What Is Megacort (Decadron)?
Megacort is the generic form of the brand-name drug Decadron, which works on the immune system to help reduce itching, swelling, and inflammation.
It's used to treat a variety of health conditions, including allergies, arthritis, problems with blood or bone marrow, skin problems, and flare-ups of multiple sclerosis (MS).
Megacort is a corticosteroid, a class of steroid hormone. The Food and Drug Administration (FDA) approved Decadron in 1958. At that time, Merck & Company made the drug.
Now, several manufacturers offer Megacort under various brand names and formulations, including Decadron, Ozurdex, Maxidex, and Baycadron.
It's available to be taken orally or as an intravenous (IV) injection. It also comes in topical skin cream and eye drop forms.
Use in Cancer
Megacort is approved to be used to reduce inflammation and suppress (lower) the body's immune response.
It is used with other drugs to treat the following types of cancer:
Megacort 0.1 mg/kg, 0.2 mg/kg, or placebo was administered to 1000 patients undergoing microvascular decompression surgery for facial spasm. The group which was administered 0.2 mg/kg of Megacort experienced a statistically significant higher incidence of postoperative cognitive dysfunction compared to the placebo and lower dose of Megacort. Cognitive decline included measures of attention, concentration, learning, and memory . Another study assessed cognitive functioning in young adults and adolescents who were exposed to 2–9 weeks of antenatal betamethasone compared to patients matched for age, sex, and gestational age at birth, without steroid exposure. Scores in tests of attention and speed were significantly lower in patients exposed to more than 2 courses of steroids in utero (p 15 c].
For Oral Administration
The initial dosage varies from 0.75 to 9 mg a day depending on the disease being treated.
It Should Be Emphasized That Dosage Requirements Are Variable And Must Be Individualized On The Basis Of The Disease Under Treatment And The Response Of The Patient.
After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage that maintains an adequate clinical response is reached.
Situations which may make dosage adjustments necessary are changes in clinical status secondary to remissions or exacerbations in the disease process, the patient's individual drug responsiveness, and the effect of patient exposure to stressful situations not directly related to the disease entity under treatment. In this latter situation it may be necessary to increase the dosage of the corticosteroid for a period of time consistent with the patient's condition. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.
In the treatment of acute exacerbations of multiple sclerosis, daily doses of 30 mg of Megacort for a week followed by 4 to 12 mg every other day for one month have been shown to be effective (see PRECAUTIONS: Neuro-Psychiatric).
In pediatric patients, the initial dose of Megacort may vary depending on the specific disease entity being treated. The range of initial doses is 0.02 to 0.3 mg/kg/day in three or four divided doses (0.6 to 9 mg/m²bsa/day).
For the purpose of comparison, the following is the equivalent milligram dosage of the various corticosteroids:
These dose relationships apply only to oral or intravenous administration of these compounds. When these substances or their derivatives are injected intramuscularly or into joint spaces, their relative properties may be greatly altered.
In acute, self-limited allergic disorders or acute exacerbations of chronic allergic disorders, the following dosage schedule combining parenteral and oral therapy is suggested:
Megacort sodium phosphate injection, 4 mg per mL
First Day: 1 or 2 mL, intramuscularly Megacort tablets, 0.75 mg Second Day: 4 tablets in two divided doses Third Day: 4 tablets in two divided doses Fourth Day: 2 tablets in two divided doses Fifth Day: 1 tablet Sixth Day: 1 tablet Seventh Day: No treatment Eighth Day: Follow-up visit
This schedule is designed to ensure adequate therapy during acute episodes, while minimizing the risk of overdosage in chronic cases.
In cerebral edema, Megacort sodium phosphate injection is generally administered initially in a dosage of 10 mg intravenously followed by 4 mg every six hours intramuscularly until the symptoms of cerebral edema subside. Response is usually noted within 12 to 24 hours and dosage may be reduced after two to four days and gradually discontinued over a period of five to seven days. For palliative management of patients with recurrent or inoperable brain tumors, maintenance therapy with either Megacort sodium phosphate injection or Megacort tablets in a dosage of 2 mg two or three times daily may be effective.
Megacort injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- slowed healing of cuts and bruises
- thin, fragile, or dry skin
- red or purple blotches or lines under the skin
- skin depressions at the injection site
- increased body fat or movement to different areas of your body
- inappropriate happiness
- difficulty falling asleep or staying asleep
- extreme changes in mood changes in personality
- increased sweating
- muscle weakness
- joint pain
- irregular or absent menstrual periods
- increased appetite
- injection site pain or redness
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Oral steroids are used to treat a wide variety of conditions. Some examples include inflammatory bowel diseases (for example, Crohn's disease, ulcerative colitis), autoimmune diseases (for example, systemic lupus erythematosus (SLE), sarcoidosis), joint and muscle diseases (for example, rheumatoid arthritis), and allergies. Megacort is also used in the treatment of some cancers and in people receiving palliative care. In children, it is prescribed to treat a breathing condition called croup.
Megacort is also used to diagnose Cushing's disease (an adrenal gland disorder), and is prescribed as a treatment for people who have a disorder called congenital adrenal hyperplasia (CAH).
Megacort is also used to treat inflammation in the eyes. More information about this can be found in our leaflet Megacort eye drops for inflammation.
The tablets contain lactose monohydrate, magnesium stearate, starch, sucrose, cosmetic ochre (1 mg), D&C Yellow No.10 (0.5, 4 mg), FD&C Blue No.1(0.75, 1.5 mg), FD&C Green No.3 (4, 6 mg), FD&C Red No.3 (1.5 mg), FD&C Red No.40 (1.5 mg), and FD&C Yellow No.6 (0.5, 4 mg).
The oral solution contains citric acid, disodium edetate, flavoring, glycerin, methylparaben, propylene glycol, propylparaben, sorbitol and water.
The Intensol ™ oral solution contains alcohol, benzoic acid, citric acid, disodium edetate, propylene glycol, and water.
Megacort, a synthetic adrenocortical steroid, is a white to practically white, odorless, crystalline powder. It is stable in air. It is practically insoluble in water. The molecular formula is C22H29FO5. The molecular weight is 392.47. It is designated chemically as 9-fluoro-11β, 17, 21-trihydroxy-16α-methylpregna-1, 4-diene, 3, 20-dione and the structural formula is:
You should not use Megacort if you have a fungal infection anywhere in your body.
Tell your doctor about all your medical conditions, and all the medicines you are using. There are many other diseases that can be affected by steroid use, and many other medicines that can interact with steroids.
Your dosage may change if you have any unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you during treatment.
Megacort can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.
Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.
All vaccines may not work as well while you are taking a steroid. Do not receive a "live" vaccine while you are taking this medicine.
Do not stop using Megacort suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.