortality (RR 1.12) and maternal infection (OR 1.45) while successfully increasing steroid use
Two large meningitis replications in Malawi and Vietnam found no overall benefit, and the Vietnam multivariate analysis suggested harm in unconfirmed cases
DEXA-ARDS never reached its planned sample size and was stopped for recruitment failure rather than for a definitive answer
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (10)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Given by a clinician
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Suppression classes recorded: S3.
No source is stored against this line.
What is in the pack
Well absorbed orally and rapidly distributed, including across the blood-brain barrier and the placenta.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold. The rest of the recorded wording: Because it is a poor substrate for placental 11-beta-hydroxysteroid dehydrogenase type 2, an intramuscular dose given to a mother reaches the fetus largely intact, which is what makes fetal lung maturation possible. The intravitreal implant exists to place the same molecule inside the eye for months without systemic exposure.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
The class warnings apply in full: adrenal suppression, infection risk and masking, hyperglycaemia, psychiatric disturbance, osteoporosis, myopathy, cataract and glaucoma, growth suppression in children. The long biological half-life makes adrenal suppression accumulate faster than with prednisolone and makes tapering harder. In critical care trials, hyperglycaemia is the most frequently recorded adverse event, occurring in around three-quarters of treated patients in DEXA-ARDS. In the RECOVERY stratum receiving no respiratory support, mortality was numerically higher on dexamethasone.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
These are reports people sent to a regulator. They do not show the medicine caused the reaction.
Nobody counted how many people took the medicine and reported nothing.
The same event can be reported more than once, and many reports are incomplete.
News coverage, lawsuits and new warnings change how often people report.
A count is not a rate and not a risk.
Dexamethasone appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 27159 reaction mentions were counted. One report can name several reactions.
open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Oral tablet including a 20 mg high-strength presentation, oral solution, sodium phosphate solution for intravenous, intramuscular, intra-articular and soft-tissue injection, ophthalmic suspension, and a biodegradable intravitreal implant
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
A recorded note compares this form with the others that are sold. It is kept below, word for word.
§ A fixed RNAWiki sentence
Where this came from
Wording RNAWiki always uses, not a finding about this substance.
The recorded note, unchanged: Because it is a poor substrate for placental 11-beta-hydroxysteroid dehydrogenase type 2, an intramuscular dose given to a mother reaches the fetus largely intact, which is what makes fetal lung maturation possible. The intravitreal implant exists to place the same molecule inside the eye for months without systemic exposure.
No source is stored against this line.
What is recorded as being sold
350 products list this as an active ingredient in the United States drug directory. 286 of them contain it and nothing else.
FDA National Drug Code directory · 71335-3054 · read 2026-08-29
They are sold as elixir, for suspension, implant, injection, injection, emulsion and injection, solution, taken auricular (otic), intra-articular, intracanalicular and intralesional.
FDA National Drug Code directory · 71335-3054 · read 2026-08-29
The regulator's established pharmacologic class for it is corticosteroid hormone receptor agonists [moa] and corticosteroid [epc].
FDA National Drug Code directory · 71335-3054 · read 2026-08-29
224 published labels name it as an active ingredient. 160 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · 11c2ba9a-7aa3-4f78-aa2f-2a35d2671681 · read 2026-08-29
Those labels are classed as human otc drug and human prescription drug.
US prescribing information · 11c2ba9a-7aa3-4f78-aa2f-2a35d2671681 · read 2026-08-29
Dexamethasone is tablets at Tablets: 1.5 mg (as supplied by this distributor), recorded as prescription product; fda label in effect 2025-10-29 in the United States.
US prescribing information · 01cfaa3e-5e30-18fa-e063-6394a90a084e · read 2026-08-27
Recorded price in US: 0.02925–8.32212 USD per one millilitre, across 36 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Recorded price in US: 0.07375–0.36489 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 65 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
Self-experiment planning is not offered for a prescription or clinician-supervised medicine. The questions below are for a clinician or pharmacist.
Questions worth asking
Which of the trials of Dexamethasone studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That the pooled RECOVERY mortality figure applies to all hospitalised COVID-19 patients — it reverses direction in the stratum not receiving oxygen
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the European meningitis result generalises to settings with high HIV or tuberculosis prevalence
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the 15-percentage-point ARDS mortality reduction is a settled number, when it comes from one open-label trial of 277 patients stopped early
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That a high-strength repackaging of a molecule available for cents represents a new therapy
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
How fast does the body clear it?
The sources RNAWiki checked hold nothing for this field.
Why it matters. Without this, nothing on this page can say how long anything lasts.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Dexamethasone are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
RECOVERY: 28-day mortality fell from 41.4% to 29.3% in ventilated COVID-19 patients
In plain words
This is the strongest randomised result any drug in this batch has. Patients in hospital with COVID-19 were randomly given dexamethasone or the usual care. Among those on a ventilator, roughly three in ten on the drug died against four in ten without it.
What was measured
All-cause mortality at 28 days, against usual care, in an open-label randomised comparison
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
RECOVERY assigned 2,104 patients to dexamethasone 6 mg once daily for up to 10 days and 4,321 to usual care alone. Death within 28 days occurred in 482 (22.9%) against 1,110 (25.7%), age-adjusted rate ratio 0.83 (95% CI 0.75 to 0.93, P<0.001). The effect varied sharply with respiratory support at randomisation: 29.3% against 41.4% on invasive mechanical ventilation (rate ratio 0.64, 95% CI 0.51 to 0.81) and 23.3% against 26.2% on oxygen without ventilation (0.82, 0.72 to 0.94).
Written into the record, not signed off as a reviewed claim
The same trial found no benefit, and a point estimate favouring harm, without oxygen
In plain words
The headline was that dexamethasone saves lives in COVID-19. The trial itself found that in patients who were not on oxygen at all, more died on the drug than off it. The result was not statistically significant, but it points the wrong way and it is the reason the indication is written as it is.
What was measured
28-day mortality in the subgroup receiving no respiratory support at randomisation
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Among RECOVERY participants receiving no respiratory support at randomisation, 28-day mortality was 17.8% on dexamethasone against 14.0% on usual care, rate ratio 1.19 (95% CI 0.92 to 1.55). The confidence interval includes both a 8% reduction and a 55% increase, so this is an absence of demonstrated benefit rather than a demonstrated harm — but the point estimate is above one, the biological reading is coherent (suppressing an immune response that is still clearing virus), and the licensed indication was written to exclude these patients.
Written into the record, not signed off as a reviewed claim
Antenatal dexamethasone cut neonatal death from 23.5% to 19.6%
In plain words
Given to a woman at risk of delivering very early, dexamethasone crosses the placenta and matures the baby’s lungs before birth. In a trial across five countries, the trial was stopped early because the benefit was clear: about four fewer deaths for every hundred babies.
What was measured
Neonatal death, and stillbirth or neonatal death, against placebo
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The WHO ACTION-I trial randomised 2,852 women and their 3,070 fetuses between 26 weeks 0 days and 33 weeks 6 days of gestation across 29 hospitals in Bangladesh, India, Kenya, Nigeria and Pakistan to intramuscular dexamethasone or identical placebo, and was stopped for benefit at the second interim analysis. Neonatal death occurred in 278 of 1,417 infants (19.6%) against 331 of 1,406 (23.5%), relative risk 0.84 (95% CI 0.72 to 0.97, P=0.03). Stillbirth or neonatal death was 25.7% against 29.2% (RR 0.88, 95% CI 0.78 to 0.99, P=0.04). Possible maternal bacterial infection was 4.8% against 6.3% (RR 0.76, 95% CI 0.56 to 1.03), meeting the prespecified non-inferiority margin.
Written into the record, not signed off as a reviewed claim
ACT: widening antenatal use in the community raised neonatal deaths and maternal infection
In plain words
A programme to get the same drug to more women at risk of preterm birth across six countries was tested against ordinary care. Among the whole population, more babies died in the intervention group, not fewer, and more mothers developed suspected infections. The drug was right. The targeting was not.
What was measured
28-day neonatal mortality and suspected maternal infection across whole populations, cluster-randomised
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
The ACT cluster-randomised trial covered 51 intervention clusters with 47,394 live births and 50 control clusters with 50,743, across Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Antenatal corticosteroid use in mothers of less-than-5th-percentile infants rose from 10% to 45% (P<0.0001). Among those infants, 28-day mortality was 225 against 232 per 1,000 live births (RR 0.96, 95% CI 0.87 to 1.06, P=0.65) — no benefit. Across the whole population, 28-day neonatal mortality was 27.4 against 23.9 per 1,000 (RR 1.12, 95% CI 1.02 to 1.22, P=0.0127), and suspected maternal infection 3% against 2% (OR 1.45, 95% CI 1.33 to 1.58, P<0.0001). The authors calculated an excess of 3.5 neonatal deaths per 1,000 women exposed to the strategy.
Written into the record, not signed off as a reviewed claim
The bacterial meningitis indication did not replicate outside Europe
In plain words
A European trial in 2002 showed dexamethasone halved deaths in adults with bacterial meningitis, and it became standard care. Two large trials in Malawi and Vietnam then found no benefit at all in the whole trial population. The field settled on a position that depends on where you are and on whether the diagnosis is confirmed.
What was measured
That the European result generalises to bacterial meningitis anywhere — two adequately powered trials in high-HIV and high-tuberculosis settings found no benefit, and one found a signal of harm where the diagnosis was unconfirmed
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The European Dexamethasone in Adulthood Bacterial Meningitis study randomised 301 patients and found unfavourable outcome in 15% against 25% (RR 0.59, 95% CI 0.37 to 0.94, P=0.03) and death in 7% against 15% (RR 0.48, 95% CI 0.24 to 0.96, P=0.04), with the largest effect in pneumococcal meningitis (26% against 52% unfavourable, RR 0.50, 95% CI 0.30 to 0.83, P=0.006). In Malawi, 465 adults of whom 90% were HIV-positive showed no mortality difference at 40 days (OR 1.14, 95% CI 0.79 to 1.64), and none in proven pneumococcal disease either (OR 1.10, 95% CI 0.68 to 1.77). In Vietnam, 435 patients showed no significant reduction in death at one month overall (RR 0.79, 95% CI 0.45 to 1.39), with benefit confined to the 300 with microbiologically confirmed disease (RR 0.43, 95% CI 0.20 to 0.94) and multivariate analysis suggesting increased death in probable — largely tuberculous — meningitis.
Written into the record, not signed off as a reviewed claim
Mild croup: a single dose halved return visits
In plain words
Seven hundred and twenty children with mild croup got one dose of dexamethasone or a placebo. Seven in a hundred on the drug came back for more care within a week, against fifteen in a hundred on placebo. They also slept better and their parents were less distressed.
What was measured
Return to a medical care provider for croup within seven days, against placebo
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
A double-blind trial at four paediatric emergency departments randomised 720 children with mild croup, defined by a Westley score of 2 or less, to a single oral dose of dexamethasone 0.6 mg/kg or placebo. Return to a medical care provider for croup within seven days was 7.3% against 15.3% (P<0.001). Croup symptoms resolved faster (P=0.003), less sleep was lost (P<0.001), and parental stress was lower (P<0.001).
Written into the record, not signed off as a reviewed claim
The ARDS result rests on a trial stopped early for slow recruitment
In plain words
A Spanish trial reported that dexamethasone cut deaths in severe lung failure from 36% to 21%. It was stopped before it finished, not because the answer was clear but because patients were not being enrolled fast enough, and a trial stopped early tends to overstate its effect.
What was measured
That a 15-percentage-point mortality reduction in ARDS is a reliable estimate, when it comes from a single trial of 277 patients stopped before completion with an unblinded control arm
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
DEXA-ARDS randomised 277 patients with established moderate-to-severe ARDS, 139 to dexamethasone and 138 to control, and was stopped by the data safety monitoring board for a low enrolment rate after reaching 88% of the planned 314. Ventilator-free days at 28 days favoured dexamethasone by 4.8 days (95% CI 2.57 to 7.03, P<0.0001), and 60-day mortality was 21% against 36% (between-group difference -15.3%, 95% CI -25.9 to -4.9, P=0.0047). Hyperglycaemia in intensive care occurred in 76% against 70%; new intensive-care infections were 24% against 25%. The trial recruited over five years and nine months at a rate of under one patient per site per year, which is the fact behind the stopping decision.
Written into the record, not signed off as a reviewed claim
A pennies-a-tablet molecule sold at a formulation price
In plain words
Dexamethasone costs about a quarter of a dollar a tablet at what American pharmacies pay. The same molecule in a 20 mg tablet approved for myeloma, and in an implant placed inside the eye, is priced in a completely different range. What is being paid for is the packaging, not the drug.
What was measured
That a reformulated presentation of a 1958 molecule justifies a price unrelated to the molecule — true for the intravitreal implant, which had to be tested on its own, and not established for the high-strength oral tablet
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The CMS National Average Drug Acquisition Cost file lists generic dexamethasone tablets at a median of US$0.2461 across 114 products. Hemady, a 20 mg oral dexamethasone tablet, was approved in 2019 for multiple myeloma in combination regimens — the molecule was already in universal off-label use for that indication at a fraction of the cost. Ozurdex, a biodegradable intravitreal implant releasing 0.7 mg of dexamethasone, is a genuinely different product with its own clinical trials, and the comparison there is against other intravitreal agents rather than against a tablet. The general claim being audited is that a high-strength or repackaged presentation of an off-patent molecule represents a new therapy; for the oral tablet it does not.
Source
CMS National Average Drug Acquisition Cost file, effective 19 August 2026; Drugs@FDA records for dexamethasone products
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
contested
Review state
Written into the record, not signed off as a reviewed claim
Where else this substance is registered
FDA substance identifier (UNII)
7S5I7G3JQL
CAS registry number
50-02-2
PubChem compound
5743
RxNorm concept
22690
Checks this page had to pass
✓ Passed
Identity resolved
no open identity hold
✓ Passed
No unresolved merge across substance families
no quarantine open
✓ Passed
Every public sentence names a source
The opening statement carries the origin: Written into the record, not signed off.
✗ Not passed
Trial roles classified for highlighted evidence
No registered study is classified as testing this substance.
✓ Passed
No internal keys in reader text
enforced by the copy-contract test over the rendered page
✓ Passed
Safety mode resolved
Suppression classes recorded: S3.
✓ Passed
Canonical metadata present
slug and display name present
What is missing or unclear◇Read from sources, not yet reviewed
How this medicine reached us
Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.
What the approval register records
154 approved applications cover products containing this substance. The earliest was NDA011664, approved 19581030 to MERCK.
This order is fixed in code and does not count clicks or time on the page.
What is not here
4 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A fluorinated glucocorticoid with no salt-retaining activity that binds the same receptor as cortisol about 25 times more strongly and for far longer — in RECOVERY it cut 28-day mortality in ventilated COVID-19 patients from 41.4% to 29.3% (rate ratio 0.64, 95% CI 0.51 to 0.81) while showing no benefit and a point estimate favouring harm in patients not on oxygen (17.8% against 14.0%, rate ratio 1.19, 95% CI 0.92 to 1.55).
Recorded evidence blocks (14)
Q2
What did Dexamethasone's largest trial (27034 people) and its longest (22 years) measure?
27034 people in Dexamethasone's largest registered study, 22 years in its longest registered window, measuring Safety of autologous peripheral stem cell transplantation (PBSCT) as measured by a treatment-related mortality of < 5% at 12 months following transplant. ClinicalTrials.gov · 2026-09-01
1050 phase2, 583 phase3, 490 phase1, 414 phase4, 274 na, 51 na or unstated, 40 early phase1; NCT00059930; 2025-03-24. Last human test completed 2026, NCT07353801.
Interpretation These counts include studies where Dexamethasone was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
phase2
1050
phase3
583
phase1
490
phase4
414
na
274
na or unstated
51
2 more recorded rows
early phase1
40
Last recorded human testNCT07353801
2026-08-28
recorded 2026-09-01 · last checked 2026-09-04
Q3
From C. elegans to human: where has Dexamethasone shown lifespan?
Safety of autologous peripheral stem cell transplantation (PBSCT) as measured by a treatment-related mortality of < 5% at 12 months following transplant — the recorded outcome words.
Show the evidence
C. elegans
lifespan
mouse
mechanism-only
rat
mechanism-only
dog
lifespan
humanNCT00275015
lifespan; Safety of autologous peripheral stem cell transplantation (PBSCT) as measured by a treatment-related mortality of < 5% at 12 months following transplant; 2619
Did Dexamethasone move epigenetic clock, and by how much?
epigenetic clock: "Dexamethasone induced dynamic changes in methylation in 31.2 % (110/353) of these CpGs and transcription in 81.7 % (139/170) of genes neighboring epigenetic clock CpGs." Europe PMC · epigenetic clock search · 2020-11-01
2 recorded sentences; 2015, 2020; biomarker
Show the evidence
epigenetic clockPMID 26673150
2015; "Dexamethasone induced dynamic changes in methylation in 31.2 % (110/353) of these CpGs and transcription in 81.7 % (139/170) of genes neighboring epigenetic clock CpGs."
epigenetic age
2020; "The final model indicated important interactions between immune cell fractions (including CD4 and CD8 T cells and neutrophils) and treatment, age, and dexamethasone status when adjusted for the main effects of epigenetic age, glioblastoma status, and the neutrophil-to-lymphocyte ratio."
recorded 2020-11-01 · last checked 2026-09-04
Q7
Which of blasts, complete and partial remission and complete remission at the end of consolidation therapy did Dexamethasone's trials measure?
blasts, complete and partial remission and complete remission at the end of consolidation therapy lead 40 outcome terms across Dexamethasone's trials. ClinicalTrials.gov · 2026-09-01
Interpretation response, response rate, duration of remission, time to progression, event free survival and dying or residual disease during induction therapy follow.
Show the evidence
complete response
1
overall survival
1
survival
1
response
1
response rate
1
duration of remission
1
14 more recorded rows
time to progression
1
event free survival
1
dying or residual disease during induction therapy
1
time to marrow recovery
1
frequency of toxicities including infectious complications
1
marrow status
1
blasts
1
complete remission at the end of consolidation therapy
1
survival following consolidation
1
event free survival following consolidation
1
progression free survival
1
toxicity
1
event free survival after first randomization
1
disease free survival after second and third randomization
1
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which of Dexamethasone's 554 ongoing trials reports first?
Proportion of Patients With Objective Response (First Phase, Step 1); Objective Response Rate of the Drug Combination in This Patient Populations.; latest 2042-01
Show the evidence
Trial
NCT00098475
"Lenalidomide and Dexamethasone With or Without Thalidomide in Treating Patients With Multiple Myeloma"; n 452; "Proportion of Patients With Objective Response (First Phase, Step 1)"; 2026-10-23
NCT00378105
"Bortezomib, Lenalidomide and Dexamethasone Combination Therapy in Patients With Newly Diagnosed Multiple Myeloma"; n 68; "Objective Response Rate of the Drug Combination in This Patient Populations."; 2026-12
NCT00489307
"Dexamethasone for Symptom Burden in Advanced Cancer Patients"; n 132; "Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Subscale Scores"; 2028-02-28
NCT00492999
"Hepatic Arterial Infusion With Floxuridine and Dexamethasone Combined With Combination Chemotherapy in Treating Patients With Colorectal Cancer That Has Spread to the Liver"; n 64; "Resectability rate"; 2027-05
NCT00501826
"Combination Chemotherapy and Nelarabine in Treating Patients With T-cell Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma"; n 160; "Complete remission rate"; 2026-10-31
NCT00572169
"UARK 2006-66, Total Therapy 3B: An Extension of UARK 2003-33 Total Therapy"; n 177; "To find out if outcomes of participants in this study will be better when compared to individuals who participated in Total Therapy II, especially those with chromosome abnormalities."; 2027-08
14 further recorded trials
NCT00644228
"Lenalidomide and Dexamethasone With or Without Bortezomib in Treating Patients With Previously Untreated Multiple Myeloma"; n 525; "Progression-free Survival"; 2027-06-10
NCT00734877
"UARK 2013-13, Total Therapy 4B - Formerly 2008-01 - A Phase III Trial for Low Risk Myeloma"; n 382; "Progression-free survival rate"; 2028-09
NCT00792948
"Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia"; n 97; "Relapse-free Survival (RFS) After Allogeneic Stem Cell Transplantation"; 2027-01-06
NCT00869232
"UARK 2008-02 A Trial for High-risk Myeloma Evaluating Accelerating and Sustaining Complete Remission"; n 90; "Accelerate and sustain, at 2 years from starting therapy"; 2028-10
NCT00871013
"Trial for Patients Not Qualifying for TT4 and TT5 Protocols Because of Prior Therapy"; n 160; "The primary objective of this study is to assess the continued complete and near complete response rate (CR/nCR) at two years after initiation of therapy. ."; 2027-12
NCT01208662
"Randomized Trial of Lenalidomide, Bortezomib, Dexamethasone vs High-Dose Treatment With SCT in MM Patients up to Age 65"; n 729; "Median Progression-Free Survival (PFS)"; 2026-12
NCT01297764
"A Study of Carfilzomib, Lenalidomide, Vorinostat, and Dexamethasone in Relapsed and/or Refractory Multiple Myeloma"; n 17; "Safety and dose of carfilzomib, lenalidomide, vorinostat and dexamethasone for MM"; 2027-06
NCT01371630
"Inotuzumab Ozogamicin and Combination Chemotherapy in Treating Patients With Acute Lymphoblastic Leukemia"; n 276; "Maximum tolerated dose of inotuzumab ozogamicin based on incidence of dose limiting toxicities (Phase I)"; 2027-12-25
NCT01424982
"Combination Chemotherapy and Ponatinib Hydrochloride in Treating Patients With Acute Lymphoblastic Leukemia"; n 88; "Event-free survival"; 2027-10-31
NCT01553214
"Improving White Blood Cell Collection From Healthy Donors"; n 1000; "Operational feasibility and impact of managing a volunteer community donor granulocytapheresis program"; 2032-01-01
NCT01562405
"Sotatercept (ACE-011) With Lenalidomide or Pomalidomide and Dexamethasone in Relapsed/Refractory Multiple Myeloma"; n 33; "Maximum Tolerated Dose of ACE-011"; 2027-12
NCT01863550
"Bortezomib or Carfilzomib With Lenalidomide and Dexamethasone in Treating Patients With Newly Diagnosed Multiple Myeloma"; n 1087; "Overall survival (OS) for the maintenance analysis"; 2034-02-05
NCT01920737
"A Novel "Pediatric-Inspired" Regimen With Reduced Myelosuppressive Drugs for Adults (Aged 18-60) With Newly Diagnosed Ph Negative Acute Lymphoblastic Leukemia"; n 39; "rate of molecular remission"; 2026-08
NCT02003222
"Combination Chemotherapy With or Without Blinatumomab in Treating Patients With Newly Diagnosed BCR-ABL-Negative B Lineage Acute Lymphoblastic Leukemia"; n 488; "Overall Survival (OS) Among Patients Who Were MRD Negative After Induction and Intensification Chemotherapy"; 2027-02-25
recorded 2026-09-01 · last checked 2026-09-04
Q9
Which running trial of Dexamethasone could settle lifespan?
NCT02406222 measures Progression free survival, reading out 2025-06.
108 open trials; n 124; "Pomalidomide in Relapsed and Refractory Multiple Myeloma (RRMM)"
Show the evidence
Trial
NCT02406222
"Pomalidomide in Relapsed and Refractory Multiple Myeloma (RRMM)"; n 124; "Progression free survival"; 2025-06
NCT03609060
"Dexamethasone Added to Intensive Chemotherapy in Older Patients with Acute Myeloid Leukemia (AML)"; n 120; "Event Free survival (EFS)"; 2025-12-31
NCT03618537
"Ixazomib Maintenance Study in Patients With AL Amyloidosis"; n 17; "event free survival (EFS)"; 2026-08
NCT02101853
"Blinatumomab in Treating Younger Patients With Relapsed B-cell Acute Lymphoblastic Leukemia"; n 669; "Disease Free Survival (DFS) of High-risk (HR) and Intermediate-risk (IR) Relapse Patients"; 2026-09-16
NCT02112916
"Combination Chemotherapy With or Without Bortezomib in Treating Younger Patients With Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Stage II-IV T-Cell Lymphoblastic Lymphoma"; n 847; "Event-free Survival (EFS) for Modified Augmented Berlin-Frankfurt-Munster Backbone With or Without Bortezomib in All Randomized Patients"; 2026-09-16
NCT05248633
"Chemotherapy Combined With Radiotherapy Versus Radiotherapy Alone for Solitary Plasmacytoma"; n 220; "event-free survival"; 2026-10
14 further recorded trials
NCT03114865
"A Study of Blinatumomab in Patients With Pre B-cell ALL and B-cell NHL as Post-allo-HSCT Remission Maintenance"; n 44; "Overall survival at two years post first treatment cycle"; 2026-10-30
NCT04025840
"Perioperative Epidural Block and Dexamethasone in Pancreatic Cancer Surgery"; n 260; "2-year overall survival"; 2026-11
NCT02877303
"Blinatumomab, Inotuzumab Ozogamicin, and Combination Chemotherapy as Frontline Therapy in Treating Patients With B Acute Lymphoblastic Leukemia"; n 80; "Relapse-free survival (RFS)"; 2026-11-01
NCT01208662
"Randomized Trial of Lenalidomide, Bortezomib, Dexamethasone vs High-Dose Treatment With SCT in MM Patients up to Age 65"; n 729; "Median Progression-Free Survival (PFS)"; 2026-12
NCT02544308
"Trial of Immunomodulatory Therapy in High Risk Solitary Bone Plasmacytoma"; n 36; "Progression-free survival (progression defined as development of myeloma or a new plasmacytoma outside the radiotherapy field)"; 2026-12
NCT03729804
"Carfilzomib, Lenalidomide, and Dexamethasone Versus Bortezomib, Lenalidomide and Dexamethasone (KRd vs. VRd) in Patients With Newly Diagnosed Multiple Myeloma (COBRA)"; n 250; "Number of Participants with progression free survival with the group taking KRd versus VRd after randomization"; 2026-12-28
NCT04545242
"Efficacy of DEXamethasone in Patients With Acute Hypoxemic REspiratory Failure Caused by INfEctions"; n 980; "60-day mortality"; 2026-12-30
NCT04216524
"Venetoclax, SL-401, and Chemotherapy for the Treatment of Blastic Plasmacytoid Dendritic Cell Neoplasm"; n 40; "Progression free survival (PFS)"; 2026-12-31
NCT00792948
"Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia"; n 97; "Relapse-free Survival (RFS) After Allogeneic Stem Cell Transplantation"; 2027-01-06
NCT05736419
"A Study of Immune Suppression Treatment for People With Sickle Cell Disease or β-Thalassemia Who Are Going to Receive an Allogeneic Hematopoietic Cell Transplantation (HCT)"; n 24; "Number of participants with treatment related mortality/TRM or primary graft failure"; 2027-02-09
NCT02003222
"Combination Chemotherapy With or Without Blinatumomab in Treating Patients With Newly Diagnosed BCR-ABL-Negative B Lineage Acute Lymphoblastic Leukemia"; n 488; "Overall Survival (OS) Among Patients Who Were MRD Negative After Induction and Intensification Chemotherapy"; 2027-02-25
NCT04181827
"A Study Comparing JNJ-68284528, a CAR-T Therapy Directed Against B-cell Maturation Antigen (BCMA), Versus Pomalidomide, Bortezomib and Dexamethasone (PVd) or Daratumumab, Pomalidomide and Dexamethasone (DPd) in Participants With Relapsed and Lenalidomide-Refractory Multiple Myeloma"; n 419; "Progression Free Survival (PFS)"; 2027-03-31
NCT07187167
"Efficacy and Safety of the RD Regimen(Lenalidomide, Dexamethasone) for Rosai-Dorfman Disease"; n 40; "Progression-free survival time （PFS)"; 2027-04-12
NCT04891289
"Gemcitabine and Oxaliplatin Chemotherapy With or Without a Floxuridine and Dexamethasone Pump in People With Cholangiocarcinoma That Cannot Be Removed With Surgery"; n 164; "assess progression-free survival (PFS)"; 2027-05
Q10
Which 630 trials of Dexamethasone posted no result?
Posted no result
630 of 630 completed trials
Registrations
NCT00000563, NCT00000703, NCT00000689, NCT00000658, NCT00000776 and NCT00000801, and 624 more
Completion dates
oldest 1983-08; newest 2024-09-01
Show the evidence
Trial
NCT00000563
1983-08
NCT00000703
1990-03
NCT00000689
1991-03
NCT00000658
1996-02
NCT00000776
1996-09
NCT00000801
1998-04
14 further recorded trials
NCT00003213
1999-08
NCT00002691
2000-06
NCT00002849
2000-07
NCT00074191
2000-10
NCT00002865
2001-08
NCT00006240
2001-08
NCT00004403
2002-03
NCT00001842
2002-06
NCT00002788
2002-09
NCT00003399
2002-09
NCT00003401
2002-09
NCT00010231
2002-11
NCT00003397
2002-12
NCT00003402
2002-12
Q11
At the median, Dexamethasone's trials enrolled 66 people — anything larger?
Median enrolment
66
Largest enrolment
27034
Registered trials counted
2587
Q12
What do 27159 spontaneous reports say about Dexamethasone — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Dexamethasone appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 27159 reaction mentions were counted: neutropenia 5239; febrile neutropenia 4619; rheumatoid arthritis 4018; pemphigus 2586. open-targets-adr · CHEMBL384467 · 2026-06-24
Dexamethasone and CYP 3A4, CYP3A4 and cytochrome P450: shared by which compounds?
CYP 3A4, CYP3A4 and cytochrome P450 appear in Dexamethasone's recorded interaction sentences, 8 in all. openfda-label+europepmc · 2026-08-21
Interpretation drug_interactions
Show the evidence
CYP 3A4
drug_interactions
Antibiotics : Macrolide antibiotics have been reported to cause a significant decrease in corticosteroid clearance (see Drug Interactions: CYP 3A4 Inducers , CYP 3A4 Inhibitors , and CYP 3A4 Substrates ).
drug_interactions
CYP 3A4 Inducers: Dexamethasone is metabolized by CYP 3A4.
cytochrome P450drug_interactions
Drugs which induce cytochrome P450 3A4 (CYP 3A4) enzyme activity (e.g., barbiturates, phenytoin, carbamazepine, rifampin) may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased.
CYP 3A4drug_interactions
CYP 3A4 Inhibitors: Concomitant administration of dexamethasone with erythromycin, a moderate CYP 3A4 inhibitor, has the potential to result in increased plasma concentrations of dexamethasone.
CYP3A4drug_interactions
Ketoconazole, a strong CYP3A4 inhibitor, has been reported to decrease the metabolism of certain corticosteroids by up to 60%, leading to increased risk of corticosteroid side effects.
CYP 3A4
drug_interactions
Co-administration with other drugs which strongly inhibit CYP 3A4 (e.g., itraconazole, clarithromycin, ritonavir, cobicistat-containing products) may lead to increased plasma concentrations of corticosteroids and potentially increase the risk for systemic corticosteroid side effects.
drug_interactions
CYP 3A4 Substrates: Dexamethasone is a moderate inducer of CYP 3A4.
drug_interactions
Co-administration with other drugs that are metabolized by CYP 3A4 (e.g., indinavir, erythromycin) may increase their clearance, resulting in decreased plasma concentration.
recorded 2026-08-21 · last checked 2026-09-04
Q14
Was Dexamethasone studied with fasting and exercise?
fasting and exercise are named in Dexamethasone's label sentences: "Each participant received an intravenous injection of either the test (imitation) or reference (original) formulation of dexamethasone palmitate in the fasting arm during each study period, with a 7-day washout period between administrations." openfda-label+europepmc · 2026-08-21
2 recorded statements; fasting, exercise
Show the evidence
fasting
Each participant received an intravenous injection of either the test (imitation) or reference (original) formulation of dexamethasone palmitate in the fasting arm during each study period, with a 7-day washout period between administrations.
exercise
Patients in the PAI dexamethasone group experienced less pain on postoperative day (POD) one than the placebo group at rest (adjusted P = 0.035) and during exercise (adjusted P = 0.028).
recorded 2026-08-21 · last checked 2026-09-04
Q15
What is recorded about Dexamethasone and autophagy?
"Using an ovalbumin-induced asthma model in BALB/c mice and 16HBE human bronchial epithelial cells treated with dexamethasone and/or autophagy inhibitor EACC (C<sub>13</sub>H<sub>11</sub>N<sub>3</sub>O<sub>6</sub>S<sub>2</sub>), we assessed cell viability and apoptosis via CCK-8 and TUNEL assays, respectively." — where Dexamethasone and autophagy appear together. Europe PMC · pathway abstract search · 2026-08-04
"Using an ovalbumin-induced asthma model in BALB/c mice and 16HBE human bronchial epithelial cells treated with dexamethasone and/or autophagy inhibitor EACC (C<sub>13</sub>H<sub>11</sub>N<sub>3</sub>O<sub>6</sub>S<sub>2</sub>), we assessed cell viability and apoptosis via CCK-8 and TUNEL assays, respectively."
PMID 42559162
"Importantly, the autophagy inhibitor EACC enhanced cell viability and attenuated dexamethasone-induced apoptotic signaling in 16HBE cells."
AMPKPMID 40425907
"Capsaicin's effectiveness in alleviating the bone-damaging effect of dexamethasone was evident through a dose-dependent reduction in ALP, RANKL, and Bax, a rise in osteocalcin and Bcl-2, and a higher expression of AMPK, SIRT1, β-catenin, and RUNX2."
sirtuinPMID 40425907
"Capsaicin's effectiveness in alleviating the bone-damaging effect of dexamethasone was evident through a dose-dependent reduction in ALP, RANKL, and Bax, a rise in osteocalcin and Bcl-2, and a higher expression of AMPK, SIRT1, β-catenin, and RUNX2."
AMPKPMID 40425907
"By upregulating the AMPK/SIRT1/β-catenin/RUNX2 pathway, capsaicin exhibits dose-dependent bone-stimulant effects in a dexamethasone-induced osteoporosis model in rats."
sirtuin
PMID 40425907
"By upregulating the AMPK/SIRT1/β-catenin/RUNX2 pathway, capsaicin exhibits dose-dependent bone-stimulant effects in a dexamethasone-induced osteoporosis model in rats."
PMID 41890904
"Inhibition of Sirt1 markedly exacerbated muscle deterioration and proteostasis impairment under dexamethasone-induced muscle atrophy in zebrafish."
autophagyPMID 42487485
"In vitro, our research revealed that high doses of dexamethasone impaired the m<sup>6</sup>A-dependent regulation of DRAM1 by YTH m<sup>6</sup>A RNA binding protein F1 (YTHDF1), leading to decreased DRAM1 levels and subsequent disruption of autophagy-associated osteogenic differentiation in human bone marrow mesenchymal stem cells (hBMSCs) and MC3T3-E1 cells."
mTORPMID 42019598
"YY1 interacts with various signaling pathways, including the mechanistic target of rapamycin (mTOR) and peroxisome proliferator-activated receptor-gamma coactivator 1 alpha (Ppargc1a/PGC-1α), all of which have been shown to be down-regulated following dexamethasone treatment."
AMPKPMID 38778385
"After separately inhibiting AMPK or PGC1α in C2C12 cells with dexamethasone administration, we have found that the activated AMPK plays the chief role in improving cell proliferation induced by GqDNVs."
mTORPMID 40594837
"This study examined whether sirtuin 1 regulates dendritic outgrowth and spine formation via mTORC1 signaling in rat primary cortical cells under dexamethasone-induced neurotoxic conditions."
recorded 2026-08-04 · last checked 2026-09-04
Where it is registeredIdentifiers, relations and other names
ChEMBL ATC CC BY-SA · ClinicalTrials.gov — US Government work · Europe PMC — metadata only, under the recorded legal gate · Open Targets 26.06 — CC0 · derived from this page's own recorded fields; no external licence · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work
✗ required summary fields resolved: 5 required field(s) not terminal: Why people use it, Best-supported result, Most important common problem, Biggest unanswered question, Human evidence
✓ public claims reviewed: 0 reviewed claim(s); drafts are never rendered
✓ source coverage passed: 11 source rows
✓ no critical contamination: no quarantine open
✓ canonical metadata passed: slug and display name present
✓ no raw internal fields: enforced by the copy-contract test over the rendered page
This is a record of evidence. It is not medical advice, and it does not say this substance suits you. Nothing here says any substance on RNAWiki is appropriate for a child.